Interdisciplinary Research into political interest, civil society support and available data to strengthen Alcohol Policy Systems in Brazil and Peru

酒精消费（“饮酒”）是全球疾病的一个主要原因，也是15-49岁人群中可预防死亡的主要原因。它通过损失工作日、暴力、关系破裂和道路交通事故，对经济以及饮酒者及其周围的人产生负面影响，并对卫生服务造成重大负担。在低收入和中等收入国家（LMICs），饮酒正在增加，导致危害上升。饮酒不仅仅是个人选择的问题，因为人们的选择取决于每个社区和国家的酒精供应、价格和吸引力。酒类公司可以通过广泛销售酒类、反对政府征税以保持低价、设计和推广吸引当前和未来饮酒者的品牌来增加饮酒量。研究表明，加强对在何处、何时以及由谁购买酒精的控制，增加酒精税和控制酒精广告可能是减少危害的措施。这些措施得到了世界卫生组织（世卫组织）的支持，但缺乏对中低收入国家的研究，它们需要政府的行动和政治支持才能实施。它们通常遭到大型酒类公司的反对。在巴西和秘鲁，对酒精的控制很少，即使有，也没有得到很好的执行，而且与酒精有关的危害程度很高。慈善机构、卫生组织和其他组织有时会成功地结成“宣传联盟”，加强对酒精的控制，但在巴西和秘鲁还没有这样做。在这两个国家，新的政策制定者最近都表示，他们担心与酒精有关的危害，并有兴趣引入更严格的控制。这为加强酒精政策以减少危害创造了机会，我们的研究将以此为基础。我们的目标是(1)了解秘鲁和巴西的政策制定者和慈善机构/卫生组织如何看待酒精消费、危害和可能的法规，他们关心什么，他们将支持什么行动，以及他们对与他人合作改善酒精控制政策有多大兴趣。我们将通过分析60个访谈来做到这一点，这些访谈分为不同的国家和不同的“利益相关者”类型，即政策制定者和慈善机构/卫生代表。我们还希望了解(2)每个国家有哪些酒精统计数据和其他数据可以帮助决策者做出决策，如何改进这些数据，以及是否可以利用这些数据来发现任何政策变化的影响。为此，我们将检查国家统计数据提供者，与两国的利益攸关方和国际研究人员交谈。我们的团队由六名经验丰富的研究人员组成，他们来自不同的学术领域（政策研究、公共卫生、心理学、流行病学、社会学、卫生经济学），拥有与该项目相关的广泛知识，其中两人在秘鲁/巴西工作，并将在那里领导研究。我们将得到一个研究咨询小组的支持，该小组由学者、世卫组织一名高级顾问、拉丁美洲的其他卫生组织和政策制定者以及美国和南非的研究人员组成，他们在酒精政策以及更广泛的政策变化和卫生系统研究方面具有专业知识。我们将在秘鲁和巴西招募全职研究人员，并为他们提供多种机会，了解酒精政策研究、如何利用研究影响政策以及与媒体合作。我们将从研究一开始就与利益相关者密切合作，让他们有机会参与制定(1)我们的访谈问题和(2)我们的数据评估，以便他们有助于当地的政策和宣传；(3)分享我们的发现并了解他们对这些发现的看法；(4)为每个国家和地区的政策制定、宣传和研究制定下一步计划。

Alcohol consumption ('drinking') is a major cause of disease globally, and is the leading cause of preventable deaths in people aged 15-49 years old. It impacts negatively on the economy as well as drinkers and those around them, through lost days of work, violence, relationship breakdown and road traffic accidents, as well as placing a major burden on health services. Drinking is increasing in low and middle income countries (LMICs) causing harms there to rise. Drinking is not simply a matter of individual choice, as people's choices are shaped by how available, affordable and attractive alcohol is in each community and country. Alcohol companies can increase drinking by making alcohol widely available to buy, opposing government taxation to keep prices low, and designing and promoting brands that are attractive to current and future drinkers.Research has shown that enforcing controls on where, when and by whom alcohol can be bought, increasing alcohol taxes and controlling alcohol advertising are measures likely to work to reduce harms. These measures are supported by the World Health Organization (WHO) although studies are lacking in LMICs, and they need government action and political support to be implemented. They are typically opposed by large alcohol companies. In Brazil and Peru, there are few controls on alcohol, those that do exist are not well-enforced, and there are high levels of alcohol-related harms. Charities, health organizations and others sometimes successfully work together in 'advocacy coalitions' to strengthen controls on alcohol, but have not yet done so in Brazil and Peru. In both countries, new policymakers have recently said that they are concerned about alcohol related harms and interested in introducing greater controls. This creates an opportunity to strengthen alcohol policies to reduce harms and our study will build on this opportunity.Our aim is (1) to understand how policymakers and charities/health organizations in Peru and Brazil view alcohol consumption, harms and possible regulations, what concerns them, what action they would support, and how interested they are in working with others to improve alcohol control policies. We will do this through analysing 60 interviews, split between countries and different 'stakeholder' types i.e. policymakers and charities/health representatives. We also wish find out (2) what alcohol statistics and other data are available in each country to help policymaker decisions, how those data could be improved, and whether they could be used to find out the impact of any policy changes. We will do this by checking national statistics providers, speaking with stakeholders in both countries and international researchers.Our team consists of six experienced researchers who have an excellent range of knowledge relevant to this bid from different academic areas (policy studies, public health, psychology, epidemiology, sociology, health economics), two of whom are based in Peru/Brazil and will lead the research there. We will be supported by a study advisory panel made up of academics, a senior WHO advisor, other health organizations and policymakers from Latin America, and researchers from the USA and South Africa, with expertise in alcohol policy as well as the study of policy changes and health systems more generally. We will recruit fulltime researchers for the study in both Peru and Brazil and offer them multiple opportunities to learn about alcohol policy research, how to use research to influence policy, and working with the media.We will work closely with stakeholders from the start of the study and throughout to give them an opportunity to be involved in shaping (1) our interview questions and (2) our data assessment, so that they are helpful to local policy and advocacy; (3) to share our findings and find out what they think of them, and (4) to plan next steps for policy development, advocacy, and research in each country and regionally.