House of Lords - A new EU Alcohol Strategy?

A new EU Alcohol Strategy? - European Union Committee Contents

CHAPTER 3: THE EU ALCOHOL STRATEGY 2006-12

Background

54. In June 2001 the Council invited the European Commission to propose an EU strategy to complement national policies, aimed at reducing alcohol-related harm.[45] Five years later, in October 2006, the Commission proposed and the Council adopted the first EU Alcohol Strategy with a Communication on 'An EU strategy to support Member States in reducing alcohol related harm'. The Strategy identified five priority themes under which action was to be taken to address the adverse health effects related to harmful and hazardous alcohol consumption in the EU.

Box 5: Priorities of the EU Alcohol Strategy 2006-12

· Protecting young people, children and the unborn child

· Reducing injuries and death from alcohol-related road accidents

· Reducing alcohol-related harm among adults, including in the workplace

· Increasing information, education and awareness raising

· Developing and maintaining a common evidence base

55. Within each of these themes, the Strategy identified the rationale and aims for action, as well as highlighting cases of good practice. It noted the different contexts in which national alcohol strategies operate and stressed the importance of local action. It also set out a 'health in all policies' approach by emphasising that "EU competence in health is not confined to specific public health actions. Where possible, the Commission will seek to improve the coherence between policies that have an impact on alcohol-related harm". The merits of this approach are examined in Chapter 5.

56. Given the EU's limited competence in the field of public health,[46] the Commission took on a mainly coordinating role. In order to support Member States in implementing the Strategy, a European Alcohol and Health Forum (EAHF) and a Committee on National Alcohol Policy and Action (CNAPA) were established in 2007.

57. The EAHF is a platform where bodies such as European NGOs and trade associations can debate and commit themselves to actions intended to tackle alcohol-related harm.[47] CNAPA is composed of national delegates appointed by the Member States. Its main objectives are "sharing good practices and aiming to achieve the broadest possible consensus and convergence of alcohol policies within the EU".[48] Unlike the EAHF, CNAPA is not referred to in the Strategy. The structure and functioning of both bodies is discussed in more detail in Chapter 8.

58. The Commission further allocated funding to a wide range of projects and research on alcohol-related harm, which was provided through the EU's health and research programmes. A list of projects on alcohol funded since 2003 is available on the Commission's public health website.[49] We consider this further in Chapter 9.

59. In 2012 DG SANCO commissioned an evaluation of the Strategy and its added value,[50] which found that several Member States introduced or strengthened national alcohol strategies between 2006 and 2012, and that the Strategy's five priorities remained relevant. The evaluation was criticised by the Commission's Unit for Evaluation for failing to establish a causal relationship between these developments and the implementation of the Strategy, and for describing "outputs rather than outcomes". This was in a sense inevitable, as the Strategy had no inbuilt evaluation mechanism and did not include quantitative targets, a problem to which we refer below in paragraphs 64-66. Nonetheless many of our witnesses, including the Government, endorsed the 2012 evaluation and regarded it as confirmation that the Strategy had generally been useful and should continue in some form, albeit taking into account their numerous suggested modifications.[51]

Impact on the United Kingdom

60. We were told of no concrete benefits to the UK in terms of reduction in alcohol consumption or alcohol-related harm which could specifically be attributed to the Strategy, and witnesses could not identify any particular national policy approach which might have been influenced by the Strategy.[52] However, there was a feeling among witnesses that this was due to the pre-existing high standards of UK alcohol policies.

61. Ms Ellison, for instance, stated that "I have not seen a huge impact on us, but I think that is because we probably took alcohol policy and the enforcement of various aspects of alcohol policy pretty seriously."[53] Nonetheless, she regarded the Strategy as a useful point of reference for the UK, in that it constituted an international agreement which the Government was keen to observe and "report against".[54]

62. Furthermore, Miles Beale, Chief Executive of the Wine and Spirits Trade Association, was of the opinion that through the Strategy, the UK had been able to positively influence other Member States: "[the Strategy] is more useful to countries other than the UK, because … the UK has made great progress and those ideas have been picked up disproportionately elsewhere."[55]

Key achievements and shortcomings

63. When asked to assess whether the Strategy had met its overall objective of reducing alcohol-related harm in the EU, many witnesses highlighted the difficulty of attributing outcomes accurately to any one policy measure or strategy. The complexity of policy-making and the many cultural, economic and social differences between Member States to which we have referred in the previous chapter, mean that it is rarely possible to establish a clear causal connection between a particular measure and increases or decreases in the level of alcohol-related harm.[56]

64. This problem is exacerbated by the lack of indicators, standardised data collection systems or an evaluation mechanism by which it would have been possible to assess whether or not the Strategy had achieved its objective. Eric Carlin, the Director of the NGO Scottish Health Action on Alcohol Problems (SHAAP), noted that, in the absence of SMART targets,[57] it was difficult to assess what would have been achieved had the Strategy not been in place.[58] This problem was also acknowledged by the 2012 evaluation of the Strategy, which stated that "as there is limited availability of timely EU-wide data, evidence of the added value of EU level action may only become available in the long term".

65. Prof Anderson was therefore critical of the Strategy's overall effect, stating that "there is little evidence that it has had any impact in reducing alcohol-related harm in Europe … There is no doubt the Strategy made a lot of noise and brought a lot of people together, but if you judge it in terms of whether or not it has had an impact in reducing harm, which was its main goal, one would have to say that it has not achieved that."[59] Professor Petra Meier from the University of Sheffield supported this view, adding that: "What the Strategy lacked was a clear focus on how to achieve change. It said it would do all sorts of things, but there was nothing in there that was clear, action-focused messaging."[60]

66. Other witnesses were more positive, and felt that despite not meeting its broad aims, the Strategy had been useful in general and also in some specific respects. Many felt that it had focused the discussion on alcohol-related harm, and Mr Carlin said: "The fact that the alcohol Strategy exists keeps in the public profile that alcohol harm remains significant … Just its very existence makes a statement that has an impact."[61]

67. Glenis Willmott MEP, a member of the European Parliament's Environment, Public Health and Food Safety Committee (ENVI), thought that the Strategy had provided an important impetus for action in several Member States: "More countries now have national alcohol strategies in place. Ten countries adopted or revised a national strategy after 2006, so that has to be seen as a positive thing … All Member States do awareness-raising activities that they would not have done in the past."[62] The industry representative body spiritsEUROPE agreed, writing that: "The Strategy has offered a stimulus to action and has pushed stakeholders towards meaningful action to reduce alcohol-related harm."[63]

68. Many witnesses suggested that the Strategy's key achievement was its ability to facilitate the exchange of best practices through CNAPA and the EAHF.[64] Ms Skar noted that in this way, the Strategy "has increased partnerships and networking across Europe".[65] Representatives of the alcohol and advertising industries were particularly eager to maintain the 'multi-stakeholder approach' introduced through the EAHF, which was seen as an "effective way of exchanging good practice",[66] and described by Mr Ashworth, Chief Executive of the Portman Group, as "very valuable".[67] This approach has not been without difficulties, as we explain in Chapter 8.

69. There was consensus among witnesses that the Strategy had been more successful in some of its five priority areas than others. Crispin Acton, Programme Manager for Alcohol Misuse at the Department of Health, referred to the 2012 evaluation of the Strategy to describe steps taken under its first priority area: "There have been quite a lot of moves towards greater commonality on underage purchasing, so there is much more similarity in the age levels for underage purchasing and improved enforcement."[68]

70. Ms Ellison and Mr Acton also mentioned a reduction in drink driving incidents as a specific area in which the Strategy had influenced and improved action across the EU.[69] In this regard Katherine Brown, the Director of the Institute of Alcohol Studies, said: "There have been some specific improvements; for example, some Member States have lowered their blood alcohol limit for the legal limit for drink driving … at the moment the UK and Malta remain the only countries with the highest legal limit that is above the recommended European Commission limit."[70]

71. Prof Sheron thought that the Strategy had been successful in increasing information and raising awareness, its fourth priority: "The Strategy has done quite a bit to do that, and the research projects funded by the Strategy, such as the ALICE RAP project,[71] have also contributed."[72]

72. Several witnesses criticised the failure by the Strategy to achieve its goals in the fifth priority area, the development of a common evidence base. Representatives of the Government and the European spirits industry were disappointed that not enough progress had been made with regard to collecting comparable standardised data on alcohol consumption and alcohol-related harm across the EU.[73] Furthermore, the alcohol and advertising industries were highly critical of EU-funded research conducted under the Strategy. We consider both these issues in Chapter 9.

EU action on alcohol-related harm since 2012

73. At the beginning of 2014, the ENVI Committee of the European Parliament started work towards a resolution calling on the European Commission to develop a new EU Alcohol Strategy. The final text was expected to be adopted in the April Plenary session of the European Parliament, but the EU Alcohol Strategy resolution was not included in its final discussions. The ENVI Committee last discussed the current state of play regarding the EU Alcohol Strategy at its meeting on 29 January 2015.

74. In January 2014 a Joint Action on Reducing Alcohol Related Harm (RARHA) was created within CNAPA in order to "continue work on key priorities of the EU Alcohol Strategy".[74] Over the course of three years, the Joint Action will focus on three core work areas: providing comparable cross-country data on levels and patterns of alcohol consumption and alcohol-related harm (including third party harms), fostering consensus on good practice regarding the setting of guidelines on low-risk drinking, and facilitating the exchange of good practices among health authorities by establishing a toolkit on using information and education to reduce alcohol-related harm.

75. On 16 September 2014 CNAPA endorsed an Action Plan on youth and heavy episodic drinking for the period 2014-16.[75] The Action Plan identifies six areas for action including related actions and operational objectives. It claims to do so as "part of the continuing work under the EU Alcohol Strategy". The Summary Report of the 15th Plenary Meeting of the EAHF confirms this relationship, stating that the Action Plan "is not intended to replace an EU strategy but rather builds upon and complements some objectives of the existing Strategy."[76]

Box 6: Objectives of the Action Plan on Youth and Heavy Episodic Drinking

· Reduce heavy episodic drinking (binge drinking)

· Reduce accessibility and availability of alcoholic beverages for youth

· Reduce exposure of youth to alcohol marketing and advertising

· Reduce harm from alcohol during pregnancy

· Ensure a healthy and safe environment for youth

· Support monitoring and increase research

76. CNAPA is currently carrying out a scoping exercise for the Commission in order to inform its next steps. In addition, the current Latvian Presidency has confirmed that it will "follow the work of [CNAPA], and is in the process of developing a scoping paper on the vision of future actions to be taken in the area of an alcohol policy in the EU. The Presidency will put in the effort requiredto bring the attention of EU health ministers to issues regarding alcohol and nutrition."[77]

The current status of the 2006-12 Strategy

77. The terminal date of 2012 is given to the Strategy in its final section: "the Commission … presents a comprehensive strategy to reduce alcohol-related harm in Europe until the end of 2012". This begs the question what the significance, if any, is of the last words "until the end of 2012".

78. The wording of both the RARHA Joint Action and the 2014-16 Action Plan seems to indicate that the EU Alcohol Strategy has remained valid as a policy tool past its expiry date of 2012. This is confirmed by the Summary Report of the 15th Plenary Meeting of the EAHF on 6 November 2014, which states that "For the time being, the existing goals and objectives of the alcohol Strategy remain valid."[78]

79. This was also the view of many of our witnesses, but not of several public health representatives, who thought that the failure to renew the Strategy in 2012 meant that there was currently a dangerous gap in EU alcohol policy. For example, the Institute for Alcohol Studies regarded "the failure to establish a renewed Strategy in 2012 as a significant setback for achieving progress on reducing alcohol harm in Europe."[79] Eurocare submitted that "The absence of a current EU Alcohol Strategy means that there is no comprehensive policy framework in existence at the EU level that can be compared to the WHO Global Alcohol Strategy or WHO EU Alcohol Action Plan."[80]

80. Ms Willmott suggested that delays in implementing a new strategy in 2012 may have been due to the pending European elections, and that to remedy such difficulties a new strategy "should cover the whole Parliament and slightly beyond that in future so we have time to have a new strategy in place."[81] She further noted that, despite subsequent political agreement in the European Parliament's ENVI Committee on the need for a new strategy, the Commission seemed reluctant to move forward: "We were very disappointed by the Commission's answer when we brought representatives to the committee and asked them what is happening to the alcohol Strategy. To be honest, they just prevaricated and did not really give much of a clear answer."[82]

81. According to Ms Skar, in 2012 stakeholders across all sectors were keen to see a new EU Alcohol Strategy put into place: "Eurocare was not the only NGO that called for it … Even industry was sending press releases calling for the Commission to move forward. A number of Member States were calling … I think the Commission was simply dragging its feet or was not willing to do it."[83]

82. We think this is a likely explanation. Among its many strategies the EU had a Drugs Strategy, which was the subject of our report The EU Drugs Strategy.[84] That Strategy too expired at the end of 2012. Drugs, unlike alcohol, were then the responsibility of the Directorate-General for Justice, and so subject to the Hague Programme for Justice and Home Affairs from 2005-10, and then to its successor, the Stockholm Programme, from 2010-15. That Programme, adopted by the European Council in April 2010, stated:

83. There is no doubt that those were the views of the Commission, since these words were taken verbatim from a Commission Communication of 10 June 2009.[87] Yet when, for our inquiry into the EU Drugs Strategy, we took evidence from Viviane Reding, then a Vice-President of the Commission and the Commissioner for Justice,[88] she described the Strategy to us as "a thing of the past" and "a nice piece of literature". Later she said: "You know strategy is wishful thinking".[89] Despite those views, following an evaluation of the Drugs Strategy, the Commission proposed and the Council endorsed on 7 December 2012 a new Drugs Strategy running from 2013-20.

84. Notwithstanding the similar evaluation of the Alcohol Strategy, the Commission undertook no comparable initiative for its renewal, and also refrained from issuing a clear statement on its current status. Unfortunately we were unable to ask DG SANCO to respond to these concerns. We invited Philippe Roux, Head of Unit for Health Determinants, to attend an evidence session in Brussels or, alternatively, to submit written comments to provide us with the Commission's views on issues covered by our inquiry. He declined both opportunities to comment on the record, referring the Committee instead to the outdated 2012 evaluation report of the Strategy as an illustration of the Commission's views on the matter.

85. At the time of the Committee's request, DG SANCO was preparing to welcome the new Commissioner for Health, following the establishment of the new Commission in the autumn of 2014. Since the Strategy had not been renewed two years earlier, it was understandable that Mr Roux did not wish to commit himself to any statements on the future of the Strategy. However, the apathy with which the Commission seems to have greeted the expiry of the previous Strategy has resulted in uncertainty over its current status and on how best to proceed in the interim before the Commission proposes a renewed, amended or entirely new strategy—if indeed this is its intention.

45 Council Conclusions of 5 June 2001 on a Community strategy to reduce alcohol-related harm (OJ C 175, 20.6.2001, p. 1): http://europa.eu/legislation_summaries/public_health/health_determinants_lifestyle/ c11564a_en.htm [accessed 24 February 2015] Back

46 See Appendix 4. Back

47 European Commission, 'European Alcohol and Health Forum: More information': http://ec.europa.eu/ health/alcohol/forum/forum_details/index_en.htm [accessed 24 February 2015] Back

48 European Commission, 'Committee on National Alcohol Policy and Action': http://ec.europa.eu/health/ alcohol/committee/index_en.htm [accessed 24 February 2015] Back

49 European Commission, 'Alcohol Projects': http://ec.europa.eu/health/alcohol/projects/index_en.htm [accessed 24 February 2015] Back

50 COWI-Milieu, Assessment of the added value of the EU strategy to support Member States in reducing alcohol-related harm (December 2012): http://ec.europa.eu/health/alcohol/docs/ report_assessment_eu_alcohol_strategy_2012_en.pdf [accessed 24 February 2015]. In this report we refer to this document as "the 2012 evaluation". Back

51 Written evidence from the Advertising Association (EAS0015), Association of Convenience Stores, (EAS0010) BBPA (EAS0013), spiritsEUROPE (EAS0025) and UK Government Department of Health (EAS0019); Q14 (Crispin Acton), Q119 (Simon Spillane) Back

52 Q37 (Dr Evelyn Gillan) Back

53 Q228 Back

54 Q228 Back

55 Q188 Back

56 Q102 (Mariann Skar and Eric Carlin), Q129 (Simon Spillane) Back