Globally, alcohol consumption is one of the most important risk factors for the burden of disease and injury, as it is causally linked to chronic and acute health problems, in particular to cardiovascular diseases, digestive tract conditions, accidents and violence. According to the World Health Organisation (WHO), the harmful use of alcohol is a causal factor in over 200 disease and injury conditions.
The African region is no exception to the global pattern. Africa faces a growing burden of harmful alcohol consumption and its disastrous effects. There is no other consumer product on the continent as widely available as alcohol that accounts for as much premature death and disability.
In Africa, alcohol consumption is one of the major risk factors for non-communicable diseases (NCDs) such as heart and lung diseases and diabetes, and the WHO predicts that over the next 10 years, Africa will experience a 27 percent increase in deaths from NCDs. This means that by 2030, NCDs are expected to become the leading cause of death in Africa, and alcohol abuse is a major driver of this NCDs epidemic.
Unfortunately, the increasing alcohol-related harm in Africa receives little attention from policymakers and from the population. Even where new legislation is proposed, it is rarely enacted into law. Being at the centre of social and cultural activities in many African countries, alcohol’s negative role in society and contribution to countries’ burden of disease are rarely questioned.
Given the tremendous impact of alcohol abuse on public health in Africa, there is an urgent need to develop and implement workable strategies that address the increasing use of alcohol
Given the tremendous impact of alcohol abuse on public health in Africa, there is an urgent need to develop and implement workable strategies that address the increasing use of alcohol, its associated burden and the new challenges that derive from the growing influence of the alcohol industry on the continent.
The alarming impact of alcohol abuse on public health in Africa
In a continent where availability of advanced diagnostics and drugs, intensive disability management, and prolonged care facilities are grossly inadequate, Africa’s healthcare system lacks the capacity to cope with the increasing disastrous immediate and long-term effects of harmful alcohol consumption.
Heart attacks, strokes and high blood pressure – all significant health conditions on the continent – can develop from the harmful use of alcohol. Alcoholic hepatitis and scarring of the liver are also devastating outcomes of alcohol use.
In sub-Saharan Africa, unintentional injuries account for most of the alcohol-attributable deaths and disability-adjusted life years (DALYs) lost in the region. This is because of the high prevalence of heavy episodic consumption and a detrimental pattern of use where large quantities of are consumed frequently, in a short space of time and outside of meals, increasing the risks of all injury outcomes.
The latest causal relationships have been established between harmful drinking and incidence of infectious diseases such as tuberculosis and the course of HIV/AIDS. Alcohol consumption, especially heavier drinking patterns, is linked with many facets of HIV disease, such as reduced adherence to antiretroviral treatment (ART), immune system impairment, drug interactions, and hepatotoxicity. Beyond health consequences, the harmful use of alcohol brings significant social and economic losses to individuals and society at large.
Strategies to reduce the burden of alcohol abuse in Africa
African countries need to implement workable solutions to reduce the health, safety, and socioeconomic consequences of alcohol abuse. This requires that action be taken on the various levels, patterns and contexts of alcohol consumption and the wider social determinants of health.
In view of this, Bloom Public Health proposes the following as effective strategies to curb the growing alcohol abuse in Africa:
• Implementing appropriate and stronger public policies: African governments and policymakers must rise to the challenge of formulating, implementing, monitoring, and evaluating stronger public policies to reduce the harmful use of alcohol. Key policies that must be implemented include pricing and taxation policies to reduce alcohol demand; drink-driving policies and countermeasures to protect young people and prevent injuries; marketing policies and advertising restrictions that regulate the availability of alcohol; and policies to address illicit and informal alcohol production.
• Strengthening health services’ response to alcohol abuse: This includes implementing screening and brief interventions programmes for hazardous and harmful drinking in health services, and providing accessible and affordable treatment for people with alcohol-use disorders. There is also a critical need to introduce alcohol-related preventive measures in primary health care facilities and in HIV clinics aimed at reducing alcohol consumption among people with HIV/AIDS or TB.
• Increasing public awareness through health campaigns and education: Raising awareness of public health problems caused by harmful use of alcohol and ensuring community support for effective alcohol policies can have a notable impact in reducing alcohol consumption and related harm.
Conclusion
In Africa, the harmful use of alcohol is an enormous public health challenge and a major contributor to the burden of disease. However, by effectively working together and engagement of all relevant stakeholders, the negative health and social consequences of alcohol abuse can be reduced on the continent.
Anyakora is the CEO of Bloom Public Health and a public health expert & Odibeli is a pharmacist and the regional communications manager at Bloom Public Health
