The Monitoring Alcohol Marketing Practices in Africa (MAMPA) Project was a public health surveillance program devoted to monitoring alcohol marketing activities in the African region as well as youth exposure to these marketing activities. Data on alcohol marketing was collected in Ghana, Nigeria, Uganda, the Gambia, Kenya, Malawi and Namibia. The main conclusions of this independent analysis of this MAMPA data are:
  • The findings of the report provide evidence of violations of industry self-regulation codes in the seven countries studied
  • The findings points to the need for systematic surveillance of alcoholic beverage marketing to protect vulnerable populations, such as youth, who may already be experiencing problems related to their alcohol use.
  • The report underscores the need for policy strategies to more effectively monitor and regulate alcohol advertising across all media outlets.
  • The report points out that a variety of options exist, including complete bans on alcohol advertising.
  This secondary analysis of the original MAMPA marketing data confirms the conclusions of the original MAMPA report, in that it provides strong evidence of code violations in all media evaluated, and suggests that exposure to potentially harmful alcohol marketing content is widespread in six of the seven countries studied. These reports also raise questions about the effectiveness of current industry efforts to regulate alcohol marketing. The report (full text, including an executive summary) can be downloaded via this link. 

Authors: Kate Robaina, MPH, Thomas Babor, PhD, MPH & Jonathan Noel, MPH (2016).

Title: Evaluating compliance with alcohol industry self-regulation in seven countries in Africa. An external evaluation of the MAMPA (Monitoring Alcohol Marketing Practices in Africa) project. OLYMPUS DIGITAL CAMERA

Executive summary

Introduction
The Monitoring Alcohol Marketing Practices in Africa (MAMPA) Project was a public health surveillance program devoted to monitoring alcohol marketing activities in the African region as well as youth exposure to these marketing activities. The first project report was the subject of a World Health Organization (WHO) technical meeting in Brazzaville in 2012, where it was recognized that MAMPA had methodological limitations that precluded definitive conclusions about the extent to which alcohol marketing in four countries within Africa violated international guidelines regarding the exposure of young persons to potentially harmful advertising content. It was recommended that content of advertisements should be analyzed using a coding scheme developed by a panel of experts.

Following the meeting, the WHO Regional Office for Africa asked researchers from the University of Connecticut School of Medicine to systematically evaluate the marketing materials collected as part of the MAMPA project, and to expand the study to include the second wave of data collected from three other sub-Saharan African countries: Kenya, Malawi, and Namibia.

The purpose of this report is to describe the results of an independent analysis of the MAMPA data. The specific aims of the re-analysis of the MAMPA marketing data were: 1) to provide estimates of the prevalence of code violations in alcohol advertisements within and across these seven African nations, 2) to determine which sections of the Code were violated most often; 3) to determine if different producers and media had more violations than others; and 4) to test the feasibility of a new standardized rating procedure to evaluate code violations in alcohol marketing materials (Babor, Xuan & Damon, 2013a). Developed initially for television and print media, the procedure is applied for the first time in this study to radio ads and outdoor advertisements.

Methods
Ethnographic field methods were used to collect marketing materials from rural and urban areas of seven countries: Ghana, Nigeria, Uganda, the Gambia, Kenya, Malawi and Namibia. These countries were selected to provide a range of social availability climates (according to religion and culture) and regulatory environments (ranging from a ban on alcohol advertising to only partial restriction).

Examples of unique marketing materials (N=282) used by both domestic and foreign alcohol producers were obtained by trained observers recruited from public health NGOs and research NGOs working on alcohol prevention and operating at the national level within each country. Observers were trained to collect digital recordings of visual stimuli across four types of media: TV, radio, print and outdoor advertising. In order to conduct this secondary analysis of the data collected in the original four MAMPA countries and in the three additional countries, all unique alcohol ads from each country were identified from the available recordings and abstracted into individual video, audio, or image files.

Because of between-country variation in alcohol marketing regulations, a set of guidelines developed by the alcohol industry (ICAP’s Guiding Principles: Self-Regulation of Marketing Communications for Beverage Alcohol) were chosen as the standard code to compare all advertisements. Using an objective Delphi rating procedure developed and validated in prior alcohol marketing research (Babor, Xuan & Proctor,
2008; Babor et al., 2013a), the ads were subjected to an evaluation by 9 trained raters across two rounds, the second of which allowed the raters to see the average ratings of the group. Each rater had experience in public health, substance use, or public health, and was considered to have the necessary expertise to protect vulnerable populations. Raters were from Kenya, Malawi, Nigeria and the US. Interrater reliability between the raters was assessed using violation level and item-level data and was found to be high.

Results
In total, 282 unique examples of alcohol advertising were analyzed. Observers collected the largest number of marketing examples in Uganda (25.2% of all examples) and Nigeria (24.8%). The Gambia, where there is a ban on alcohol advertising, contributed only 1.4% of the total ads collected. Over seventy percent (70.6%) of ads collected from all countries were obtained from outdoor media (billboards, posters, signage, etc.).

Overall, 78 advertisements (27.7%) were found to contain at least one violation, representing an industry compliance rate of 72.3%. Advertisements collected from Kenya were the most likely to contain a violation. Guiding Principle 5, which refers to “the effects of alcohol,” accounted for the largest number of violations (77 ads). This guideline was most often scored as a violation because of the suggestion that alcoholic beverages can enhance attractiveness and/ or remove social or sexual inhibitions (n=51) and/ or presenting alcohol as necessary for social success or acceptance (n=63). The second most frequently violated guideline was Guiding Principle 3 (69 ads), which speaks to health and safety aspects in marketing communications. This principle was most often violated for presenting alcohol as a stimulant, sedative or tranquilizer (50 ads), and suggesting that alcohol can “prevent, treat or cure illness or resolve personal problems” (29 ads).

Violation rates significantly differed between media (p = <.001), with television ads having the highest proportion of violations (72.2%) and outdoor ads having the lowest (21.6%). Certain types of outdoor ads, however (e.g. billboards and posters), contained higher violation rates (37.3% and 30.8%, respectively).

Conclusion
The findings suggest that code violations of the ICAP Guiding Principles were prevalent in the four types of media sampled during the MAMPA project in the seven countries. It is interesting to note that the country with the fewest marketing materials recorded (n = 4) was The Gambia, which is a Muslim country with a ban on most forms of advertising. Despite the limitations of the prior MAMPA project and the current re-analysis, this research establishes a basis for a monitoring and regulating alcohol advertising in African countries. The methodology offers a systematic way to evaluate media advertisements of alcoholic beverages to determine whether their contents comply with generally accepted guidelines for responsible advertising practices.

Based on the evidence described above, governments and policymakers should give serious consideration to the key messages emerging from the Consultative meeting on addressing alcohol marketing in the African Region (WHO, 2012) and from the PAHO Expert Meeting on Alcohol Marketing Regulation (PAHO,
2016), which are consistent with the well-documented premise that alcohol is not an ordinary commodity (Babor et al., 2010) and should not be marketed as such.

These findings provide evidence of violations in the seven countries studied and the need for systematic surveillance of alcoholic beverage marketing to protect vulnerable populations such as youth, who may already be experiencing problems related to their alcohol use.

Our secondary analysis of the original MAMPA marketing data confirms the conclusions of the original MAMPA report, in that it provides strong evidence of code violations in all media evaluated, and suggests that exposure to potentially harmful alcohol marketing content is widespread in six of the seven countries studied. These reports also raise questions about the effectiveness of current industry efforts to regulate alcohol marketing.

The report (full text) can be downloaded via this link. 

In recent years the Dutch government gave  a € 6.6 million grant to Heineken for so-called development aid in Africa. Prime Minister Rutte praised Heineken in September 2015 during a speech to the UN, because of the purchase of beer barley from local farmers in Africa.

Research journalists of the Dutch television-program Zembla studied the impact of the € 1.3 million grant Heineken received from the Dutch government for the acquisition of two state breweries in Ethiopia.

Who benefited? The advantage for Heineken is obvious: net sales rose sharply and the company now controls 30% of the Ethiopian beer market. But that does not apply to the Ethiopian government: Heineken currently pays - despite increased sales - less income tax than before the acquisition in 2011. In addition, Heineken also paid much less wage tax. That's because since the acquisition of the two breweries, 699 Ethiopians were fired by Heineken.

The impact on poverty in the country and on the beer barley farmers who participate is unclear. The latter have a higher yield and a better price, but may only supply the breweries of Heineken. An expert of the IMF judges the results of the Dutch policy as a lose-lose-win situation. A loss for the Ethiopian treasury, a loss for the personnel of the breweries and a win for Heineken.

Source: Zembla.vara.nl via our colleagues at STAP the Dutch Institute for Alcohol Policy.
ep-ghana_flag The Ghanaian Food and Drugs Authority (FDA), has asked the media to ensure that advertisements on food, medicines and cosmetics are prevetted by government authority, before such adverts are aired of published. These include alcohol ads. “A manufacturer or distributor, advertising agent and advertising media and or organisation who advertises a food product without the prior approval of the Authority shall be in breach of this guidelines and shall be fined an administrative charge as specified in the fees and charges Amendment Instrument, 2013 (LI2206)”. At a stakeholders meeting held in Accra to educate the media and advertisers on the laws concerning advertisement of food and alcoholic beverages, Mr Hudu Mogtari, FDA Chief Executive Officer said the move by the Authority to regulate advertisements of certain products are backed by the Public Health Act 2012, Act 851, which mandates it to enforce the law in a bid to protect public Health. He said the FDA had toured other parts of the country to engage the citizenry and media personnel on the reviewed laws on advertisements and on the need to work to secure public health. Mr Mogtari urged all to support FDA at regulating and sanitising the system to ensure orderliness in the advertising landscape. Mr Thomas Amedzro, Head of Drug Enforcement Unit of FDA, said the law cautions against adverts with content that exaggerates, offers refund of money to persons and misleading to the public. Mrs Isabella Mensa Agra, Acting Deputy Chief Executive Officer in charge of Food Inspectorate Division, FDA, said the Food Advertisement Guidelines also bans radio and television advertisement of alcoholic beverages from 0600 to 2000 hours. She said no well-known personality or professional is allowed to advertise alcohol. “No well-known personality or professional shall be used in alcoholic beverage advertisements. Approval will be revoked where a personality subsequently appeals to persons under the legal drinking age,” she added. Mrs Agra explained that all such advertising must be consistent with a sense of responsibility in depicting the serving or use of liquor and also advertisements shall not promote or depict excessive consumption of alcohol. “An advertisement shall not imply that consumption of alcoholic beverage is required for social or professional achievements, personal success, any sporting activity, sexuality, pleasure, resolution of social, physical or personal problems. Mr Francis Dadzie, a member of the Advertisers Association of Ghana expressed support for the prohibition of the use of professionals and well known personalities in advertising alcoholic beverages, saying that, “it is not done in Nigeria and in other jurisdictions and in the USA alcohol is advertised after 10pm”. Source: Ghanaweb 09/02/15
Flag_of_Ethiopia.svg On the 31st of January, the Dutch television program ‘Nieuwsuur’ broadcasted a program on the fast growing beer market in Ethopia that is subsidized by Dutch foreign aid. Africa is the place to be for international beer brewers. The fast growing middle class poses an opportunity for alcohol producers. Water and fertile grounds is allocated to produce barley instead of food for the locals.  The Dutch government increases the problem by supporting international beer producers and farmers to produce alcohol. The 'Nieuwsuur' broadcast explains that Ethiopia produces enough food for its population, and that famine is only a problem in deprived areas where that food can't reach. However, it makes no mention of the catastrophic drought that plagued the country as recently as 2011. As reported by EM-DAT CRED, an average of 2.2 million people a year have been affected by natural disasters in Ethiopia over the last 10 years. Drought has had the largest impact, affecting 34 million people between 2004 and 2013. Taking this into consideration, it's remarkable that foreign aid would go to an industry that uses large amounts of water in its production processes. Ethiopia has been in the top 10 recipients of humanitarian assistance in all of the last 10 years. Humanitarian assistance peaked at US$937 million in 2008, when it was the second largest recipient. As reported by the World Health Organization in its 2010 MAMPA report, an increasing beer market and production is expected to raise a number of alcohol-related problems: water pollution, poverty, sexual transmitted diseases, violence and health problems. The broadcast can be viewed in Dutch, here>>
Author: Avalon de Bruijn, Carina Ferreira-Borges, Rutger Engels & Megha Bhavsar Title: Monitoring outdoor alcohol advertising in developing countries: Findings of a pilot study in five African countries Journal:  African Journal of Drug and Alcohol Studies 13.1 (2014). AbstractOLYMPUS DIGITAL CAMERA This paper aims to describe alcohol advertising in the public arena of Gambia, Ghana, Madagascar, Nigeria and Uganda. Analyses on the placement, channels, size and content of outdoor alcohol advertising practices (N=807) in relation to existing regulations are given. For example, in Gambia, the country with the most stringent alcohol marketing regulations of all countries studied, outdoor alcohol advertisements are on average smaller and less attractive to youth; whereas, in Uganda and Ghana, countries with selfregulation, there is limited protection. Findings illustrate the innovative ways in which the alcohol industry attempts to reach their market despite existing alcohol marketing regulations and cultural boundaries. Legal measures could be a policy instrument to protect against harmful exposure.