The Public Health Responsibility Deal: why alcohol industry partnerships are bad for health?

Abstract

The results from the evaluation of the Public Health Responsibility Deal Alcohol Network 1, 2 raise questions about what evidence exists to support alcohol industry partnerships as effective mechanisms for reducing alcohol harm. These reports corroborate findings from previous studies that show initiatives based on partnerships with drinks industry actors and voluntary agreements have minimal, if any, impact on rates of alcohol consumption and its associated health and social problems 3. This growing body of evidence is unsurprising: how can corporations legally obliged to prioritize the interests of their shareholders consider actions that would essentially diminish their sales and profits? The revelations that an alcohol industry-funded body interfered with data during the evaluation process of the Responsibility Deal pose further difficult questions about industry's role in public health policy 4. This highlights the pressing need for information on the effectiveness of alcohol industry partnerships to be subject to careful scrutiny, and suggests that we should be investigating if such partnerships have a detrimental impact on public health. There is evidence to indicate a number ways in which alcohol industry-led initiatives can have a negative impact on public health outcomes. First, they can lead directly to increased harms through promotion of irresponsible drinking, neglect of safe retailing practices or generation of stigma among vulnerable groups 5-7. Secondly, industry partnerships can divert resources and attention away from evidenced-based interventions, presenting significant opportunity costs for public health outcomes. Commentators have argued that the UK Department of Health's prioritization of the Responsibility Deal was to the detriment of other evidence-based measures outlined in the Government's Alcohol Strategy, such as minimum unit pricing, which was discarded in the face of drinks industry opposition 8. Perhaps more importantly, partnerships with drinks industry bodies legitimize their place at the table, enshrining conflicts of interest in public health policymaking and enabling Big Alcohol to influence the wider policy agenda. The WHO Director General, Dr Margaret Chan, has voiced her concerns on this issue, stating that alcohol policies ‘must be protected from distortion by commercial or vested interests’ 9. Similar to the tobacco industry, alcohol companies have reportedly worked to undermine public health objectives in the pursuit of economic goals by discrediting evidence to support effective policies, co-opting policymakers and launching aggressive lobbying campaigns designed to ‘kill off’ regulations intended to save lives 8, 10-12. Analysis of corporate documents indicates that tobacco and alcohol companies have worked together, shared information and similar arguments to defend their products and prevent or delay restrictions being placed upon them 10, 11. However, in spite of the similarities between these two ‘unhealthy commodity industries’, the approaches taken to public–private partnerships and protecting public health from conflicts of interest are very different. The World Health Organization (WHO) guidelines for implementing article 5.3 of the Framework Convention for Tobacco Control (FCTC) stipulate that governments must not enter into partnership agreements with tobacco companies. The WHO FCTC, of which the United Kingdom is a signatory, explicitly acknowledges well-documented evidence that tobacco companies have ‘worked for years with the express intention of subverting the role of governments and WHO in implementing public health policies to combat the tobacco epidemic’ 13. Conversely, alcohol industry partnerships form the cornerstone policies for the UK Government in dealing with alcohol-related harm 14 and there has been much speculation over the government's justification for reneging its commitment to introduce minimum unit pricing. Despite clear evidence, commissioned by the government 15, that the policy would not penalize ‘responsible drinkers’, the government followed closely the unsubstantiated industry-promoted narrative that it would, in fact, do this 16. The longer-term impact of the Responsibility Deal on public health is unknown. All the available evidence indicates that this industry partnership has not generated any improvements in rates of alcohol-related hospital admissions or deaths. Further research is required in order to estimate what the opportunity costs to public health have been, due to delays in implementing evidence-based policies such as minimum unit pricing. Research is also needed urgently into the wider impact of corporate behaviour on public health, in order to inform the management of conflicts of interest in public policymaking. The Institute of Alcohol Studies receives funding from the Alliance House Foundation.