Public health science and the global strategy on alcohol.

Science plays an increasingly important role in the development of international health policy and this has certainly been true in the case of a global response to alcohol-related problems. In May 2010, the World Health Assembly adopted resolution EB126.R11, Global strategy to reduce the harmful use of alcohol, 1 based in part on an impressive amount of evidence on both alcohol's contribution to the global burden of disease and the policies capable of ameliorating the harm it causes. 2 Now that the strategy has been adopted, it is time for public health science to take on two new challenges. The first is to expand the evidence base so that it applies not just to the developed countries where most of the world's alcohol consumption is concentrated, but also to the low-and middle-income countries where alcohol consumption is increasing and where the policy response is still weak. The second challenge is to use scientific research to guide the adoption of effective alcohol policies at the national and international levels. Regarding the evidence base for effective alcohol policy, there is good scientific support for the interventions highlighted in the global strategy 2–5 : increasing capacity of health and social welfare systems to deliver treatment and early intervention; drink-driving countermeasures; limits on the availability of alcohol; restrictions on alcohol marketing; taxation and pricing policies to discourage frequent and heavy alcohol consumption; measures to control social contexts that promote excessive drinking; and reducing the public health impact of illicit and informally produced alcohol. Many of these interventions are universal measures that restrict the afford-ability, availability and accessibility of alcohol. Given their broad reach, the expected impact of these measures on public health is relatively high, especially when the informal market and illegal alcohol production can be controlled. When universal measures are combined with interventions targeted at high-risk populations, such as adolescents (age restrictions), automobile operators (drink-driving), alcoholics (treatment and support) and hazardous drinkers (brief interventions in primary health care), the combined effect is likely to be substantial. 3,6 Despite the considerable amount of cross-national research in support of these policy options, policy-makers in many countries, particularly in developing countries, are sceptical about the extent to which the scientific evidence derived primarily from high-income countries applies to their populations and drinking cultures. 7 Thus further research will be needed to replicate the science base in a variety of different countries, even as " the precautionary …