Building Capacity Project
First Meeting of Alcohol Policy Network
Bled,Slovenia, 24-26 September 2007

Notes of the meeting

pdf icon small List of participants

1. Welcome and Introductions
Marija Seljak, representing the Ministry of Health of the Republic of Slovenia stressed the importance of alcohol policy, noting that it is an important part of the political agenda both in Slovenia and at the level of the European Union. She stressed the importance of the Alcohol conference which will be held in April 2008 in Barcelona, Spain. Ada Hočevar Grom, Acting Director of the Institute of the Republic of Slovenia, also emphasized the importance of alcohol policy at the European level.

Wilfried Kamphausen, representing the European Commission emphasized that alcohol policy is an important issue on the agenda of the European Union, following the 2006 Council Conclusion. He stressed the need to establish coordinated strategies and plans at the country level. He noted that whilst many obstacles are still present, there are also some encouraging results and developments.

2. The Building Capacity Project
Peter Anderson presented alcohol policy development in Europe describing the activities of different organizations in the field of alcohol policy, stressing the important role of NGOs. He noted that alcohol policy continues to face a number of challenges: alcohol related harm causes very high social costs in Europe, and expansion of the EU brings new challenges since there are many inequalities and discrepancies in income between Member States.  Participants were reminded of the European Charter on Alcohol which stressed the need for country based strategies and clear targets in implementing alcohol policy.
pdf icon small Presentation - Alcohol policy development in Europe

Sandra Rados Krnel introduced the Building Capacity project, noting that it includes 35 associated partners and more than 10 collaborating partners. She emphasized that one of the main aims of the project is to broaden the networks involved in alcohol policy.
pdf icon small Presentation - Building Capacity project

The discussion stressed the importance of the link between the Bridging the Gap project and the Building Capacity project, including the need for newer and older partners to work  together, to bring in new partners, to stimulate networking, and to involve  collaborating partners.

3. Work Package 5: Inventory of country based experiences
Claudia Kønig introduced work package 5, the HP-Source database and its two alcohol policy modules. She stressed that the next steps were to update data, to expand the data base to all countries, and to analyze data with comparative studies of different European countries.
pdf icon small Presentation - Work package 5

The discussion stressed the importance of countries that were not part of the BtG project and countries that had not completed the data to enter and update data. The database is important since it provides information to document the current situation in Europe, describing different policy options and programs, and providing information of the number of countries that have a national strategy, and how many active NGOs there are. The obstacles to data input were mentioned, including limited resources for the WP leader on the one hand, and limited data resources for data entry by the countries on the other hand.

4. Work Package 10: Prevention of alcohol-related accidents and injuries
On behalf of Andrej Marusič, Peter Anderson stressed the epidemiological importance of alcohol related accidents and injuries. Work package 10 included four deliverables: a 20 page report of the public health and economic importance of alcohol-related accidents and injuries, describing the evidence for the impact of effective policies and programmes; a data base and inventory of examples of innovative and best practice and experience to reduce alcohol-related accidents and injuries; recommendations of a common set of methodologies and indicators that can be used throughout Europe to report on alcohol-related accidents and injuries; and a 3 page summary of practical recommendations as to what could be done at European and Member State level to reduce alcohol-related accidents and injuries, of which the report and the recommendations of indicators were planned to be completed for the Barcelona conference.
pdf icon small Presentation - Work package 10

5. Work Package 7: Capacity Building
Work package 7 including the Barcelona conference and advocacy training. Lidia Segura introduced the basic logistics of the April 2008 Barcelona Conference were presented. Peter Anderson noted that the advocacy manual and course will focus on training the trainers, with hopefully, two people from each country trained to implement the training programme at the country level.
pdf icon small Presentation - Work package 7

6. Work Package 8: Regional Alcohol Policy
Ourania Georgoutsakou and Karin Mernelius emphasized that the focus of work package 8 (pdf 277kb) is regional alcohol policy development. It is a network of regions working with peer reviews on different aspects of alcohol policy, co-ordinated by Jönköping Region in Sweden.  A special workshop on regional policy will be convened during the 2008 European Alcohol Policy conference. A report on best practice and effective policy making at the regional level will be published, with a prize awarded for the most innovative and effective regional policy. Cooperation with the Assembly of European Regions (AER) youth team will be made and a page on the AER website dedicated to the project will be created. The work package will focus on four alcohol policy areas: protection of children and third parties; traffic; pregnancy and nursing; and early identification and brief intervention in primary health care.
pdf icon small Presentation - Work package 8

7. Work Package 9: Municipal alcohol policy
Wim van Dalen stressed that the main goal of work package 9 is to support local and municipal-based development of the prevention of alcohol-related harm, through exchanging experience and developing knowledge about  the most effective interventions and strategies in Municipal Alcohol Policy to prevent harmful alcohol consumption; monitoring, research and evaluation models of community-based prevention; and, building a network. The work pacakage noted that municipalities are obliged to develop a health policy; there is a concrete demand for alcohol prevention; there is a potential power in communities to get involved (and not only professionals); there is a need to focus on an integrated approach rather than just education; there is a lack of knowlegde about what works; and municipal action can stimulate national policy making.
pdf icon small Presentation - Work package 9

8. Work Package 6: Economic and Health Impact Assessment
Dan Chisholm introduced the context of Work Package 6. He emphasized that we know that alcohol use is a leading risk factor for disease ( 4% of global disease burden); interventions exist that have been shown to be effective in reducing alcohol use, e.g. taxation, brief interventions. On the other hand, what we are not so sure about are the comparative cost, effect and cost-effectiveness of implementing interventions in different socio-cultural settings and populations; the international cross price elasticities;  the impact of roadside breath-testing in different road use environments; the robustness of the evidence of the impact of advertising bans; which type of availability controls confer greatest potential benefit; and estimates of resource input requirements for implementing policies and programmes at the country level. The aim of the work pacakage was to address some of these information gaps and undertake cost effective analyses of different policy options in each of the partner countries.
pdf icon small Presentation - Work package 6

9. Work Package 2: Dissemination of results
Emilie Rapley introduced the dissemination strategies of work package 2, noting that the project website will be one of the main, but not only, dissemination tools http://www.ias.org.uk/buildingcapacity/index.html. The website of the Bridging the Gap(BtG) project will be moved to the Institute of Alcohol Studies server, and the country reports and profiles built up during the BtG project will be seamlessly linked to the Building Capacity website. It was noted that a Google search with ‘building capacity alcohol’ returned the project site at the top of the list.
pdf icon small Presentation - Work package 2

10. Work Package 4: Support to networking
Walter Farke introduced work package 4, on networking. The main priorities inlcuded support of the new Memebr States in the south-eastern part of Europe by building up networks and coalitions, review of the countries of the APN with regard to their network on alcohol policy (NGOs), assessment of the needs of the project network, regular exchange of experiences, data and information, enhancing collaboration, and coalitions with international organisations, which are not directly linked to the alcohol policy field.
pdf icon small Presentation - Work package 4

11. Introduction to support to new Member States and bilateral and regional
Walter Farke described how the Building Capacity project could support new Member States through bilateral and regional agreements. Member States in the south-eastern part of Europe could be supported by building up networks and coalitions, through a national meeting or conference with relevant national organisations, institutions, experts, politicians, regular exchange of information, support of Alcohol Policy activities at European level, and the option to be a possible member of Eurocare.
pdf icon small Presentation - Bilateral and regional agreements 

12. The ELSA project
Wim van Dalen presented the ELSA (Enforcement of National Laws and Self-regulation on advertising and marketing of Alcohol) project on Alcohol marketing, co-financed by the European Commission: http://www.stap.nl/elsa/elsa_project/introduction.html. The project concluded that alcohol advertisements are related to positive attitudes and beliefs about alcohol amongst young people, and increase the likelihood of young people starting to drink, the amount they drink, and the amount they drink on any one occasion, that there is no available scientific evidence which shows that the non-statutory regulation of commercial communications impacts on the content or volume of advertisements, that there is great variety in regulations related to the advertisement of alcoholic products in the European Member States, that there is very little documentation on adherence to the existing regulations, that the most appealing alcoholic beverages and alcohol advertisements to young people use elements associated with youth culture, and that there is no informative body which systematically monitors the impact of regulations on alcohol marketing and its adherence.
pdf icon small Presentation - Alcohol marketing

13. The Public Health Executive Agency and its role in managing and supporting co-financed projects
Stephan Van den Broucke introduced the role of the Public Health Executive Agency (PHEA), which became operational in 2006 and autonomous in 2007. The agency executes policy, but does not make it. The tasks of the agency include implementing the EU Public Health Programme, carrying out all the operations necessary for the management of the programme, in particular those linked to the award of contracts and grants, disseminating the know-how and best practices based on the contracts and grants, providing logistical, scientific and technical support by organising technical meetings, preparatory studies, seminars or conferences, fostering exchange and co-ordination between all players involved, and contributing to an improvement in the Public Health programme. The technical and financial basis of project monitoring were described.
pdf icon small Presentation - Public Health Executive Agency (PHEA)

14. Inequalities, accidents and injuries, and alcohol
Marta Manczuk presented the importance of alcohol as a cause of inequalities in deaths from accidents and injuries.  She noted that for men dying between the ages of 20 and 64 years, injuries were responsible for nearly half (46%) of the difference in life expectancy between the three Baltic states (Estonia, Latvia and Lithuania) and the older EU15 countries, and for one fifth (22%) of the difference between central and eastern Europe (Poland, Czech Republic, Slovakia, Hungary, Slovenia, Romania, Bulgaria) and the older EU15 countries.  Whereas in the EU15, alcohol is responsible for 29% of all male injuries and 19% of all female injuries, in the central and eastern European countries, the proportions are 38% and 29%, and in the three Baltic states 48% and 42% respectively.
pdf icon small Presentation - Alcohol as a cause of inequalities

15.  Violence and injury prevention
In his presentation on preventing injuries and violence, Dinesh Sethi of the World Health Organization noted that injuries are the third leading cause of death in the European Region, with the burden disproportionably affecting young people. Alcohol is implicated in between 40% and 60% of injuries and violence in the Region. Alcohol-related injuries and violence can be reduced by measures such as reduced access, taxation, restricted advertising, brief advice for at individuals at risk, and treatment for those dependent on alcohol.
pdf icon small Presentation - Preventing injuries and violence

16. The Barcelona European Alcohol Policy conference
Vesna Petric noted that the European Alcohol Policy Conference will take place in Barcelona 3-5 April 2008 http://www.ias.org.uk/buildingcapacity/conference/index.html. The objective of the conference is to place reducing alcohol-related harm on a high political level, with a proposal that a paper on the conclusions of the conference could be submitted to an informal meeting of health ministries.  The conference is a B-activity within the frame of Slovenia’s EU Presidency and is supported by the Ministries of Health of Slovenia and Spain.
pdf icon small Presentation - European Alcohol Policy Conference

Joan Colom introduced the conference model, noting that the preparation of the conference is based on learning from previous conferences. The intention is to involve all relevant stakeholders, to have a large media impact and to achieve engagement at a high policy level. The conclusions of the conference would include recommendations for further development of alcohol policy and recommendations to prevent alcohol-related injuries and violence.

17.  Royal College of Physicians Conference: Reducing the harm caused by alcohol, a co-ordinated European response
In introducing the Royal College of Physicians Conference: Reducing the harm caused by alcohol, (http://www.rcplondon.ac.uk/event/details.aspx?e=937), Nick Sheron reminded the participants that alcohol places an enormous burden on the health and well-being of European citizens and Europe as a whole. He noted that the purpose of the Royal College of Physician’s conference is to launch a co-ordinated European response by the medical profession to alert public and political opinion about the burden that alcohol places on European citizens and Europe as a whole and what should be done to reduce this burden.
pdf icon small Presentation - Royal College of Physicians Conference

18. Alcohol in a WHO global perspective
In his presentation on Alcohol in a WHO global perspective, Dag Rekve noted that a WHO Expert Committee had produced its report on Problems Related to Alcohol Consumption including a global assessment of the public-health problems caused by alcohol, and describing evidence-based strategies and interventions to reduce alcohol-related harm: http://www.who.int/substance_abuse/expert_committee_alcohol/en/index.html. He noted that the global response to reducing alcohol-related harm will be discussed at the next meeting of the WHO Executive Board in January 2008.
pdf icon small Presentation - Alcohol in a WHO global perspective

19. European WHO  framework on alcohol policy
Dinesh Sethi, on behalf of WHO-EURO described the main pillars of the European WHO framework on alcohol policy and introduced the 2005 WHO Regional Committee for Europe Resolution addressing the prevention of injuries in the European Region:  http://www.euro.who.int/violenceinjury/network/20050429_1. In the discussion, members of the Alcohol Policy Network asked both representatives of the WHO to feedback to the Regional Office for Europe, the Network members’ urgent concern that the post of Regional Advisor in the European office still had  not been filled.
pdf icon small Presentation - European WHO framework

20. The Commission Communication and the Alcohol and Health Forum
Wilfried Kamphausen of the European Commission described the implementation of the EU strategy to reduce alcohol related harm, with five priority themes and three levels of action: http://ec.europa.eu/health/ph_determinants/life_style/alcohol/alcohol_com_en.htm. In addition, he described the Charter establishing the European and Alcohol and Health Forum:
http://ec.europa.eu/health/ph_determinants/life_style/alcohol/documents/Alcohol_charter2007.pdf.

Tiziana Codenotti, vice-President of EUROCARE (pdf 201kb) noted that whilst Eurocare welcomed the Commission’s strategy it was sad to see that despite the efforts of the European Health Community and DG SANCO to protect the health and wellbeing of European citizens, in the end, the alcohol industry and other parts of the Commission have ensured that the strategy reflects the undue influence of the alcohol industry, which has been responsible for one of the most intensive lobbying campaigns ever known in regard to public health policy.  She noted that Eurocare also welcomed the action oriented remit of the Forum, and hoped that all European alcohol producers and retailers will commit to evidence based actions, thus explicitly recognizing their responsibilities towards curbing alcohol related harm in Europe. Eurocare was pleased to see a clear separation between the Forum as a platform for action, and the Committee on National Policy and Action as one for policy discussion among Member States, noting that public health policies on alcohol should be formulated without the interference of commercial interests.
pdf icon small Presentation - Eurocare

Following the two presentations, the participants split into parallel groups to discuss the Commission Communication and the Alcohol and Health Forum based on three questions:

The group work was followed by a round table and discussion on the Commission Communication and the Alcohol and Health Forum, facilitated by Tamsin Rose. The discussion brought forward issues such as how much staff resources should non-governmental organizations and those working in public health commit to the forum, the need to continue working on alcohol policy issues outside of the Forum and with other sectors, and the recognition that the Forum was not a place to discuss alcohol policy, but rather to seek commitments for action to reduce alcohol-related harm.

21. Work Package 1: Project Management
Sandra Rados introduced work package 1, project management, describing the differing roles of country, associated, and collaborating partners.  The management of the project and general information on budget and grant agreement where emphasized and explained, including the reimbursement of travels.
pdf icon small Presentation - Work package 1

It was noted that the second network meeting will take place in Barcelona 2 April 2008, and that the third network meeting will take place in Sweden, possibly in September 2009. 

In the discussion, it was confirmed that the travel and per diem costs for the Barcelona conference would be covered for the associated partners and up to 25 of the collaborating partners, but that the registration fee was not an eligible cost.

22. Work Package 3: Evaluation
Peter Anderson introduced the methodology of work package 3, on behalf of Andrej Marušič of the University of Primorska who will undertake the evaluation of the project. The evaluation will be based on network surveys, advocacy surveys, in-depth interviews and informal interviews, workshops, written documentation, participant observation, and respondent validation. Network functioning will be measured using the Partnership Synergy Questionnaire or a similar tool. The research officer who will undertake the evaluation will start in October 2007.
pdf icon small Presentation - Work package 3

23. Domestic violence and alcohol
In her presentation on intimate partner violence and alcohol, Susanne Koehler of the German Women Lawyers Association and Attorney at Law, introduced the field of domestic violence and alcohol, giving definitions of intimate partner violence and alcohol (IPV). She described the effects of and risk factors for IPV, and the results of surveys, studies and initiatives on IPV, as well as outlining a number of multinational prevention efforts.
pdf icon small Presentation - Intimate partner violence and alcohol

24.  Alcohol and suicide
Andrej Marusic introduced the interactions between alcohol and suicide, emphasizing that alcohol is an important determinant of psychosocial behaviour. He described the toxicological analysis of youth suicide, stressing the importance of mental disorder, harmful alcohol use and intoxication as risks factors for suicidal behaviour.  He underlined the importance of a history of alcohol and substance use disorders and impulsivity (noting that alcohol use can lead to impulsive behaviour) and alcohol dependence as additional risk factors for suicidal behaviour.
pdf icon small Presentation - Alcohol and suicide

25. PHP-Pathways for Health Project
Walter Farke described the outcomes of the Pathways for Health project (pdf 430kb), all of which were available on the project website: http://www.dhs.de/web/dhs_international/pathways.php. Three detailed reports had been prepared on drink driving, binge drinking, and consumer information and labelling, as well as a series of recommendations to reduce drink driving and binge drinking, and to enhance consumer protection through health warnings. A report of stakeholders’ views on consumer labelling had been prepared by the Belgian consumer organization, CRIOC-OIVO. Examples of innovative projects had been collected from all the participating countries, which provide examples of projects and practices that can be implemented to reduce drink driving and binge drinking, and to enhance consumer protection through health warnings http://www.dhs.de/web/dhs_international/php-project.php. The examples of innovative practices are supplemented by documentation of the available infrastructures related to policies and programme to reduce drink driving and binge drinking, and to enhance consumer protection through health warnings http://www.hp-source.net/dataoutput.html?module=btg2. The discussion focussed on the importance of the partners in using the results of the Pathways for Health project in their daily work, and in the importance of ensuring that the project and its results are promoted and made accessible to a wide range of partners at all levels, not just in the Member States, but also in the candidate and potential candidate countries.
pdf icon small Presentation -  Pathways for Health project

26.  Next steps

WP 1 Management

WP 2 Dissemination

WP 3 Evaluation

WP 4 Networking

WP 5 Inventory HP-Source

WP 6 Impact assessment

WP 7 Capacity Building and Barcelona conference

WP 8 Regional alcohol policy

WP 9 Municipal alcohol policy

WP 10 injuries

27.  Close of the meetingc
Cees Goos, Chair of the meeting, thanked the participating organisations, WHO and the European Commission, the new members of the network, the presenters, the facilitators, the Ministry of Health of the Republic of Slovenia (Vesna Kerstin Petric), the Institute of Public Health of the Republic of Slovenia (Sandra Rados Krnel, the coordinator of the project), Manca Drobne for organizing the meeting, Laura Sustersic Zorn for her assistance at the meeting, and Peter Anderson for his continuing leadership at the European level, and throughout the project. In addition, he emphasized the need to continue strengthening the network, and appealed to all the participants to broaden the network and to share all information of the project with others in their countries.

 Ljubljana, 19th October 2007

sovl_kj9en