By Connie Hoe (Johns Hopkins Bloomberg School of Public Health)
Background
Road traffic injuries are a major public health problem and the leading killer of children and young adults around the world. One of the key risk factors is drinking and driving. This is because alcohol impairment leads to poor judgement, increased reaction time, lowered vigilance and weakened eye muscle coordination; all abilities necessary for an individual to safely operate a vehicle.
In 2012, the world’s leading beer, wine and spirit producers collectively vowed to continue their efforts to combat harmful drinking, including the goal of reducing drinking and driving. Acknowledging the serious effects that the harmful use of alcohol can have, these producers committed themselves to supporting the World Health Organization’s Global Strategy to Reduce the Harmful Use of Alcohol as well as Target 3.6 of the United Nation’s Sustainable Development Goals to halve the number of global deaths and injuries from road-traffic crashes.
Good corporate citizenship? Or a wolf in sheep’s clothing?
Our study showed that while the alcohol industry acknowledges that drinking and driving is an issue of concern, it usually promotes solutions that are not aligned with public health evidence-based recommendations and would limit impact on sales, while allowing the industry to maintain its reputation as a good corporate citizen. It is important to note that the majority of the most effective and cost-effective interventions for reducing alcohol-related road traffic injuries are directed at reducing the availability and sale of alcohol, either overall or to particular vulnerable groups. Public health key informants from the study explained that drinking and driving is an issue that the alcohol industry cannot outright deny and as a result it has become a public health area where the industry has been investing in, particularly in terms of its corporate social responsibility activities, to make itself look like a good corporate citizen and divert attention away from the fact that alcohol serves as a major risk factor for over 200 different health conditions. This is similar to the message “drink – but don’t drive.”
The alcohol industry accomplishes this by developing arguments to frame the issue of drink-driving. One example is that alcohol misuse is an issue of personal responsibility – a rhetoric that has also been employed by other health harming industries such as the tobacco industry. Other arguments include: the majority of drinkers are moderate and responsible, and that the alcohol industry is a legitimate stakeholder. These messages are then conveyed through the following mechanisms described below to achieve the industry’s preferred outcome:
- Coalition management
The alcohol industry presents itself as a legitimate stakeholder by partnering with public health and road safety stakeholders and participating in road safety coalitions. The industry also uses third parties such as Social Aspect Public Relations Organizations and other “astroturf” organizations (e.g. American Beverage Institute) to represent the industry during policy debates and in public and social discourse. Our study showed that partnership between the alcohol industry and public health/road safety stakeholders appeared to the enabler for all other types of involvement listed below.
- Information production and management
The alcohol industry recruits scientists to carry out research, funds research directly or through a third party, and conducts research itself. It also manages its reputation as a good corporate citizen through engaging in corporate social responsibility activities: donating breathalyzers to police departments, putting money into the road safety sector, providing training and technical assistance to government, sponsoring campaigns, and promoting activities that have high public relations visibility.
- Direct involvement in policymaking
The alcohol industry is also directly involved in the road safety policymaking process at both the global and national levels. At the global level, there is evidence to suggest that the alcohol industry is very active in its engagement with the United Nations. At the national level, industry representatives, lobbyists and other affiliates cultivate positive relationships with decision makers, setting up events to increase interactions and providing incentives, including donations to political campaigns.
- Implementation of interventions
The alcohol industry supports and carries out drink-driving interventions, which often advocates for “responsible” drinking. A study conducted in 2016 found that of the 266 alcohol industry sponsored global initiatives to reduce drink-driving, only 2 (0.08%) were consistent with evidence-based public health recommendations.
Questions for the Future
Given this scenario, we would expect an outcry from the road safety and public health communities. Unfortunately, the responses thus far have been fragmented particularly with regards to the topics of receiving funding from and partnering with the alcohol industry. Groups affiliated with the industry argued that one of the key advantages of partnering with the alcohol industry is funding since there are few funders in the area of road safety. Several of them also highlighted that they were able to maintain independence from the industry, while retaining funding. On the other hand, non-industry-affiliated public health groups asserted that there is an inherent conflict of interest between public health and the alcohol industry and funding from the industry will necessarily make recipients more susceptible to industry influence, whether they are aware of such influence. Some groups within the road safety community also separate the issue of drink driving from other alcohol problems, arguing that it goes beyond the organization’s mandate.
This raises several important questions:
- Should corporations that are promoting health harming products engage in corporate social responsibility activities, particularly when these activities help promote their products?
- Should guidelines be developed to help road safety organizations gauge when it is ethical to partner with and/or receive funding from the alcohol industry?
- In the field of tobacco control, Cohen et al identified 8 criteria that could be used by tobacco control organizations to evaluate tobacco industry funding: 1) transparency and independence, 2) competitive funding process, 3) ownership of data and freedom to publish, 4) independent research agenda, 5) governance, 6) protection against conflict of interest, 7) industry public relations gains that counteract public health and 8) feasibility
- How do we convince road safety organizations that by separating the issue of drink driving from other alcohol problems we are actually doing public health a disservice?
- And what about a Framework Convention for Alcohol Control?
Conclusion
The alcohol industry is involved in road safety despite the fact that drink driving is a key risk factor for road traffic injuries. Yet, responses from the public health and road safety communities remain fragmented. Political scientists have long argued that cohesiveness among the networks of actors concerned with a particular social issue is a key ingredient for meaningful macro-level change. Given this, there is an urgent need to raise awareness about the involvement of the alcohol industry in road safety and for the public health and road safety communities to generate consensus, rally in one voice, and build a cohesive transnational alcohol control advocacy alliance to curb injuries and deaths unnecessarily lost to drink driving.