Alcohol now a major global health concern

It is midday on Friday, May 16 and a group of young men are sitting on a wooden bench outside a shack on the northern fringes of Kiambu town.

Most are engaged in rowdy conversations in the din of blaring folk music, but one of them seems deeply engrossed in some sort of a soliloquy, completely unaware of the world around him.

Impulsively, he fumbles for his tiny cupful of alcohol on the dirty stool in front him.

Inside, more young men line the rusty-brown, metal-sheet walls of this dimly lit dive, one of the many drinking dens whose patrons died just a fortnight ago after consuming adulterated alcohol. But, today, an improbable “normal” prevails here.

One of the revellers, who only identifies himself as Gachoka, explains why: all the poisonous alcohol was poured! He saw it happen on national TV and there can’t be any left. “After all,” he poses, “does it mean that people will stop drinking because a few bottles killed a few people?”

It is this freewheeling with alcohol that is causing concern among health experts. The World Health Organisation earlier this month warned that alcohol was killing more people than the top three worst rated killer diseases of modern times; one person every ten seconds, or 3.3 million people annually. This is equivalent to 5.9 per cent of global deaths — 7.6 per cent for men and 4.0 per cent for women.

MULTITUDE OF DISEASES

In its Global Status Report on Alcohol and Health 2014, the organisation notes that alcohol not only leads to drink-driving, alcohol-induced violence and abuse and injuries, but also to a multitude of diseases and disorders that cause one in every 20 deaths globally, annually.

Alcohol has been associated with more than 200 health conditions, including liver cirrhosis, tuberculosis, pneumonia, pancreatitis and most of the cancers. Previous WHO studies have found a link between heavy drinkers and liver, throat, colon, oral and esophageal cancers as well.

That heavy drinking mainly occurs between Friday and Sunday evenings, when, according to the WHO, about 16 per cent of drinkers worldwide “engage in weekly heavy episodic drinking”. These are the average weekend drinkers who will not touch a tot on weekdays, but who will wait until the weekend to pub-crawl and get knocked flat out.

The WHO reports that the total alcohol per capita consumption, in litres of pure alcohol, for Kenyan drinkers aged 15 and above stood at 22.8 litres for males and 9.6 litres for females. This, when compared to the global average of 6.2 litres, shows how enamoured with the momentary high Kenya has become.

Yet Kenya has numerous policy responses that ought to have ended this problem. The country, though having a written national policy and action plan that dictate, for instance, the legal minimum age for off-premise sales, restrictions for on- and off-premise sales of alcoholic beverages in terms of hours, and the recently tightened national maximum legal blood alcohol concentration (BAC) when driving, is held back by monitoring systems.

But John Mututho, the National Authority for Campaign Against Alcohol and Drug Abuse (Nacada) chairman, says everybody — from the local authorities to the Kenya Bureau of Standards (Kebs), to the police and, ultimately, his office — is culpable.

“The main body charged with ensuring the soundness of all the brews sold anywhere in Kenya is Kebs, which needs to ascertain the quality of what is being manufactured by brewers before we can license them,” says Mututho. “The police and local administration are supposed to provide intelligence on the manufacturing and distribution of maleficent liquor. This is not a one-man show.”

Not a one-man show, true, but, according to the Consumers Federation of Kenya (Cofek), all these bodies regulating alcohol production, distribution and consumption in the country could actually be the problem.

When nearly 100 people died after consuming illicit brews earlier this month, Cofek accused Nacada of failing in its mandate by conspiring with the Parliament “through unrealistic, moralistic over-legislation” to strangle the industry.

According to Cofek, Nacada lacks the capacity and has inadequate policy to make any impact in the industry. “This problem is big; there is need for unified approach. The biggest problem we are facing with the agencies is the silo management syndrome where every agency seems to try to be locking out others yet they share overlapping mandates. This is not cost-effective yet the financial and technical resources like labs could have been easily shared,” argues the consumer lobby.

James Gichuru Kariuki, a lecturer of sociology at the University of Nairobi and a consultant researcher, says that, although difficult to express in monetary terms, alcoholism has a greater impact on human resources than previously thought.

“It deters investment for families headed by habitual drunks because it affects individual and household decision-making in ways that have a negative impact on economic productivity and growth,” he says.

His views are corroborated by the WHO, which says it fears that the problem could massively impact developing countries where health facilities and systems are weaker, and where chronic diseases related to alcohol could cause further impoverishment.

That, Mr Kariuki warns, is already happening in Kenya, where the society has embraced a sub-culture of deviant drinking and attached heroic labels on heavy drinkers.