1. The Burden of Alcohol consumption in the African Region
World Health Organization
6 April, 2017
The Burden of Alcohol consumption in the African Region
By Dr F. Zawaira
WHO Representative

2. Harmful use of alcohol
A pattern of drinking that causes or contributes to “physical or psychological harm, including impaired judgment or dysfunctional behaviour which may lead to disability or have adverse consequences for interpersonal relationships” WHO ICD-10 classification of mental and behavioural disorders.

3. The African context Highest alcohol consumption per drinker
30% female: 55% male are drinkers
2.2% of deaths attributable to alcohol
Uganda highest per capita consumption in the world
Alcohol production and consumption an integral part of the culture and the economy
Local brews cheap and readily available

4. Alcohol and young people
Binge drinking> 5drinks per occasion
Decreasing age of onset
42.3% of Zambians aged consume alcohol and 42.8% have been drunk (GSHS 2004)
Namibia 32.8 and 31.8%
Poverty, urbanization & socio-economic changes
Drink for fun, social reasons, peer pressure

5. Alcohol and women Rates of consumption increasing
In Zambia ratio of female : male adolescents heavy consumption 50.2 : 44.1% (GSHS 2004)
South Africa weekday “risky drinkers” 8.7 : 6.9%
Weekend “risky drinkers” 32.0 : 32.3%

6. Harmful patterns of drinking
In 2006 STEPS survey among those who had drunk in the past 12 months:
23.7% had engaged in harmful patterns of drinking in Mozambique and Ivory Coast
60% in Algeria

7. Risk Factors for harmful use
Urbanization
Aggressive marketing
Weak cultural controls
Stress
Financial and family problems
Conditions of work
Availability of alcohol

8. Costs of alcohol consumption
High risk sexual behaviour and infection with STIs including HIV
Traumatic injury and death due to RTAs caused by drink driving
Absenteeism and Unemployment
25-30% of general hospital admissions alcohol related

9. Costs of alcohol consumption
More than 50% of mental hospital admissions in Lesotho, Mauritius and Swaziland—alcohol dependence and delirium tremens
Crime
Violence, especially against women
Chronic liver disease including cancers
Blindness and death caused by home brews recorded in East Africa

10. Costs of alcohol consumption
Fetal alcohol syndrome: per 1000 births in South Africa compared to in the USA
Neglect and abuse of children leading to emotional, physical and educational problems
Worsening of poverty

11. Issues & Challenges in the region
Difficulty in quantifying consumption between industrial beverages and home brews
Communal drinking and consumption of illicit brews with unknown alcohol levels
No regular systematic surveillance and recording systems for production, consumption and quantifying health and social consequences – Southern African Epidemiology Network on Drug Use (SENDU)

12. Issues & Challenges in the region
Lack of counseling, primary care intervention and specialized treatment centers in the Region. Where treatment centers exist as in SA, women are not accessing them due to stigma or domestic responsibilities
Africa is targeted for marketing alcohol and tobacco especially to young people due to weak regulatory systems

13. Issues & Challenges in the region
Lack of data from health facilities
Public health problems caused by harmful use of alcohol are considerable and multi dimensional
Low budgetary allocations in the absence of comprehensive policies

14. Policy processes
WHO STEPS surveys undertaken by a number of countries…Malawi scheduled for next year
Global school health surveys undertaken and still ongoing including in Malawi
Technical consultation meeting—Brazzaville 2006
Regional committee in 2007 doc AFR/RC57/14 presented: Situation analysis and perspectives

15. Policy processes
Member States requested for support to develop policies and plans to combat harmful use of alcohol
RC in 2008 doc AFR/RC58/3: Actions to reduce harmful use of Alcohol tabled
Regional office was requested to submit a Regional Strategy for consideration by the Regional committee in 2009
African Region Member states during the WHA this year requested for development of a Global strategy to be submitted in 2010

16. Strategies and policy options to reduce alcohol related harm
Raising awareness and political commitment
Strengthen Health-sector response
Community action to reduce the harmful use of alcohol
Enact/Enforce drink-driving policies and countermeasures
Regulating the availability and sale of alcohol
Addressing marketing of alcoholic beverages
Pricing and taxing policies
Harm reduction
Reducing the public health impact of illegally and informally produced alcohol
Improve surveillance

17. In Conclusion
We all have a role to reduce harmful effects of alcohol in our societies.
On behalf of WHO we stand ready to give the required assistance to our Member States

18. Thank you!
Zikomo kwambiri!!