Background: The World Health Organization (WHO) 2017 Global Conference in Montevideo, Uruguay, was dedicated to promoting successful cases and best practices in fighting and preventing noncommunicable disease (NCDs). The global effort undertaken by WHO aims to reduce road traffic deaths in order to meet goal number 3.4 of the sustainable development goals. Objectives: To describe two Brazilian road safety prevention programs, presented at the WHO 2017 Global Conference: São Paulo Traffic Safety Movement (Movimento Paulista de Segurança no Trânsito) and Safe Life Program of Brasília (Programa Brasília Vida Segura), along with their governance structures, models and results. Design and setting: This was a descriptive case study conducted in São Paulo and Brasilia from 2015 to 2018. These programs aimed to reduce the number of deaths caused by road accidents to 8.3 deaths per 100,000 inhabitants in São Paulo by 2020 and in Brasília by 2016; and to reduce harmful use of alcohol by 10% by 2020. Methods: These two initiatives were designed, managed and operated to bring together government and civil society, i.e. industry, academia, non-governmental organizations (NGOs), etc., around the common goal of saving lives. They were collaborative and guided by sharing of best practices, learning and information, thereby making it possible to attain more and better results. Their format enables reproduction in cities across all Brazilian regions. Results: The results attest to the efficacy of the programs implemented in these two cities. In Brasília, the initiative helped reduce the number of traffic-related deaths by 35% (2017). In the same year in the state of São Paulo, 7,600 deaths were avoided. Conclusion: Both programs are innovative public policies that deal with health issues caused by the external agents that ultimately account for the rapid increase in days lost to disability. Prevention of external causes of deaths and injuries, such as traffic violence, strongly correlates with changes in habits and actions, especially excessive consumption of alcohol, and with NCDs in Brazil.

We describe the rationale for and design of an independent evaluation of the Global Smart Drinking Goals (GSDG) program. The primary purpose of this program, supported by the AB InBev Foundation, is to reduce harms associated with alcohol use by 10%. Our evaluation focuses on the effects of prevention strategies sponsored by the Foundation that are being implemented in six city pilots located in as many countries. These strategies are designed to reduce heavy episodic drinking, underage drinking, drink driving, and alcohol-related violence. Each city pilot has been matched with a comparison city in which the GSDG program will not be implemented. In this quasi-experimental community trial, we will assess each city pilot’s progress toward reaching its harm reduction goals, relative to its comparison city, by means of annual adult and youth surveys. We will then supplement these analyses with the use of pertinent local archival data, where available. We discuss several challenges related to this evaluation and its quasi-experimental design. These include operating in a fluid and unpredictable environment in regard to the implementation, adaptation, and (on occasion) abandonment of the prevention strategies selected by each city pilot. We also discuss issues concerning our decision to accept funding from the alcohol industry and the measures we have taken to ensure the independence of our evaluation.

Despite high rates of youth drinking in Mexico, little is known about the availability and consumption of specific types of alcoholic beverages within this population or the contexts in which alcohol is consumed. This descriptive study examined alcohol consumption, perceived availability, and purchase of different types of alcoholic beverages (i.e., beer, wine, tequila, other spirits, pre-mixed cocktails, alcohol energy drinks, homemade alcohol), and drinking contexts.
The sample comprised 594 students aged 12–17 in three cities in central Northeastern Mexico, where the legal drinking age is 18. Over half had consumed alcohol in the past year. Of past-year drinkers, almost 57% had consumed alcohol in the past 30 days. Over half of these students reported that they or their friends had purchased alcohol at an off-premise establishment for their personal consumption, and 40% had consumed it at an on-premise establishment. Beer, which almost 60% of the study’s adolescents thought was either fairly or very easy to get, was the most commonly consumed type of alcoholic beverage in the past 30 days. The majority of youth (70%) reported that their last drinking location was at home, someone else’s home, or a public place. Importantly, however, 39% of young drinkers reported that the last time they consumed alcohol was at an on-premise establishment, and most of these youth (90%) did so in the absence of their parents. The findings suggest the need to implement and enforce measures to decrease retail and social alcohol availability to Mexican youth.

This paper was also presented at the 2018 Research Society on Alcoholism Conference in San Diego, California, United States.

As part of needs assessment and baseline data collection for AB InBev’s Global Smart Drinking initiative, to ascertain the extent of drink-driving in selected cities in 6 countries. Gallup designed and fielded a survey instrument. They conducted stratified random sample surveys of people age 18 and over face-to-face at homes in Santa Cruz, Bolivia; Brasilia, Brazii; Jiangshan and Lanxi, China; Zacatecas-Guadalupe and Aguascalientes, Mexico; and by telephone in Columbus, Ohio, Indianapolis Indiana, and Leuven and Antwerp, Belgium. 3000 interviews were completed in each country. Among those who drank during the past 30 days, the percentage who drove after drinking ranged from 2.7% in China and 5.7% in Bolivia to 24.0% in the United States and 29.0% in Mexico, with Brazil and Belgium between these extremes at 18.1% and 19.1% respectively. Variation between cities within country was modest except in the United States where 21.3% of drinkers in Indianapolis, Indiana and 26.5% of drinkers in Columbus, Ohio drove after drinking. Heavy drinkers were more likely than other drinkers to drive after drinking (relative risk 1.4–2.4). In Bolivia, the rate of driving after drinking was highest at ages 50 and over. Elsewhere, the rate was highest at ages 30–49. The rate was much higher among men than women. In part, the differences observed reflect exposure, with motorized vehicle ownership low in China. The cities surveyed in Mexico are on the north-central feeder route for illegal entry to the United States. Visiting them, the need for policy intervention is readily apparent. They have drive-through liquor stores. They lack laws to support fully effective roadside breath testing/sanctioning and open container laws to reduce the pastime of circling the city center while drinking. Zacatecas just legislated earlier bar closing but enforcement resources are scarce.

This paper was also presented at Poster Presentation of the World Safety 2018 Congress.

The World Health Organization (WHO) 2017 Global Conference in Montevideo, Uruguay, was dedicated to promoting successful cases and best practices in fighting and preventing noncommunicable disease (NCDs). The global effort undertaken by WHO aims to reduce road traffic deaths in order to meet goal number 3.4 of the sustainable development goals. To describe two Brazilian road safety prevention programs, presented at the WHO 2017 Global Conference: São Paulo Traffic Safety Movement (Movimento Paulista de Segurança no Trânsito) and Safe Life Program of Brasília (Programa Brasília Vida Segura), along with their governance structures, models and results. This was a descriptive case study conducted in São Paulo and Brasilia from 2015 to 2018. These programs aimed to reduce the number of deaths caused by road accidents to 8.3 deaths per 100,000 inhabitants in São Paulo by 2020 and in Brasília by 2016; and to reduce harmful use of alcohol by 10% by 2020. These two initiatives were designed, managed and operated to bring together government and civil society, i.e. industry, academia, non-governmental organizations (NGOs), etc., around the common goal of saving lives. They were collaborative and guided by sharing of best practices, learning and information, thereby making it possible to attain more and better results. Their format enables reproduction in cities across all Brazilian regions. The results attest to the efficacy of the programs implemented in these two cities. In Brasília, the initiative helped reduce the number of traffic-related deaths by 35% (2017). In the same year in the state of São Paulo, 7,600 deaths were avoided. Both programs are innovative public policies that deal with health issues caused by the external agents that ultimately account for the rapid increase in days lost to disability. Prevention of external causes of deaths and injuries, such as traffic violence, strongly correlates with changes in habits and actions, especially excessive consumption of alcohol, and with NCDs in Brazil.

This paper was also presented at the WHO 2017 Global Conference in Montevideo, Uruguay.

Economic and programmatic transitions are changing the global health landscape profoundly. A cohort of countries that have historically relied on development assistance for health (DAH) is transitioning into higher-income status. At the same time, countries that have provided DAH are shifting focus away from traditional development assistance in favor of investments focused on value for money and global public goods. In response, processes are underway to transition countries out of traditional bilateral and multilateral health funding mechanisms, and countries are expected to spend more of their own resources on health systems. In this changing landscape, the global health community is exploring innovative, coordinated, and sustainable solutions to support countries and maintain health gains during and after transitions. To explore how public-private partnerships can ease transitions and offer sustainable solutions, the Forum on Public-Private Partnerships for Global Health and Safety held a workshop, planned by an ad hoc expert committee, on June 13-14, 2018 to examine these transitions and innovative models for sustainable solutions in the current global health context.

This paper was also presented at the U.S. National Academies of Sciences, Engineering, and Medicine Forum on PPP for Global Health and Safety in June of 2018 in Washington, DC.

This study will evaluate effects of a multi-component, population-level intervention on alcohol use and related harms in six intervention cities relative to six matched comparison cities. The trial is expected to expand to nine intervention and nine comparison cities in 2018. Intervention components include screening and brief interventions by health providers, other evidence-based interventions (e.g., enforcement of drink-driving or underage drinking laws), and novel or partially tested interventions that warrant further evaluation. Key outcomes of interest include alcohol-related harms such as alcohol-related motor vehicle crashes and fatalities, heavy/binge drinking, underage drinking, and drinking and driving.

Multiple years of pre- and post-intervention survey data will be collected from cross-sectional samples of adults and youth in each city to assess intervention effects on harmful alcohol use. Multiple years of archival data will also be collected from each city to assess intervention effects on alcohol-related harms such as motor vehicle crashes and fatalities, violence and unintentional injuries. Multi-level analyses will be conducted with data for the total sample of 18 cities and for each pair of cities to determine whether the overall goal of reducing harmful alcohol use by at least 10% is achieved.

Evaluations of drink-driving crash interventions and crash burden in middle-income countries often rely on assumptions supported by data from the United States. We described crashes using pooled survey data across 2 Chinese agricultural cities in the 600,000 population range and then assessed comparability of selected crash characteristics to those in the United States.

We conducted household interviews on drinking and related harms with representative samples of 1,500 people aged 18 and over in both Jiangshan and Lanxi, China. Near the end of the survey, 2,962 people responded to questions about motor vehicle crashes during the past year. We report survey data weighted to match the population demographically.

Across the 2 cities, 28% of adults were licensed drivers and 24% drove a motorized vehicle. Fifty-three respondents (unweighted) reported that they personally were involved in at least one crash in the past year. Among these, 32% (weighted) were driving a car, truck, or bus; 7.5% were driving a motorcycle; 9.5% were pedalcyclists; 17% were pedestrians; and 34% were passengers. Of the crashes, 42% involved just one motorized vehicle. Most crashes (62%) occurred in broad daylight, followed by at dawn or dusk (19%) and at night (19%). Only 4% were single-vehicle nighttime crashes. Someone was injured or killed in 22% of crashes. Respondents thought it likely that at least one driver was drinking alcohol in 21% of the crashes and thought it unlikely in 51%; the remaining 28% were unsure whether anyone was drinking or refused this question. Alcohol involvement was similar in injury and no-injury crashes. Respondents thought a driver had been drinking in 24% of daytime crashes, 34% of crashes at dawn or dusk, and 36% of nighttime crashes. All 3 crashes involving an alcohol-involved pedestrian or pedalcyclist also included an alcohol-involved driver. Respondents said that 40% of the crashes were reported to the police and 40% were not reported; the remaining 20% of respondents did not know whether anyone reported their crash. Among crashes where reporting status was known, all crashes with injuries were reported.

Compared to published data, crash rates are similar among licensed drivers in the United States and these Chinese cities. The percentage of crashes that involved injury did not differ significantly between the 2 countries. Injury crashes were well reported in both. Crashes involving property damage only were significantly less likely to be reported to the police in the Chinese cities. Alcohol involvement rates in crashes were similar. Although our crash sample was small, some crash parameters appear to be transferable between these 2 countries.

The purpose of this study is to develop and implement a community-based prevention initiative to prevent youth alcohol use and abuse in Zacatecas, Mexico.

This article discusses the place of the alcohol industry in reducing harmful alcohol use. Specifically, AB InBev, the world’s largest producer of beer, launched its four ‘drinking goals’ 2015-2015 which aim to reduce the harmful use of alcohol. Is noted that the nature and potential impact of these goals are of paramount concern for global public health. The goals are: (1) Ensure no- (ABV: 0.0–0.5%) or lower- (ABV: 0.51–3.5%) alcohol beer products represent at least 20% of AB InBev’s global beer volume by end 2025; (2) place a guidance label on all products by 2020; (3) pilot cities to reduce harmful alcohol use by 10% by 2020 and (4) influence social norms and individual behaviors to reduce harmful use of alcohol by 2025.

Alcohol use is a major contributor to the burden of gastrointestinal disease. WHO’s global strategy to reduce harmful use of alcohol encourages the alcohol industry to contribute to this effort. However, evidence that alcohol producers have contributed to the reduction of harmful use of alcohol is scarce. Reduction of alcoholic strength of beer has been proposed and initiated as one potential way forward. We examine the evidence base for the success of such an initiative. Direct evidence from natural experiments or other controlled studies is scarce. We identified three potential mechanisms for how reduction of alcoholic strength could affect harmful use of alcohol: by current drinkers replacing standard alcoholic beverages with similar beverages of lower alcoholic strength, without increasing the quantity of liquid consumed; by current drinkers switching to no alcohol alternatives for part of the time, thereby reducing their average amount of ethanol consumed; and by initiating alcohol use in current abstainers. The first mechanism seems to be the most promising to potentially reduce harm, but much will depend on actual implementation, and only an independent assessment will be able to identify effects on harmful drinking. The potential of alcoholic strength reduction is independent of initiation by law or by self-initiative of the industry.

Background: Public sector bodies have called for policies and programmes to shift collective social norms in disfavour of the harmful use of alcohol. This article aims to identify and summarize the evidence and propose how policies and programmes to shift social norms could be implemented and evaluated. Design: Review of reviews for all years to July 2017. Data sources: Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Joanna Briggs Institute EBP, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register and Epub Ahead of Print databases. Eligibility: All reviews, without language or date restrictions resulting from combining the terms ((review or literature review or review literature or data pooling or comparative study or systematic review or meta-analysis or pooled analysis) and (social norms or culture) and (alcohol drinking)). Results: Two relevant reviews were identified. One review of community-based interventions found one study that demonstrated small changes in parental disapproval of under-age drinking. One review stressed that collective social norms about drinking are malleable and not uniform in any one country. Three factors are proposed to inform programmes: provide information about the consequences of the harmful use of alcohol, and their causes and distribution; act on groups, not individuals; and strengthen environmental laws, regulations and approaches. Conclusions: Purposeful policies and programmes could be implemented to change collective social norms in disfavour of the harmful use of alcohol; they should be evidence-based and fully evaluated for their impact

Background: The World Health Organization global strategy on alcohol called for municipal policies to reduce the harmful use of alcohol. Yet, there is limited evidence that documents the impact of city-level alcohol policies. Methods: Review of reviews for all years to July 2017. Searches on OVID Medline, Healthstar, Embase, PsycINFO, AMED, Social Work Abstracts, CAB Abstracts, Mental Measurements Yearbook, Health and Psychosocial Instruments, International Pharmaceutical Abstracts, International Political Science Abstracts, NASW Clinical Register, and Epub Ahead of Print databases. All reviews that address adults, without language or date restrictions resulting from combining the terms (“review” or “literature review” or “review literature” or “data pooling” or “comparative study” or “systematic review” or “meta-analysis” or “pooled analysis”), and “alcohol”, and “intervention” and (“municipal” or “city” or “community”). Results: Five relevant reviews were identified. Studies in the reviews were all from high income countries and focussed on the acute consequences of drinking, usually with one target intervention, commonly bars, media, or drink-driving. No studies in the reviews reported the impact of comprehensive city-based action. One community cluster randomized controlled trial in Australia, published after the reviews, failed to find convincing evidence of an impact of community-based interventions in reducing adult harmful use of alcohol. Conclusions: To date, with one exception, the impact of adult-oriented comprehensive community and municipal action to reduce the harmful use of alcohol has not been studied. The one exception failed to find a convincing effect. We conclude with recommendations for closing this evidence gap.