1. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Measuring the problem of alcohol and the unborn child Dr Lars Møller Programme Manager a.i. WHO Regional Office for Europe Dr Vladimir Poznyak Coordinator WHO Headquarter

2. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Global strategy to reduce the harmful use of alcohol Endorsed by the 63 rd World Health Assembly in May 2010. Represents a unique consensus among WHO 193 Member States on ways to tackle harmful use of alcohol at all levels.

3. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels European Action Plan to reduce the harmful use of alcohol 2012-2020 European Region has Alcohol Action Plan back in 1992 European action Plan to reduce the harmful use of alcohol 2012- 2020 - for discussion on 14 September 2011 A plan to implement the Global Alcohol Strategy 10 Action areas

4. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Global Strategy and European Action Plan. Area 2: Health services’ response supporting initiatives for screening and brief interventions for hazardous and harmful drinking at primary health care and other settings; such initiatives should include early identification and management of harmful drinking among pregnant women and women of child-bearing age; improving capacity for prevention of, identification of, and interventions for individuals and families living with fetal alcohol syndrome and a spectrum of associated disorders; Regular reports on alcohol can be prepared and cover drinking among adults, including trends in alcohol consumption, types of alcohol consumed, socioeconomic variables, demographic characteristics, drinking and pregnancy, adults’ drinking behaviour and knowledge of alcohol, and geographical patterns of alcohol consumption;

5. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Global and European actions: key role and components Public health advocacy and partnership Technical support and capacity building Production and dissemination of knowledge –continuing its collaboration with international networks of scientists and health experts to promote research on various aspects of harmful use of alcohol; Resource mobilization

6. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels The UN High-level Meeting on Noncommunicable Diseases

7. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Harmful use of alcohol as preventable risk factor of NCDs Four main risk factors and the influences on the global epidemic: Tobacco : 6 million deaths per year Harmful use of alcohol: 2.3 million deaths per year Insufficient physical activity: 3.2 million deaths per year Unhealthy diet: partially reflected in the 2.8 million overweight and obesity deaths per year; raised cholesterol causing 2.6 million deaths

8. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels WHO International Collaborative Research Project on Fetal Alcohol Spectrum Disorder: Background Intensive consultation process on developing global strategy to reduce harmful use of alcohol (started in May 2008) where FAS- related issues were raised by MS representatives. FAS also raised in European Consultations (February and May 2011) The continuing work on alcohol-attributable global burden of disease (GBD) and comparative risk assessment (CRA) Global Expert Meeting on Alcohol, Health and Social Development. 23 September 2009, Stockholm, Sweden WHO meeting "Alcohol, Health and Development: agenda for international research". Stockholm, 24-25 September 2009. Identified and discussed priority research projects on alcohol, health and development.

9. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels WHO Project on Alcohol, Health and Development: priority areas for WHO-supported international research Fetal Alcohol Syndrome/Fetal Alcohol Spectrum Disorders Harm to others from drinking ("collateral damage") Implementation of effective alcohol policies in the context of development Alcohol and Infectious Diseases –TB –HIV

10. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Prevalence of Fetal Alcohol Exposure Self-reported drinking among mothers: –UK 1 : 33% report drinking during pregnancy –France 2,3 : 23-52% report drinking during pregnancy 3.4-7.3% report at least one binge drinking episode –Sweden 4 : 30% report regular alcohol consumption during pregnancy 9% report drinking >5 drinks more than 1x/month 1% report drinking >5 drinks at least 1x/week 1 Dex & Joshi, 2005; 2 Kaminski et al., 1995; 3 De Chazeron et al., 2008; 4 Goransson et al., 2003

11. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels Prevalence of FASD Data available in only 21 countries, often outdated and methodologically unreliable Prevalence estimates: –USA 1 : FAS: 2-7 per 1000 FASD: estimated 2-5% in young school children –Italy 2 : FAS: 3.4 - 7.4 per 1000 primary school children FASD: 35 per 1000 primary school children –France 3,4 : FAS: 1.3 – 4.8 per 1000 births FASD: 5.6 per 1000 births – Norway 5 : FAS: 1.2 per 1000 FASD: 1.5 per 1000 1 May et al., 2009; 2 May et al., 2006; 3 Sampson et al., 1997; 4 De Chazeron et al., 2008; 5 Elgen et al., 2007

12. "Protecting the Unborn Child" European Parliament Policy Debate 7 th September 2011, Brussels WHO collaborative research study to determine the prevalence and incidence of FASD Main objectives: 1.to determine the prevalence of FAS and FASD in selected countries 2.to determine the prevalence of fetal alcohol exposure in selected countries and to indirectly estimate the incidence of FASD Methods: 1.active case ascertainment among school children (7-9 years) 2.maternal drinking data and biomarkers of fetal alcohol exposure Countries envisaged to participate in study: Confirmed participation: Ukraine, Belarus, Rep. of Moldova, Russia, Canada Under consideration: Poland, Kazakhstan, Mongolia, Ghana, Kenya, Chile