The Need to Enact and Strengthen Alcohol Policies in the English-speaking Caribbean: A Civil Society Perspective

• Author: RG Maharaj, Kimberley Benjamin, TA Hassell, M Hutton
• Pages: 161-185

The Need to Enact and Strengthen Alcohol

Policies in the English-speaking Caribbean:

A Civil Society Perspective

Rohan Maharaj,1 Kimberley Benjamin,2 Maisha Hutton3 & Trevor Hassell4

Abstract

English-speaking Caribbean countries are inundated with alcoholic beverages as

well as marketing by the alcohol industry. This contributes to high levels of alcohol

per capita consumption and alcohol-related harms. Internationally, multiple alcohol

policy options exist, such as the cost-eective WHO ‘Best Buys’. However, English-

speaking Caribbean countries have been slow to enact and strengthen alcohol policies

to protect public health. This paper analyses the uptake of the three WHO alcohol

‘Best Buys’ – (1) increase excise taxes on alcoholic beverages; (2) enact and enforce

bans or comprehensive restrictions on exposure to alcohol advertising and (3) enact

and enforce restrictions on the physical availability of retailed alcohol. Finally, it

provides a civil society perspective on addressing any gaps and opportunities in the

regional policies.

Keywords

Alcohol; Policy; Caribbean; Civil society; WHO ‘Best Buys’; SAFER initiative

Introduction

Countries in the English-speaking Caribbean Community5 (CARICOM) are

inundated with locally-made and imported alcoholic beverages as well as marketing

1 Technical Advisor, Healthy Caribbean Coalition and Professor of Family Medicine, The Unit

of Public Health and Primary Care, The University of the West Indies, St. Augustine, Trinidad

and Tobago. Email: rohan.maharaj@sta.uwi.edu.

2 Consultant, O’Neill Institute for National and Global Health Law, Georgetown University and

Healthy Caribbean Youth Member. Email: keb323@georgetown.edu

3 Executive Director, Healthy Caribbean Coalition.

4 President, Healthy Caribbean Coalition.

5 In this paper, the ‘English-speaking Caribbean Community’ is used to refer to the English-speaking

Member States of the Caribbean Community (CARICOM), namely Antigua and Barbuda, The

Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint

155 The Need to Enact and Strengthen Alcohol Policies in the English-speaking Caribbean:

A Civil Society Perspective

by the alcohol industry.6 The role of alcohol in Caribbean culture is pervasive – from

popular rum shop village scenes, to alcohol-centric and branded festivals and other

social gatherings, as well as alcohol’s perceived medicinal benets and even its use

as a rite of passage from childhood to adulthood.7

Among both male and female adults, total alcohol per capita consumption in four

Caribbean countries – Barbados (10.37 litres), Saint Lucia (9.59 litres), Antigua and

Barbuda (9.4 litres) and Grenada (8.96 litres) – ranked within the top six countries

in the Americas in 2019.

8

Trinidad and Tobago held the record for the highest level

of heavy episodic drinking, that is, “consuming 60+ grams of pure alcohol (roughly

ve standard alcoholic drinks) on at least one occasion monthly”9 in the Americas

for both adolescent (15-19 years) drinkers (59.8%) and drinkers aged 15 years and

older (31.0%) in 2016.

10

The health, social, economic and developmental burdens of

harmful alcohol consumption are well-established.

11

Harmful alcohol consumption

is a main risk factor for noncommunicable diseases (NCDs), the leading cause of

death in the Caribbean.12 However, alcohol is also carcinogenic, immunosuppressive,

teratogenic and a risk factor for communicable diseases, such as HIV, tuberculosis

Lucia, Saint Vincent and the Grenadines and Trinidad and Tobago.

6 In this paper, ‘alcohol industry’ includes “not only the producers of beer, wine and distilled spirits

and their network of distributors and retailers, but also related proprietors of local hospitality

outlets and entertainment industries such as restaurants, clubs, hotels, tourism, and sports.” See,

Robaina, K; Babor, T; Pinksy, I; and Johns, P, ‘The alcohol industry’s commercial and political

activities in Latin America and the Caribbean’ (2020) NCD Alliance, Global Alcohol Policy

Alliance, Healthy Latin America Coalition, and Healthy Caribbean Coalition, p. 13 [hereinafter

referred to as Robaina et al, 2020].

7 Sandra D. Reid, ‘Time for a regional alcohol policy – A literature review of the burden of

normative alcohol use in the Caribbean’ (2015) Vol. 36 (4) Journal of Public Health Policy 469-

484 [p. 469] [hereinafter referred to as Reid, 2015].

8 Pan American Health Organization (PAHO), ‘Alcohol consumption’ <https://www.paho.org/

en/enlace/alcohol-consumption> Accessed 19 January 2024 [hereinafter referred to as ‘PAHO

Enlace: alcohol consumption’].

9 PAHO. Regional Status Report on Alcohol and Health 2020. Washington, D.C.: Pan American

Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO, p. 21 [hereinafter referred to as

PAHO Regional Status Report 2020’].

10 PAHO Enlace: alcohol consumption (n 8).

11World Health Organization (WHO), Global Strategy to reduce the harmful use of alcohol.

Geneva: WHO; 2010 [hereinafter referred to as ‘WHO Global Strategy’]; PAHO Regional

Status Report 2020; OECD. Preventing Harmful Alcohol Use. OECD Health Policy Studies

(19 May 2021) > Accessed 19 January 2024.

12PAHO Regional Status Report 2020 (n 9) p 29; María Elena Medina-Mora, Maristela Monteiro,

Claudia Raul and Itzel Samano, ‘Comprehensive analysis of alcohol policies in the Latin America

and the Caribbean’ (March 2021), 40 Drug and Alcohol Review 385 [hereinafter referred to as

María Elena Medina-Mora et al 2021].