"Addressing the Non-Communicable Diseases (NCDs) burden and protecting the young through comprehensive Alcohol Policies: Lessons from recent studies in Africa".

Abstract

The age-standardized alcohol-attributable burden of disease and injury is highest in the WHO African Region, at 70.6 deaths and 3 044 DALYs per 100 000 people, placing an enormous strain on already challenged health systems. Drinkers in Africa consume 21% more alcohol per day than the global average. Small disposable plastic sachets- pouches which contain single use quantities of alcohol which often contain 40% spirits- have led to significant abuse amongst the most vulnerable and poorest communities in Malawi and Uganda. Concerns about harmful consumption and the public health and societal impact led to national bans on sachets of alcohol in Malawi (2016) and Uganda (2019), but those may not have had the impact anticipated. We will conduct interviews with key policy stakeholders and with district and local stakeholders in enforcement and trade in Malawi and Uganda to understand the adoption and formulation of the bans, what mechanisms for implementation were proposed and put in place, how the bans were enforced in practice, and any unintended consequences that have resulted. We will conduct focus group discussions with community members, health staff from local health centres and with traditional/ church leaders and school headteachers to explore the perceived impact of the ban and any unintended consequences from a local community perspective. Our multidisciplinary international team will conduct a robust analysis based the Health Policy Analysis framework to highlight contextual factors important for the transferability of findings to other Sub-Saharan countries in order to inform alcohol policy development and implementation across the region. We will publish results in peer reviewed journals and share them at stakeholder events in each country to discuss how the results may be used to further regulation of the supply of alcohol and reduction of related harms. Our researchers in LMICs will benefit from a strong capacity-building and research skills programme.