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• W4245753611 abstract "We thank the commentators for helping to stimulate the debate regarding alcohol consumption in Africa and for their acknowledgement of the importance of this review. Ingeborg Rossow argues that forecasted increases in alcohol consumption may vary substantially from country to country, and she points to the importance of country-specific assessments. Along these lines, in the first systematic assessment of alcohol control policies in the African region, Ferreira-Borges et al. 1 show the diverse state of policy interventions enacted across 46 countries. According to Rossow, additional factors such as corruption, level of conflict and informal social control should also be considered, as they have the potential to influence levels of alcohol consumption and the implementation and enforcement of existing alcohol control policies. This point is well taken, and suggests that generalized descriptions of the alcohol environment in the African continent, with its multiplicity of drinking cultures, is probably oversimplified 2, 3. At the same time, Rossow identifies major policy challenges regarding the implementation of evidence-based measures to curb increasing alcohol consumption, such as political instability and the weaknesses of institutions in some countries. As Rossow notes, national alcohol control policies in these fragile environments may be vulnerable to alcohol industry influence. We also appreciate Raul Caetano's commentary that highlights the similarities between Africa and Latin America, where alcohol consumption is already problematic 4. The parallels between the two regions suggests the importance of monitoring changes in levels and patterns of consumption, as well as enhanced surveillance of alcohol-attributable morbidity and mortality in Africa. Furthermore, Caetano underlines the importance of engaging health professionals as a vehicle for successfully mobilizing government officials and communities to respond to increases in alcohol-related harm, although this may be challenging in Africa, with the extreme shortage of health-care workers. In Africa, there are 2.3 health-care workers per 1000 population compared to the Americas, with 24.8 health-care workers per 1000 population 5. The heavy work-loads experienced by health workers in Africa might make them hesitant in taking on new responsibilities. However, it should be recognized that decreasing alcohol-related harm could lead to reductions in the burdens to health workers in the long term. In discussing the need for multiple strategies to reduce alcohol-related harms, both commentators highlight two important factors for Africa—high levels of activity for the alcohol industry, leading to increases in alcohol availability 6, and weak public health regulatory structures. There is a need for greater organized action to address issues concerning the globalization of alcohol production and marketing 7, 8, as well as global trade negotiations 9, 10. While strong leadership and enhanced engagement between various stakeholders and policy sectors are important at the country level, multi-regional collaborations are also needed. Such collaborations would facilitate the sharing of experiences, thereby assisting countries to strengthen the effectiveness of their alcohol control policies. An international public health network could also help promote the implementation of alcohol control policies to reduce harmful alcohol consumption effectively in Africa and in other emerging markets around the world. None." @default.
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• W4245753611 date "2015-07-29" @default.
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• W4245753611 title "Response to commentaries" @default.
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• W4245753611 doi "https://doi.org/10.1111/add.13022" @default.
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