Politique Nationale de Lutte contre l’Usage Nocif de l’Alcool 2016-2025

Objectives

Burundi’s 2016-2025 national policy on harmful alcohol use provides a public-health framework to reduce alcohol-related morbidity, mortality and wider social harm. It envisages zero alcohol consumption among people under 18 by 2025 and responsible consumption among adults, while improving population wellbeing through promotion, prevention and accessible care.[1][2]Harmful alcohol use is framed as a risk factor for non-communicable diseases, neuropsychiatric conditions, injuries, accidents, violence, social problems and harm to people other than consumers.[1][3]

• Reduce morbidity and mortality associated with harmful alcohol consumption across the Burundian population.[2]
• Establish and strengthen legislation governing alcohol production, marketing, sale and consumption.[4][2][5]
• Protect children, young people and other highly exposed populations, while safeguarding people from pressure to drink and ensuring equitable access to effective, affordable prevention and care.[5]
• Promote primary, secondary and tertiary prevention, including health promotion, early detection, treatment and care.[2][6]
• Strengthen partnerships, intersectoral coordination, governance, advocacy, resource mobilisation and communication for behavioural change.[4][7]
• Improve strategic information, surveillance and research on alcohol consumption and alcohol-related harm.[2][6]

The policy is aligned with the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol and is intended to guide the planning, implementation and evaluation of health-development projects and programmes.[8][3]Its wider policy context recognises that alcohol harm interacts with poverty, gender inequality, limited access to healthcare, demographic and environmental pressures, and health-system weaknesses.[9][10][11]National evidence on non-communicable diseases and alcohol-related risk factors is described as fragmented, with research on harmful alcohol use still underdeveloped.[12]

Implementation

Implementation is designed as an integrated, multisectoral process led by the Ministry of Public Health and the Fight against AIDS through the National Integrated Programme for the Control of Non-Communicable Chronic Diseases.[6]A strategic plan and operational plans are to organise delivery, supported by periodic coordination and evaluation meetings.[13]The approach combines regulation, prevention, community mobilisation, health-service strengthening, information systems, research and sustained collaboration between public institutions, civil society, communities, private-sector actors and technical and financial partners.[7][6][13]

• Lead national coordination through the Ministry of Public Health and the Fight against AIDS, working with public- and private-sector partners and assigning clear responsibilities to participating institutions.[8][7][6]
• Implement locally adapted measures using reliable evidence, political commitment, permanent coordination mechanisms and financing distributed across health-system levels according to need.[5][7]
• Engage decision-makers and communities at all levels in prevention and reduction activities, using community dialogue, plural media, mobile telephone networks, information and communication technologies, cultural channels and mobile cinema where relevant.[14][6][13]
• Strengthen health-sector capacity through workforce training, infrastructure, financing, integrated interventions at all levels of the health system, primary-care screening and management, effective treatment, brief interventions and education delivered by health professionals.[6][13]
• Involve civil-society organisations, parents, families, peers, mutual-aid groups, advocacy associations and religious communities in prevention, treatment and reduction of alcohol-related problems.[13]
• Support youth prevention through awareness activities and programmes such as those implemented by the Association of Guides of Burundi and the Scouts of Burundi.[15]
• Build on regulatory action, including the 2014 order governing beverage outlets, restaurants and other public establishments and restricting the manufacture, sale and consumption of certain drinks and liqueurs.[12]

Communes and decentralised structures provide a potential implementation platform, within a national administrative framework of 18 provinces, 119 communes and 2,847 hills, with communes supported by community development plans.[14]The policy also identifies women’s associations and microcredit organisations as mechanisms that may support women’s economic autonomy, while recognising barriers associated with poverty, education, early pregnancy, legal constraints and gender-based violence.[10]

Monitoring should use local and national surveillance data to assess the scale and trends of alcohol-related harm, inform advocacy and strategy design, and evaluate intervention impact.[6]Sustainable information systems are envisaged using indicators, definitions and data-collection methods compatible with World Health Organization systems, alongside research partnerships and operational research on unrecorded consumption and effective interventions.[6]Periodic coordination and evaluation meetings are intended to follow implementation.[13]The available material does not specify quantitative targets, a full indicator set, reporting timetable, evaluation methodology, sanctions or detailed accountability arrangements.[6][13]

Resource mobilisation is to be continuous, drawing on Government, individuals, the private sector and international partners, while integrating harmful alcohol use within national health-development priorities and using resources available through other programmes where appropriate.[7]The material does not provide a quantified policy budget, programme costings, unit costs, funding allocations, funding gap or financing assumptions.[7]Although alcohol production and marketing generate revenue, alcohol-related illness is associated with treatment costs, reduced productivity, absenteeism and premature deaths.[9][15]

Monitoring & Evaluation

Monitoring and evaluation are envisaged through policy-guided activity evaluation, periodic coordination meetings, strengthened surveillance and research, and national information systems compatible with World Health Organization standards.[8][6][13]However, the supplied extracts do not define a complete indicator framework, reporting timetable, evaluation methodology, quantitative targets or sanctions for non-compliance.[12][6][13]

• Use the policy as a reference for health-sector actors in planning, implementing and evaluating activities addressing harmful alcohol use.[8]
• Conduct periodic coordination and evaluation meetings to follow policy implementation.[13]
• Measure the extent and trends of alcohol-related harm through local and national monitoring and surveillance data, using findings to support advocacy, strategy design and assessment of intervention effects.[6]
• Develop sustainable national health-information systems with indicators, definitions and data-collection approaches compatible with World Health Organization systems.[6]
• Promote research partnerships and operational research, including work to estimate unrecorded alcohol consumption and identify effective interventions.[6]
• Strengthen surveillance and research as a policy objective, recognising that available data on harmful alcohol use are inadequate and that research remains underdeveloped.[2][12]
• Maintain institutional oversight through the General Inspectorate of Public Health and the Fight against AIDS, alongside professional and ethical oversight by national medical and pharmaceutical orders and the national ethics committee.[11]
• Improve financial accountability and transparency through modernised financial-management and public-procurement procedures, including treasury and commitment plans for budget-execution control.[14]

Evidence cited in the extracts includes a 2008 Bujumbura survey in which 88.1% of respondents reported alcohol consumption by at least one family member, and reported alcohol consumption of 88% in Kirundo.[3][12]Broader population-health context includes a crude mortality rate of 15 per 1,000 and life expectancy of 56 years, but these statistics are not presented as formal policy performance indicators.[11]

Costing & Financing

Resource mobilisation is a core policy area, with financing expected to be sustained and drawn from government, individuals, the private sector and international partners.[4][7]Resources are intended to be distributed across health-system levels according to relative need, while alcohol-harm prevention and treatment are to be integrated with other national health-development programmes where resources can be shared.[7]No quantified policy budget, activity costing, funding allocation, funding gap, unit cost or economic assumption is provided in the supplied extracts.[16][7][13]

• Mobilise resources continuously from public, private, household and international-partner sources.[7]
• Include harmful alcohol use among national health-development priorities and use integrated prevention and treatment approaches that may draw on resources from other programmes.[7]
• Support implementation through technical and financial partners, although their respective contributions are not specified.[13]
• Recognise that alcohol production and marketing generate significant revenue, while treatment for conditions related to harmful alcohol use creates substantial costs.[15]
• Address the economic consequences of alcohol-related illness, including treatment expenditure, workplace absenteeism, reduced productivity and premature deaths.[9]
• Use women’s associations and microcredit organisations to facilitate access to small loans at reasonable rates, without specifying loan values or financing targets.[10]

The extracts describe a constrained economic and household-financing context: national poverty was 66.9% in 2014; gross domestic product per capita was 437,381 Burundian francs in 2014; and 81.5% of patients reportedly incurred debt or sold assets to meet health expenditure.[16][9]These contextual figures are not presented as a dedicated alcohol-policy financing plan.[16][9]