| By Dr Mary Madden, Professor Jim McCambridge, and Dr Andrew Bartlett
Strategic collaborations and cross-ownership mean the tobacco and alcohol sectors have long been closely linked, and remain so today. There are striking similarities in their approaches to science and policy, including counterarguments to proposals to improve public health.
The global alcohol market is dominated by a small number of producers, particularly of beer and spirits. These have collaborated to form the International Alliance for Responsible Drinking (IARD), a type of industry organisation no longer allowed for tobacco companies. IARD claims to promote “responsible drinking”. Being seen as part of the solution, rather than the problem, has been the key long term alcohol industry strategy since the end of national prohibition in the United States of America.
IARD has been grossly understudied given its significance to global health. In a recent article we looked closely at an IARD toolkit on building public-private partnerships. This examined partnership formation as a strategic approach to policy influence. It showed how alcohol industry corporate social responsibility (CSR) vehicles like IARD enable the largest corporations to exercise leadership of all parts of the industry, while itself remaining off-stage. This IARD toolkit is guidance published by the major global companies on how other actors in the alcohol industry can build partnerships at the national and sub-national levels. It admits that CSR organisations such as Drinkaware are part of the alcohol industry, even though they claim to be independent. It is to a large degree about prospective civil society and government partners and how to work with them; such partners are not the audience.
Gifting legitimacy and credibility by association
Weak text in the 2010 WHO Global Strategy to reduce the harmful use of alcohol encouraged alcohol industry actors “to consider effective ways to prevent and reduce harmful use of alcohol within their core roles”. The IARD toolkit seizes on this, via self-referencing interpretations, as providing authority for partnerships. Contributions it claims the industry can make to such partnerships include areas well outside its core roles and competence, such as implementing and evaluating public health programmes.
At the same time the toolkit acknowledges that industry members, “may lack the necessary expertise or the credibility” to reduce alcohol-related harm and promote responsible drinking (p3). Industry actors’ principal roles are in the constitution of the harm rather than its reduction. Their profit-seeking adds to harm through increasing sales and consumption. As such they do have an interest, but it is not aligned with public health. Hence the IARD toolkit states, “working with others better positioned to engage in these areas is valuable and important for industry members” (p2). Proposed partnership working provides industry the opportunity to gain credibility by association, as well as a means of securing a role in problem definition and how to respond to resulting narrowly identified problems.
Undermining and sidelining the population-level evidence-base
Despite the evidence base which supports whole population interventions on alcohol availability, pricing and marketing, the toolkit promotes preferred “targeted” initiatives e.g., education and industry self-regulation of marketing and advertising. These do little to reduce the harms of drinking, in part because these initiatives are not designed to do so. A key challenge for partnerships is potential lack of receptivity to industry arguments and ideas, particularly concerns about, “the unintended, negative consequences of whole-population approaches” (p11). The IARD toolkit states it is essential to clearly define roles of stakeholders in partnerships, adroitly positioning the alcohol industry in the implied role of director. Proposed “stakeholders” must have an interest in, “maintaining the viability of the organisations products and services” (p3). In this manner, stakeholders are not therefore defined by their ‘stake’ in the problem or in evidence-informed responses, but through a commitment to a particular form of outcome for the organisation (i.e. the partnership). This makes those interested in evidence-informed solutions inherently problematic because they may privilege solutions to problems over organisational needs.
Potential distrust is dealt with by framing conflicts of interest as “perceived”, i.e. misperceptions in need of correction. Both material conflicts of interest, and the public health evidence-base on interventions that may effectively reduce alcohol harm, are thus reduced to mere positions to be corrected by more ‘transparency’ and contact with industry during the partnership. The toolkit identifies those most potentially receptive to partnership advances as consumer organisations which, “take into account what the general population actually wants” and are in sympathy with industry’s own advocacy of “freedom of choice” in the market (p12). Other civil society and public organisations, while valued for their networks, advocacy and role in shaping policy towards ineffective “targeted” interventions, may be wary of working with the industry for what are alleged as “ideological reasons” (p11).
Conclusion: reasons to resist co-optation
The model of working proposed in the IARD toolkit involves a pivot on a “balanced” industry harm reduction mission that:
- dismisses population level approaches out of hand (p10)
- promotes the benefits of alcohol as an economic resource (p10)
- focuses only on the positives in evaluating its own approaches, whilst avoiding any serious evaluation (pp13-15) and
- despite advocating transparency in partnerships, without any sense of irony guards against “adding or expanding warning labels” for consumers (p10).
The primary purpose served by this toolkit is the reverse of what industry actors routinely claim; it is as an ideological resource to equip actors across the industry and across the world to prevent effective actions on alcohol being taken. It is designed for co-optation of actors who may be useful. Industry reliance on acquiring credibility and legitimacy from potential partners carries with it the means of undermining public confidence in the trustworthiness of those partners and in their expertise. The user would not know from reading it that the deaths of three million people every year are attributed to alcohol consumption, with countless more lives ruined, and that constructing partnerships in this manner will make the situation worse not better. It is in the interests of public health to resist the corporate capture of civil society and governments by intrinsically health harming industries.
Written by Dr Mary Madden, Associate Fellow, Professor Jim McCambridge, Chair in Addictive Behaviours & Public Health, and Dr Andrew Bartlett, Associate Fellow, Department of Health Sciences, University of York.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.