TABLE 2.
Scoring framework for the alcohol control scorecard based on the World Health Organization Global Strategy to Reduce Harmful Use of Alcohol according to the health systems building blocks (Singapore and the Philippines, 2022) a .
| Health systems building block | World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol | Indicators | Score |
|---|---|---|---|
| Leadership and Governance (73) | Alcohol control measures must be guided and formulated by public health interests and protected from industry interference and commercial interests | Whole-of-government written code of conduct or non-interference policy (proxy indicator) | 5 |
| Area 1. Leadership, awareness, and commitment (15) | National, subnational strategies, plans of action and activities | 5 | |
| • Written national policy | |||
| • National action plan | |||
| Establishment of implementing institution or agency | 0.5 | ||
| Coordination with other relevant sectors | 5 | ||
| Access to information, effective education, and public awareness of alcohol-related harms | 2 | ||
| Raising awareness of harm to others | 2.5 | ||
| • Presence of awareness-raising activities | |||
| Area 3. Community Action | Community mobilization to prevent under-age drinking and develop alcohol-free environments | 1 | |
| • National support for community action | |||
| Area 4. Drink-driving policies and countermeasures | National minimum legal blood alcohol concentration when driving a vehicle | 1 | |
| sobriety checkpoints and random breath testing | 1 | ||
| administrative suspension of driving licences | 1 | ||
| graduated licensing for novice drivers | 1 | ||
| ignition interlocks | 1 | ||
| mandatory driver education, counselling, and treatment | 2 | ||
| availability of alternative transportation in drinking places | 1 | ||
| public awareness and information campaigns | 1 | ||
| targeted mass media campaigns (youth events, holidays) | 1 | ||
| Area 5. Availability of alcohol | Legislation to prevent illegal alcohol production | 3 | |
| • National control of production, import, sale, distribution and export (through government monopoly or through licensing) | |||
| Legislation to prevent illegal alcohol sale | 3 | ||
| Appropriate minimum age for purchase and consumption of alcohol | 2 | ||
| • National legal minimum age for on-/off-premise sales of alcoholic beverages | |||
| Prevent sales to intoxicated persons and those below legal age | 2 | ||
| • Restrictions for on−/−off premise sales of alcoholic beverages | |||
| Area 6. Marketing of alcoholic beverages (10)a | Regulatory frameworks based on legislation for alcohol marketing | 6 | |
| • Legally binding regulations on alcohol advertising (beer, wine, spirits) | |||
| • Legally binding regulations on product placement (beer, wine, spirits) | |||
| • Legally binding regulations on alcohol sponsorship (beer, wine, spirits) | |||
| • Legally binding regulations on sales promotion (beer, wine, spirits) | |||
| Development of public agencies for systems of surveillance of alcohol marketing | 2 | ||
| Administrative and deterrence systems for infringement on marketing restrictions | 2 | ||
| Area 7. Pricing policies (10) | Domestic taxation | 3 | |
| • Excise tax on beer, wine, spirits | |||
| Regular price review | 3 | ||
| • Inflation adjustment on alcohol taxes | |||
| Price measures other than taxation | 4 | ||
| • Banning of price promotions, discounts, sales below costs, flat rates for unlimited drinking and other volume sales (1) | |||
| • Minimum alcohol pricing (1) | |||
| • Price incentives for non-alcoholic beverages (1) | |||
| • Reducing subsidies to economic operators in alcohol (1) | |||
| Area 8. Reducing the negative consequences of drinking and alcohol intoxication) (7) | Regulating drinking context to minimize violence | 1 | |
| Laws against serving to intoxication and legal liabilities | 1 | ||
| Management policies on server training | 0.5 | ||
| • Systematic alcohol server training | |||
| Reducing alcoholic strength | 0.5 | ||
| Care or shelter for severely intoxicated people | 0.5 | ||
| Providing consumer information and labelling alcoholic beverages on alcohol-related harms | 3.5 | ||
| • Legally required health warning labels on alcohol advertisements and/or on alcohol containers | |||
| • Requirement to display consumer information about calories, additives, vitamins and micro-elements on the labels of alcohol containers | |||
| • Number of standard alcoholic drinks displayed on containers | |||
| • Alcohol content displayed on containers | |||
| Area 9. Reducing the public health impact of illicit alcohol and informally produced alcohol (5) | Licensing regimes on production and distribution of alcoholic beverages | 2.5 | |
| • Legislation to prevent the illegal production of alcohol (beer, wine, spirits) | |||
| • Legislation to prevent the illegal sale of alcohol (beer, wine, spirits) | |||
| Regulation on sales of informally produced alcohol | 0.5 | ||
| Control and enforcement system (tax stamps) | 0.5 | ||
| Tracking and tracing systems for illicit alcohol | 0.5 | ||
| Cooperation in combating illicit alcohol | 0.5 | ||
| Public warnings about contaminants and health threats from informal or illicit alcohol | 0.5 | ||
| Health Service Delivery (10) | Area 2. Health services’ response (9) | Increasing capacity for health and social welfare systems for prevention, treatment and care for alcohol use disorders | 2 |
| Supporting initiatives for screening and brief interventions for hazardous and harmful drinking at primary health care settings & early identification and management of harmful drinking among pregnant women | 2 | ||
| Improving capacity for prevention, identification and interventions for families and individuals living with foetal alcohol syndrome | 1 | ||
| Coordination of integrated prevention, treatment and care strategies and services for alcohol use disorders and comorbid conditions | 1 | ||
| System of registration and monitoring of alcohol-attributable mortality and morbidity with regular reporting | 1 | ||
| Culturally sensitive health and social services | 1 | ||
| Securing and enhancing availability, accessibility, and affordability of treatment services for groups of low socioeconomic status | 1 | ||
| Area 3. Community Action | Providing community care and support for affected individuals and their families | 1 | |
| Information (5) | Area 10. Monitoring and Surveillance (5) | Framework and systems for monitoring alcohol consumption, and alcohol-related harm | 2 |
| • National monitoring system for alcohol consumption | |||
| • National monitoring system for health consequences of alcohol | |||
| • National monitoring system for social consequences of alcohol | |||
| • National monitoring system for alcohol policy responses | |||
| National entity for monitoring alcohol | 0.5 | ||
| Common set of indicators for tracking harmful use of alcohol and policy responses | 0.5 | ||
| • National surveys where alcohol is specifically addressed or part of a larger international survey | |||
| Data repository based on internationally agreed indicators | 1 | ||
| Policy evaluation mechanisms | 1 | ||
| Human Resources (5) | Area 3. Community Action (5) | Rapid assessment of gaps and priority areas for intervention | 0.5 |
| Facilitating recognition of alcohol-related harms at the local level and promoting responses to local determinants | 1 | ||
| Strengthening the capacity of local authorities | 1 | ||
| Providing information on effective community-based interventions and building capacities at the community level | 1 | ||
| Developing community programs | 1.5 | ||
| Financing (4) | Mobilizing resources/funding for prevention, treatment, and rehabilitation (proxy indicators) | Mobilizing resources/funding for prevention | 2 |
| Mobilizing resources/funding for treatment | 1 | ||
| Mobilizing resources/funding for rehabilitation | 1 | ||
| Access to Essential Medicines (3) | Availability of essential medicines for alcohol use disorders and alcohol dependence (proxy indicators) | Availability of naltrexone in the national Essential Medicines List | 1 |
| Availability of acamprosate in the national Essential Medicines List | 1 | ||
| Availability of disulfiram in the national Essential Medicines List | 1 | ||
| Maximum score | 100 |
a
This scoring framework used relevant indicators from the World Health Organization Global Information System for Alcohol and Health which is a component of the World Health Organization Global Health Observatory, and the World Health Organization Global Status Report on Alcohol and Health.