Editorial - A Framework Convention on Alcohol Control
The Lancet 2007; 370:1102, 29 September 2007

International conventions exist to control narcotics, psychotropic substances, tobacco, and doping in sport. But when it comes to alcohol—the drug that causes 4% of global deaths and disability—nearly as much as tobacco (4·1%) and five times the burden of illicit drugs—no similar legally binding agreement has been sought.

In many cultures, alcohol has long been considered in a more salubrious, socially acceptable light than other drugs. This attitude might be because of the putative health benefits associated with moderate drinking. Or perhaps it is due to the popularity of alcohol among higher socioeconomic groups, who, in many countries, are more likely to drink and more likely to drink regularly, while lower socioeconomic groups are more likely to smoke. Public-health advocates have also been lenient on the alcoholic beverage industry compared with big tobacco.

These lax attitudes along with free trade and competition rules, which treat alcohol as any other commodity, have undermined effective alcohol control measures, such as increasing taxes or restricting the hours or days of sale. Instead, at country level, ineffective control strategies (warning labels, education in schools) have been adopted. Internationally, resolutions on alcohol control exist but are non-binding and easily flouted.

For alcohol-control measures to be taken more seriously by governments, an international treaty modelled on the Framework Convention on Tobacco Control (FCTC) is needed. One of WHO's greatest achievements, the FCTC aims to counter the increase in tobacco consumption by making it a legal requirement for countries to introduce certain tobacco-control strategies.

Momentum is already gathering for a Framework Convention on Alcohol Control (FCAC). In the past couple of years the World Medical Association and the American Public Health Association have been among those who have voiced their support for such a move.

From its initial inception, the FCTC took 10 years to become a reality. The road to an FCAC is likely to be similarly long. Next year's World Health Assembly provides a crucial opportunity for WHO and member states to make those first steps towards a global treaty to reduce alcohol-related harm.

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