Cutting alcohol consumption in middle-income countries

WHO reports show that more than 3 million people died from alcohol-related illness in 2016, yet low-cost interventions to measure how much people drink can lead to major reductions in heavy consumption. The EU-funded SCALA project promises significant results by introducing some of these techniques in Latin America.

Countries
Countries
  Algeria
  Argentina
  Australia
  Austria
  Bangladesh
  Belarus
  Belgium
  Benin
  Bolivia
  Bosnia and Herzegovina
  Brazil
  Bulgaria
  Burkina Faso
  Cambodia
  Cameroon
  Canada
  Cape Verde
  Chile
  China
  Colombia
  Costa Rica
  Croatia
  Cyprus
  Czechia
  Denmark
  Ecuador
  Egypt
  Estonia
  Ethiopia
  Faroe Islands
  Finland
  France
  French Polynesia
  Georgia

Countries
Countries
  Algeria
  Argentina
  Australia
  Austria
  Bangladesh
  Belarus
  Belgium
  Benin
  Bolivia
  Bosnia and Herzegovina
  Brazil
  Bulgaria
  Burkina Faso
  Cambodia
  Cameroon
  Canada
  Cape Verde
  Chile
  China
  Colombia
  Costa Rica
  Croatia
  Cyprus
  Czechia
  Denmark
  Ecuador
  Egypt
  Estonia
  Ethiopia
  Faroe Islands
  Finland
  France
  French Polynesia
  Georgia


  Infocentre

Published: 4 October 2019  
Related theme(s) and subtheme(s)
Health & life sciencesPublic health
International cooperation
Research policyHorizon 2020
Countries involved in the project described in the article
Colombia  |  Germany  |  Netherlands  |  Peru  |  Spain  |  United Kingdom
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Cutting alcohol consumption in middle-income countries

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© mrfotos_fotolia #6781649 , source: fotolia.com 2019

People whose alcohol consumption is tracked are likely to drink less, according to research from high-income countries. But is this also the case in middle-income countries, where alcohol poses a significantly higher health risk?

The EU-funded SCALA project sets out to answer this question, while also examining how to encourage health care professionals to track alcohol consumption in the first place. The initiative measures the drinking habits of 180 000 patients, in Mexico, Colombia, Bolivia and Peru, where alcohol is one of the leading risk factors for morbidity and premature death.

‘It’s not just about proving the hypotheses,’ says SCALA project coordinator Peter Anderson of Universiteit Maastricht in the Netherlands. ‘Setting up the infrastructure to encourage practitioners to measure and treat alcohol consumption counts as a result on its own.’ He adds that once the project is completed, practitioners will have treated as many as 9 000 heavy drinkers.

Simplifying the process

Anderson hopes that the project can be scaled up across Latin America and beyond as part of global measures against alcohol-related diseases. Statistics from the Global Burden of Disease Study recorded 63.5 million cases of alcohol use disorder (AUD) in 2015, causing 137 500 deaths, and 6.3 million years lived with disability.

Interventions can quickly produce results to improve patient outcomes. The Organisation for Economic Co-operation and Development (OECD) estimates that increasing to 30 %  the proportion of eligible patients receiving advice and treatment for heavy drinking could lead to a fall in the harmful use of alcohol by as much as 10-15 % in OECD countries, with reductions in the annual incidence of AUD of 5-14 %.

Given the scale of the problem, health care providers in middle-income countries know that if they help cut alcohol intake among their patients, they’ll have to deal with fewer recurring problems. However, Anderson says that limited resources and punishing schedules can limit their ability to take on new projects.

Referred for further treatment

The key is to simplify the process, he says. ‘We make sure that there is a questionnaire in every consulting room, with a simple three-question test. We also offer a one-pager that doctors can give to patients with alcohol problems. If health care providers see that drinking is not decreasing, they can refer the patient for further treatment.’

Given the strong correlation between heavy drinking and some mental disorders, SCALA also aims to identify patients at risk from conditions such as depression. ‘The process is the same,’ says Anderson. ‘Health-care providers offer a questionnaire, people with a raised score receive a brochure, and those with a very high score are referred for further assessment and treatment.’ 

Anderson is satisfied with the uptake so far, but says his team weren’t quite expecting the influence that political changes would have on their work. ‘When a new government comes in, you’ll find changes right down to the level of a director in a local health centre. If this happens, we start the whole process again in convincing people to come on board.’

With the support infrastructure in place, SCALA will start providing interim reports on the project’s results. And while Anderson is keen to see similar initiatives in poorer countries benefit from the project’s outcomes, he emphasises the importance of a scaled approach.

‘We are making everything publicly available. During the last year of the project we will mobilise a range of networks of health professionals, healthy cities and WHO to try to ensure widespread scale-up of our strategy and programme throughout primary health care services in Latin America.’

Project details

  • Project acronym: SCALA
  • Participants: Netherlands (Coordinator), Peru, Colombia, Germany, Spain, UK
  • Project N°: 778048
  • Total costs: € 2 568 692
  • EU contribution: € 2 568 692
  • Duration: December 2017 to November 2021

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