Alcohol and HIV: Zimbabwe’s experience developing an alcohol

Policy

Dorcas SitholeMental Health DepartmentMinistry of Health & Child Welfare

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Background

Initial discussions began in 2008 Consultations very extensive 6 drafts have been made from six

consultative meetings Final draft agreed on end of 2011 Final Draft awaiting cabinet approval Regulations will be modified to

comply with new policy

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National alcohol policy

SUMMARY

The Zimbabwe National Alcohol Policy is a comprehensive national strategy to address and reduce the harmful use of alcohol. The Policy reaches into the health sector and beyond to engage development, transportation, justice, social welfare, agriculture, trade and commerce, education as well as employment and the community in partnerships so that the entire population can be free from alcohol related harm. 3

The Intersection of Alcohol and HIV/AIDSStigma- shame, blame and fear

Speeds up HIV diseasePromotes high risk sex

Lack of adherence to medsPoorer health-poor nutrition

Risk factor for aggressive/violence

National alcohol policy

•IMPLEMENTATION

Implementation of a comprehensive and community endorsed national policy assures availability of alcohol in the community with an appropriate level of regulation and protection of at-risk populations, particularly in the context of HIV/AIDS and society-at-large from the harmful effects of alcohol use

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Guiding Principles of the Policy

Political and Social Commitment Needed for a change in social norms

Freedom to Choose Drinking or not behavior is respected

Protection of Vulnerable Populations Such as children , pregnant women and PLHIV

Protection of At-Risk Individuals and Groups Children and adults adversely affected by harmful behavior

Community Participation Crucial to ownership and effectiveness of programs

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Guiding Principles of the Policy Inter-Sectoral Approach

Essential for harnessing strengths, advantages and different directions

Evidence-Based Based on evidence locally & internationally sourced with

sustainability

Prevention, Treatment and Care Services Services are available, accessible and affordable for those affected

Alcohol Production Manufacturers follow best practices with social & environmental

responsibility

Packaging and Consumer Information Regulations that promote legal and harm-free consumption

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POLICY AIMS and OBJECTIVES Using the Guiding Principles of the Policy the

overarching objective is to prevent and minimize all harm related to alcohol consumption. POLICY AIMS To raise awareness of the public health problems

caused by the harmful use of alcohol and the commitment of the government to reduce and prevent, where possible, the harmful use of alcohol

To mobilize all relevant parties to take appropriate and concerted action to reduce and prevent, where possible, the harmful use of alcohol

To enhance the national capacity and capability to reduce and prevent, where possible, the harmful use of alcohol

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POLICY AIMS (continued)

To strengthen the knowledge base through coordinated public education programs along with effective interventions to reduce and prevent the harmful use of alcohol

To implement evidence based interventions addressing:▪ Incidence of intoxication and use by at –risk and vulnerable

groups and populations▪ Education and information dissemination to health care

providers▪ Evidence-based prevention and treatment▪ Promoting public safety by reducing drink-driving and other

alcohol-related social disorders, ▪ Regulation of production , promotion and marketing of

alcohol products▪ Prison programming and the criminal justice system▪ Addressing underage drinking

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POLICY Priorities and Target Areas Related to Alcohol and HIV/AIDS

COMMUNITY ACTION AND EDUCATIONPolicy Interventions Develop public education campaign Initiate & support specific programs e.g. youth and

workplace Develop local capacity for community action programs Develop school curricula on prevention and treatment

HEATH SERVICES RESPONSEPolicy Interventions Increase capacity of health and social welfare system

to deliver prevention , care and treatment for alcohol use disorders

Develop health education for at-risk and vulnerable populations

Health education for health care/security forces /criminal justice

Develop health referrals between hospitals and specialists

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POLICY Priorities and Target Areas related to Alcohol and HIV/AIDS

AT-RISK POPULATIONSPolicy Interventions Rigorously enforce under age drinking legislation Develop educational materials specific for at –risk groups Target outreach & counseling services for at-risk & vulnerable

groups Educate women of child bearing age about alcohol harm

REDUCING ILLEGAL AND INFORMAL ALCOHOLPolicy Interventions Develop legislation on informal alcohol Ensure quality and purity standards on commercial non-licit

products Develop an education program on the harm of informal /illicit

alcohol Develop tracking and shipping systems with border surveillance

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National alcohol policy

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IMPLEMENTATION• Success will require action by government to engage all relevant

stakeholders on the guiding principles of the National Alcohol Policy as well as the policy priorities and target areas of the policy.

• Sustained political commitment, • effective co-ordination , • appropriate engagement of all stakeholders

• Critical to the success of the National Alcohol Policy are:• Dissemination, communication and promotion of the

National Alcohol Policy to key stakeholders • Building partnerships, including partnerships among

government, industry and the community• Coordination of activities and outcomes through strategic

planning• Monitoring and Evaluation of the policy and it’s

implementation • A National Alcohol Action plan with annual reporting

National alcohol policy and HIV/AIDS

Where are we now?Under review by the Cabinet MinistersUpon approval sign by the PresidentPre-launch meeting with stakeholders including the HIV communityPolicy launch with initial implementation focused on community based services integrated with ongoing HIV/AIDS services

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Acknowledgments

Government of Zimbabwe Government ministries and departments Health Advisory office Municipalities

Zimbabwe stakeholders Private companies, health professions

councils, AA WHO country office USG

DHHS/SAMHSA CDC Zimbabwe

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Thank youSiyabonga

Tatenda

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