Sperkova Kristina, Anderson Peter, Llopis Eva Jané
Movendi International, Stockholm, Sweden.
Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2022 May 4;17(5):e0267010. doi: 10.1371/journal.pone.0267010. eCollection 2022.
By adopting Agenda 2030, governments agreed to review and report on their approach and action for achievement of sustainable development goals annually through the High-Level Political Forum (HLPF) on Sustainable Development. Health and well-being are at the heart of the United Nations Agenda 2030. Given the social and economic harm that can be done by alcohol, reducing the consumption of alcohol is a pre-requisite to achieve the sustainable development goals. We explored how selected European countries have considered alcohol-related harm as an obstacle to achievement of SDGs and the extent to which they view alcohol policy as a solution to the achievement of sustainable development by analysing their voluntary national reviews (VNRs) submitted to the HLPF between years 2016 and 2020.
We developed our own framework with 260 questions reflecting three dimensions of alcohol-harm considerations: indication, action, and evaluation. We analysed 36 VNRs of 32 European countries by first assessing them against the 260 questions to find out how they report on alcohol harm and whether they, in their action, refer to evidence-based, cost-effective alcohol policy solutions. Afterwards we used content analysis to assess the extent to which the countries addressed alcohol related harm, whether they refer to alcohol harm within SDG 3 (good health and well-being) or look beyond the health goal and consider alcohol harm having impact on goals other than the Goal 3.
Nine countries (28.1%) did not mention alcohol in their report. Only eight countries (25%) mentioned one or more of the alcohol policy best buys among the actions they are taking to reduce alcohol related harm and only three (9.3%) explicitly elaborated on their impact on goals other than goal 3. Only five countries referred to the agreed indicator 3.5.2 measuring alcohol per capita consumption in the adult population. Many of the remaining countries used a range of terminology rather than alcohol per capita consumption, including "excessive use of alcohol", "heavy use", "too much alcohol ", "harmful alcohol consumption", "use among young people".
Alcohol use is, for example, associated with violence (SDG 5 and 16), it contributes to inequalities (SDG 5 and 10), it hinders economic growth (SDG 8), disrupts sustainable consumption (SDG 12) and it adversely impacts environment (SDG 13 and 14). The findings of this study show that these effects are not considered in the design of measures to achieve these goals. Moreover, inaccurate language related to alcohol harm indicates a gap in understanding of extend of alcohol burden and the consequences for sustainable development. So does the choice of ineffective measures to reduce alcohol consumption. Education programs and awareness raising campaigns focusing on individual lifestyle are neither in line with WHO Global Strategy to reduce the harm caused by alcohol that all selected countries adopted in 2010, nor do they reflect the seriousness of the problems related to alcohol use. Effective alcohol policy measures, so called three best buys, are missing from the transformative action that the Agenda 2030 calls for and governments committed to.
各国政府通过采纳《2030年议程》,同意每年通过可持续发展高级别政治论坛(HLPF)审查并报告其实现可持续发展目标的方法和行动。健康和福祉是联合国《2030年议程》的核心。鉴于酒精可能造成的社会和经济危害,减少酒精消费是实现可持续发展目标的一个先决条件。我们通过分析2016年至2020年间提交给HLPF的欧洲部分国家的自愿国家审查报告(VNR),探讨了这些国家如何将与酒精相关的危害视为实现可持续发展目标的障碍,以及它们在多大程度上将酒精政策视为实现可持续发展的解决方案。
我们制定了自己的框架,包含260个问题,反映了酒精危害考量的三个维度:指征、行动和评估。我们分析了32个欧洲国家的36份VNR,首先根据这260个问题对它们进行评估,以了解它们如何报告酒精危害,以及在行动中是否提及基于证据的、具有成本效益的酒精政策解决方案。之后,我们采用内容分析法评估各国在多大程度上解决了与酒精相关的危害,它们是否在可持续发展目标3(良好健康和福祉)中提及酒精危害,或者是否超越健康目标,考虑酒精危害对目标3以外的其他目标的影响。
九个国家(28.1%)在报告中未提及酒精。只有八个国家(25%)在其为减少与酒精相关危害而采取的行动中提到了一项或多项最佳酒精政策措施,只有三个国家(9.3%)明确阐述了这些措施对目标3以外其他目标的影响。只有五个国家提到了商定的指标3.5.2,即衡量成年人口人均酒精消费量。其余许多国家使用了一系列术语,而非人均酒精消费量,包括“过度饮酒”“大量饮酒”“饮酒过量”“有害饮酒”“年轻人饮酒”。
例如,饮酒与暴力(可持续发展目标5和16)相关,它加剧不平等(可持续发展目标5和10),阻碍经济增长(可持续发展目标8),扰乱可持续消费(可持续发展目标12),并对环境产生不利影响(可持续发展目标13和14)。本研究结果表明,在设计实现这些目标的措施时,并未考虑到这些影响。此外,与酒精危害相关的不准确表述表明,在对酒精负担程度及其对可持续发展的后果的理解上存在差距。减少酒精消费的无效措施的选择也是如此。侧重于个人生活方式的教育项目和提高认识运动既不符合2010年所有被选国家通过的世界卫生组织减少酒精危害全球战略,也没有反映出与饮酒相关问题的严重性。《2030年议程》所呼吁的、各国政府承诺的变革性行动中缺少有效的酒精政策措施,即所谓的三项最佳措施。