Safeguarding public health: managing conflict of interest and interference in alcohol policy to support the SAFER implementation

Safeguarding public health: managing conflict of interest and interference in alcohol policy to support the SAFER implementation
Safeguarding public health: managing conflict of interest and interference in alcohol policy to support the SAFER implementation

Join us on Thursday 19 May, at 10:00 am (EDT) and attend the webinar "Safeguarding public health: managing conflict of interest and interference in alcohol policy to support the SAFER implementation", organized jointly by PAHO, WHO/EURO and Vital Strategies.

The objective of this webinar is to support decision-makers who protect effective alcohol regulations by raising awareness of conflicts of interests, summarizing the current evidence on interference from the alcohol industry in public health policy as well as discuss best practices. We will describe the fundamental conflict of interest that exists between the alcohol industry’s objectives and public health purposes and bring clear and current examples of the way this involvement unfolds and the consequences for public health. In addition, the webinar will outline actions to avoid and manage conflicts of interests and interference by drawing from examples of similar fields.

The webinar is aimed to policy makers, researchers and alcohol policy advocates, as well to the general public interested on the topic. 

How to participate




The harms associated with alcohol consumption are a monumental public health problem, contributing considerably to injuries, diseases, and death. Alcohol consumption is the leading risk factor for premature mortality and disability among people 15-49 years-old, with 10%of deaths among this age group being attributable to alcohol (1). The WHO European Region and the Americas are the two regions with the highest alcohol per capita consumption levels and highest contribution of alcohol to all-cause mortality.  The impact of the COVID-19 pandemic on alcohol use indicates a mixed picture where alcohol use seems to have decreased in many countries (the USA is one exception), but intensified in some population groups (those with a history of problematic alcohol use and poor mental health) (2-5) .

Effective alcohol policies are well-known, including mainly populational level strategies addressing the overall populational alcohol consumption.  SAFER is an acronym for a WHO-led initiative and technical package of five high-impact alcohol policy interventions that can help governments prevent and reduce alcohol harm and related health, social and economic consequences. The five SAFER interventions are based on accumulated evidence of their impact on population health and their cost-effectiveness:

  • Strengthen restrictions on alcohol availability
  • Advance and enforce drink-driving countermeasures
  • Facilitate access to screening, brief interventions and treatment
  • Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion
  • Raise prices on alcohol through excise taxes and other pricing policies

The SAFER initiative was launched in 2018 by the WHO, PAHO, and partners to provide support for Member States in reducing the harm due to alcohol consumption. Among its key principles, the SAFER initiative indicates the need to monitor and evaluate the impact of these interventions as well as to protect public health from the alcohol industry’s conflict of interest (COI) and interference in policy making.

A COI refers to “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary or a competing interest” (6). COI can exist at all levels – global, regional, and national – in academia and policymaking bodies, in institutions, and among individuals. Examples include appointments on influential boards, imbalance of stakeholder representation during decision making, alcohol industry corporate social responsibility programs done in partnership with governments or non-governmental organizations (NGOs), donations to campaign financing. Relationships including COIs may open the door for long-term connections with public health stakeholders. Conflicts of interests among researchers have been challenging to discuss; recent studies shed light on the related issues (7-9). An interference in public health refers to strategies employed by corporate companies to shape, influence, and block progress on health interventions and policies.  Examples include influencing science by producing or promoting junk research studies, challenging existing published research to muddy the waters (such as questioning the link of alcohol and cancer), threatening job/economic overwhelming losses (if effective alcohol policies are put in place), promoting self-regulation/voluntary marketing guidelines (which scientific evidence already found not to work), disputing existing regulation (as in the case of the World Soccer Cup in Brazil) (10), lobbying policymakers to make it harder to pass public health regulations, threatening governments with litigation if specific alcohol policies are endorsed.

Member States, advocates, and public health experts have identified the influence and interference of the alcohol industry on policymaking as one of the greatest barriers to the implementation of effective control policies within government and across sectors. As a result, the development and adoption of alcohol policies have been uneven throughout the world. The reasons why the involvement of the alcohol economic sector in public health policies represents an inherent risk of conflict of interest as well as the several forms in which the alcohol industry interference occurs is, at times, unrecognized or considered inevitable by policymakers and governments.


Moderator – Adam Karpati, Senior Vice President, Public Health Programs, Vital Strategies 

  • SAFER implementation: why conflicts of interest and interference matter?  
    • Maristela Monteiro, Senior Advisor on Alcohol at the Pan American Health Organization  
  • The involvement of the alcohol industry in research: findings from new studies on conflicts of interest
    • Jim McCambridge, Chair in Addictive Behaviours and Public Health, University of York, United Kingdom. 
  • The insidious presence of harmful industries and lessons for countering them  
    • Nandita Murukutla, Ph.D. Vice president, Global Policy and Research, Policy Advocacy and Communication, Vital Strategies. 
  • A tool to support Member-States in their decision-making on engaging with private sector entities for the prevention and control of noncommunicable diseases  
    • Katia Pinho, Technical Officer, Partnerships, Global Coordination Mechanism on the Prevention and Control of NCDs, Global NCD Platform Department, World Health Organization 
  • Resistance from below: the I-Mark movement; supporting communities free from alcohol industry influence
    • Paula Leonard, National Lead for Community Action on Alcohol, Irish Community Action on Alcohol Network and Alcohol Forum Irelanda. 
  • Questions and Answers
    • Moderated by Adam Karpati 
  • Closing and main takeaways
    • Carina Ferreira-Borges, Acting Director Noncommunicable diseases, WHO Regional Office for Europe, World Health Organization 


Time correspondence

  •  7:00 am.– Los Angeles, Vancouver
  •  8:00 am. – Belmopan, Guatemala City,  Managua, San Jose (CR), San Salvador, Tegucigalpa
  •  9:00 am. – Bogota, Mexico City, Panamá City, Kingston, Lima, Quito
  • 10:00 am. – Asunción, Bridgetown, Caracas, Castries, Georgetown, Havana, La Paz, Nassau, Ottawa, Port-au-Prince, Port of Spain, San Juan, Santiago, Santo Domingo, Washington DC 
  • 11:00 am  –  Buenos Aires, Brasilia, Montevideo, Paramaribo
  •  4:00 pm. – Geneve, Madrid

For other cities, check the local time in the following link.



  1. GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018 Dec;5(12):987-1012. doi: 10.1016/S2215-0366(18)30337-7. Epub 2018 Nov 1.
  2. Sohi I, Chrystoja BR, Rehm J, Wells S, Monteiro M, Ali S, Shield KD. Changes in alcohol use during the COVID-19 pandemic and previous pandemics: A systematic review. Alcohol Clin Exp Res. 2022 Apr;46(4):498-513. doi: 10.1111/acer.14792. Epub 2022 Apr 12. PMID: 35412673.
  3. Kilian C, O'Donnell A, Potapova N, López-Pelayo H, Schulte B, Miquel L, Paniello Castillo B, Schmidt CS, Gual A, Rehm J, Manthey J. Changes in alcohol use during the COVID-19 pandemic in Europe: A meta-analysis of observational studies. Drug Alcohol Rev. 2022 Feb 20. doi: 10.1111/dar.13446. Epub ahead of print. PMID: 35187739.
  4. Capasso A, Jones AM, Ali SH, Foreman J, Tozan Y, DiClemente RJ. Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Prev Med. 2021 Apr;145:106422. doi: 10.1016/j.ypmed.2021.106422. Epub 2021 Jan 7. PMID: 33422577.
  5. Tran TD, Hammarberg K, Kirkman M, Nguyen HTM, Fisher J. Alcohol use and mental health status during the first months of COVID-19 pandemic in Australia. J Affect Disord. 2020 Dec 1;277:810-813. doi: 10.1016/j.jad.2020.09.012. Epub 2020 Sep 7. PMID: 33065821; PMCID: PMC7476559.
  6. Lo B, Field MJ. Washington (DC): National Academies Press; 2009. Conflict of Interest in Medical Research, Education, and Practice.
  7. McCambridge J, Mitchell G. The views of researchers on the alcohol industry's involvement in science: findings from an interview study. Eur Addict Res. 2022 Mar 22:1-8. doi: 10.1159/000522603. Epub ahead of print. PMID: 35316806.
  8. Mitchell G, McCambridge J. The 'snowball effect': short and long-term consequences of early career alcohol industry research funding. Addict Res Theory. 2021 Jul 22;30(2):119-125. doi: 10.1080/16066359.2021.1952190. PMID: 35299957; PMCID: PMC8919977.
  9. Mitchell G, McCambridge J. The Ubiquitous Experience of Alcohol Industry Involvement in Science: Findings From a Qualitative Interview Study. J Stud Alcohol Drugs. 2022 Mar;83(2):260-266. PMID: 35254249; PMCID: PMC7612520.
  10. Pinsky I. The alcohol industry and the World Cup in Brazil. Addiction. 2014 Jul;109(7):1213-4. doi: 10.1111/add.12566. PMID: 24903301.


Related links

SAFER - WHO´S package to prevent and reduce alcohol-related death and disability

More information

SAFER initiative: cost-effective policies to reduce alcohol problems

SAFER initiative: cost-effective policies to reduce alcohol problems

 Access the course

Pahola, PAHO's first digital health specialist on alcohol use

Talk to Pahola

More information


More information on alcohol