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Keywords:

  • Brazil;
  • drinking and driving;
  • drunk driving laws;
  • South America

In their paper on drinking and driving, Pechansky & Chandran [1] argue that limited knowledge of the extent of this risky behaviour and its consequences might help to explain the lack or inadequacy of policies and strategies to address the problem in southern America compared to North American countries. In order to address this gap they propose improvements in data collection, passage of drinking and driving laws, where such laws do not exist, and better enforcement of the laws.

These are essential strategies in a broad and systematic policy response aimed at reducing the health burden attributable to road traffic accidents. However, it seems that in the case of Brazil, the problem is not so much the lack of data or laws but lapses in the enforcement of existing laws. Even with an unsatisfactory situation (as illustrated in the vignette), Brazil is already ahead of many developing countries, especially most countries in the African region, where alcohol policies have not been developed and implemented (although discussions are currently taking place in a few of these countries). It is noteworthy, too, that even where, as in Kenya, a national Alcoholic Drinks Control Act has been passed recently, no provision was made for the control of drunk driving, including specifying the limit of blood alcohol concentration for drivers [2].

However, there is good reason to be concerned. Compared to South America, African countries report very high levels of abstention from drinking; however, the average quantity consumed by drinkers per year is higher than in all regions [3], the rate of weekly heavy episodic drinking is more than double the global rate (three times more among female drinkers) and the pattern of drinking is of moderate to high risk, all of which support the ‘all-or-nothing’ drinking pattern or habitual drinking to intoxication reported in several studies [4,5]. It is not surprising, therefore, that the major contributor to alcohol-attributable disease burden in subSaharan Africa is unintentional injuries, especially from road traffic accidents [6]. In a region currently experiencing the positive and negative impacts of globalization and rapid economic growth, and where alcohol producers are poised to increase their market shares through unrestrained marketing and promotion and undue influence on policy [7], the problem will worsen without appropriate responses.

The place to begin, as suggested by Pechansky & Chandran, is in better understanding of the problem through research and monitoring activities. In this regard, the growing interest in alcohol's harms to others among alcohol epidemiologists might help to focus the attention of national policy makers on road traffic accidents in these countries. Much is expected from this emerging research tradition, but there is already good evidence from studies in developed societies which show that high rates (up to 40% in New Zealand) of crash injuries are suffered by people who were not drinking [8]. That a significantly high proportion of the health and economic burden associated with drunk-driving accidents is borne by innocent passengers or pedestrians should be a sober reminder to policy makers in developing countries that the victim of drunk driving can be anyone.

In subSaharan Africa the fundamental policy challenge is recognizing that a problem exists, and that the problem is amenable to effective interventions. There is reason for optimism: the global and regional strategies to reduce harmful use of alcohol developed by the World Health Organization (WHO) have led at least to serious discussions of policy strategies in many African countries, and the involvement of international non-governmental organizations in training on evidence-based policy has helped to focus the attention of experts and policymakers on what works [9]. The gap between countries in how they respond to drinking and driving problems will remain for a long time but any country, whether in Africa or South America, can benefit from available knowledge on policy effectiveness as long as the realities of their particular contexts are always kept in view.

References

  1. Top of page
  2. Declaration of interests
  3. References
  • 1
    Pechansky F., Chandran A. Why don't northern American solutions to drinking and driving work in southern America? Addiction 2012; 107: 12016.
  • 2
    Republic of Kenya. The Alcoholic Drinks Control Act, 2010. Kenya Gazette Supplement, Nairobi, 30 August 2010. 2010.
  • 3
    World Health Organization. Global Status Report on Alcohol and Health. Geneva: WHO; 2010.
  • 4
    Partanen J. Abstinence in Africa. In: Maula J., Tigerstedt C., editors. Alcohol in Developing Countries. Helsinki: Nordic Council for Alcohol and Drug Research; 1990, p. 7085.
  • 5
    Obot I. S. Drinking Behaviour and Attitudes in Nigeria: A General Population Survey. CDS Monograph. Jos, Nigeria: University of Jos; 1993.
  • 6
    Roerecke M., Obot I. S., Patra J., Rehm J. Volume of alcohol consumption, patterns of drinking and burden of disease in sub-Saharan Africa, 2002. Afr J Drug Alcohol Stud 2008; 7: 116.
  • 7
    Bakke O., Endal D. Vested interests in addiction research and policy, alcohol policies out of context: drinks industry supplanting government role in alcohol policies in subSaharan Africa. Addiction 2010; 105: 228.
  • 8
    Connor J., Casswell S. The burden of road trauma due to other people's drinking. Accid Anal Prev 2009; 41: 1099103.
  • 9
    Wengen A. Training programme for evidence-based alcohol policies in developing countries. Afr J Drug Alcohol Stud 2009; 8: 8991.