Gender and the WHO Global Alcohol Action Plan

In late August, DruGS team members David Moore and Suzanne Fraser made a submission, along with colleagues Helen Keane, kylie valentine and Kate Seear, to the World Health Organization’s web-based consultation on its ‘Global Alcohol Action Plan 2022-2030’. The submission addressed a specific aspect of the Plan – namely its treatment of gender – and our concerns and recommendations are summarised below.

1. The targeting of women

The recommendation that drinking be prevented ‘among pregnant women and women of childbearing age’ (p. 17, emphasis added) requires critical scrutiny. The singling out of the majority of women for special attention and restrictions is starkly inconsistent with data cited elsewhere in the Plan. These data suggest that if any gender should be the target of specific policy attention and initiatives, it is men.

In addition, the targeting of ‘women of childbearing age’ reduces women to their reproductive capacity, devalues and restricts women’s personhood, is consistent with long and oppressive traditions that seek to control women’s bodies as if they are public property, and erases the many women who choose not to bear children, or indeed cannot become pregnant, reinforcing socially harmful stereotypes about women – the very same stereotypes known to be associated with intimate partner violence, a key concern of the Plan.

The Plan’s very limited approach to gender is also evident in the failure to consider issues pertaining to non-binary, trans and gender diverse populations, and to acknowledge their needs and interests.

2. Alcohol and violence

Another related focus of the Plan in need of attention is its treatment of alcohol and violence (see pp. 3, 11, 17, 26). A recent review of the ‘history and current state of interpersonal violence research and prevention’, which cites WHO and UN global estimates, notes that ‘[m]en are overwhelmingly more likely than women to be both perpetrators and victims of interpersonal violence’. If the relationship between ‘harmful alcohol use’ and violence is to be genuinely addressed by the Plan, men’s drinking (as well as masculinities in general) should be a prime focus of specific policy attention and initiatives.

The reluctance to identify masculinities and men’s drinking is at odds with the Plan’s willingness to identify other specific population or sub-population groups as requiring specific attention.

3. Addressing male gender

Taking a broader view, based on these and other issues in the Plan, we question why male gender has been overlooked. For example, in relation to violence, if reducing the availability of alcohol is an effective means of reducing violence, and men are primarily responsible for this violence, should men’s access to alcohol be limited? Such a policy might appear sweeping, but it would be consistent with the ‘evidence base’, and, as noted above, with alcohol policy’s willingness to single out other specific ‘priority groups’ for special attention and restrictions.

4. Taking gender seriously in health research and policy

In recent years, calls to take gender more seriously in health research and policy, and in alcohol research and policy specifically, have grown. Recognising that gender is not a neutral binary but is embedded in material conditions and social relations would also generate insights into broader questions such as the unequal distribution of alcohol-related harm.

Suitable tools to allow such steps remain to be developed and implemented, however. Investment in resourcing the development and implementation of gender-sensitive quantitative tools would allow for the systematic integration of gender (not just ‘women’) into alcohol policy, and the tracking of gendered effects when alcohol policy choices are made.

Future policy should recognise that alcohol consumption and related harm are heavily gendered, and that existing research makes clear that much more policy attention needs to be paid to men if harms are to be tackled meaningfully. Although this insight is not new in the social sciences, it is strikingly absent from contemporary policy discourse and legal debates on alcohol. Unless the issues most directly associated with male drinking are addressed, little or no lasting progress will be made in reducing alcohol-related harm.

The full submission can be found here.