Given the debilitating effects the abuse of alcohol has on the country’s economy, health and social services, Minister of Health Dr Leslie Ramsammy said there is need for higher taxation on alcohol products and called for a national effort to address the abuse of the substance, which results myriad social ills.
“…I would forever want to be on record as asking for even more taxes [on alcohol products] and this is the balance we make between looking at health and looking at economic concerns,” the minister told Stabroek News in a recent interview.
Ramsammy described higher taxation on alcohol products as a “trouble area” since high taxes are already being paid on such products.
This call by the minister follows last May’s consensus for the first time by all the delegates from all 193 member states of World Health Organisation (WHO) at annual assembly on a resolution to confront the harmful use of alcohol. A release from WHO had stated that every year the harmful use of alcohol kills 2.5 million people, including 320,000 young people between 15 and 29 years old. The global organisation listed alcohol as the eighth leading risk factor for deaths globally, and harmful use of alcohol was responsible for almost 4% of all deaths in the world, according to the estimates for 2004. The health ministers, at the assembly held in Geneva, Switzerland agreed to try to curb binge drinking and other growing forms of excessive alcohol use through higher taxes on alcoholic drinks and tighter marketing regulations.
According to the WHO, the ten main policy recommendations of the global strategy to reduce the harmful use of alcohol while adopted by all the countries are not binding but rather serve as guidance to the member states.
Very affordable
A very passionate Ramsammy told Stabroek News that while companies which produce alcoholic beverages would always argue that their products are already heavily taxed, it was up to the Ministry of Finance to balance such concerns with health concerns.
“This is a constant thing that we have to address, the resolution at the World Health Assembly called for higher taxes, Guyana and the Caribbean are not among the highest taxed but we are kind of in the middle so we are not also on the lower side and the question is how far more do we go,” the minister said.
He said from public health approach he would say that higher taxes should be imposed but his colleagues from the private sector would have huge disagreements with him and that he understood.
“But I think that we need more. I think that in spite of the taxes, alcohol is still a very affordable thing in Guyana, and that is the issue. It is too affordable. We need to make it less affordable,” he pointed out.
The minister said he does not subscribe to the argument by some that imposing more taxation will make it more difficult for “poor people who need it, even if it is more harsh on poor people in this case it is a good thing for poor people, I believe that. I believe that we don’t need alcohol to have fun.
“I think that we don’t need alcohol and if we make it such that it is not affordable to poor people then so much the better because that little money that they are spending now is going to go for some useful purpose,” the minister said.
In response to the argument that those who could not afford it would resort to ‘bush rum’ (moonshine), the minister said measures needed to be put in place to ensure this did not happen and while that would not be an easy task it has to be done.
Partnerships
Meanwhile, Ramsammy said his ministry is in partnership with other ministries: Education, Culture, Youth and Sport, Labour, Human Services and Social Security and Home Affairs, to increase public awareness of the harmful effects of alcohol abuse.
He said his ministry has been working with the Ministry of Labour to develop work place programmes to monitor workers. In the case of the Education Ministry, it is working with children. Part of the work for the training of the police officers is being done by the Health Ministry, Ramsammy said.
He said his ministry has included the issue in its adolescent health programme and at every public activity held by the ministry there would be engagements with members of the public on the issue.
Additionally, the minister said it is working with the Caribbean Brewery Association, whose membership includes Guyanese companies, as it is important that they be engaged in the issue in terms of responsibility to the community. And it is expected that local companies involved in the alcohol business will come together in a campaign to promote responsible alcohol use. Among the initiatives to be undertaken, the minister said, is the placing of advertisements in the local media. This follows a similar campaign that was launched by companies in Trinidad earlier this year.
“They will be talking about underage drinking, they will be doing things like ‘don’t drink and drive’, all of these things that are usually are done by us and it is a major cost for us. So if the manufacturers and major suppliers will take on those responsibilities then that will save us some money,” the minister said.
However, the minister said, the work would have to done under the watch of his ministry as “we don’t want them in the guise of talking about these things also promoting the use…
“We don’t want people to say when they put an ad saying don’t drink and drive that it is okay to drink like a duck when you are home or when you are not driving. So we have to be careful that this is a partnership with us and that the message is genuine…” the minister said.
Demerara Distillers Ltd (DDL) had launched a one-off media campaign on the issue some time last year, but it is not clear what impact, if any, it had on changing the way people drink alcohol.
Rehabilitation
And while it is important to focus on preventing persons from abusing the legal liquid, the minister that focus must also be placed on those who are already hooked and his ministry has been training persons around the country to become counsellors for persons who not only abuse alcohol but for substance abusers in general.
However, the minister admitted that there are not enough trained persons as there is need for such personnel in every community, something the government alone cannot do. He said the government has a hard enough time dealing with dengue, malaria, and diabetes among other diseases and to take on a social issue of alcohol abuse is going to be an overwhelming task.
“We accept responsibility that we have to lead this process, but we cannot deliver this as a service in every community,” the minister said adding that the churches, NGOs and other social groups can contribute but they must do this with trained personnel.
He said his ministry will ensure that there is at least one government non-residential rehabilitation centre in each region and he revealed that such centres are expected to be established shortly in Linden, West Demerara and Region Two. Such centres already exist at the New Amsterdam Hospital, Angoy’s Avenue and Skeldon. The most successful of them all is the one at the Georgetown Public Hospital (GPH).
“We need that programme across the country in every community because it is unlikely that somebody from Enmore or from Dem Amstel will come to Georgetown [for help],” the minister said.
The minister said what is needed is more residential substance abuse rehabilitation centres as the few in Guyana serving only a small section of society are not free. He said the non residential centres would not help someone who already has a “major, major” problem with alcohol abuse as they would need residential service.
“We need a much bigger effort with the residential service, and that is what I am struggling with, trying to find how we can put that in place. But my goal, my target is to have such a centre before the end of this year…,” the minister said even though he later admitted that such a centre may become a reality sometime next year.
Harmful drinking is also a major avoidable risk factor for non-communicable diseases, in particular cardiovascular diseases, cirrhosis of the liver and various cancers. It is also associated with various infectious diseases like HIV and TB, as well as road traffic accidents, violence and suicides.
