在联合国背景下界定酒精危害——语言的重要性。

IF 5.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Øystein Bakke, Sally Casswell
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引用次数: 0

摘要

背景:酒精是一个具有高度争议的全球性健康问题。在缺席世界卫生组织(世卫组织)全球理事机构的讨论约20年后,酒精在2005年重新进入议程。经过艰苦的谈判,“有害使用酒精”一词成为了妥协用语,这是“采用用语”的一个例子,已经存在了近20年。本文分析了世卫组织理事机构“有害使用酒精”一词的背景和用法、当前的挑战和对公共卫生的影响。方法:本文基于对2004-2010年和2019-2022年期间源文件的文本分析,以及作者参与全球酒精政策领域20多年的经验:分析了世卫组织理事机构的记录和其他文件,以及会员国和非国家行为体在世卫组织理事机构辩论的磋商和发言中的立场和贡献。结果:从2005年起,世卫组织文件中引入“有害使用酒精”这一概念是侧重于“酒精滥用”或侧重于更广泛的酒精消费危害概念的方法之间的政治妥协。它已经渗透到国家酒精政策文件、关于酒精危害的学术文献和联合国文件中,并被酒精行业所接受。然而,它并没有阻止,有些人会争辩说,它使世卫组织能够制定规范性声明,其中包括对广泛人口干预措施的建议。有关低水平酒精有害的相对较新的证据,以及对表明适度饮酒有益效果的证据的质疑,以及行业对“有害使用”的盗用,导致了对“有害使用酒精”所隐含的框架的越来越多的批评。结论:世卫组织文件中使用的语言具有政治力量,因为它可能影响事件的后续进程。世卫组织在全球卫生政策中的规范性作用以及在世卫组织文件之外采用谈判语言,使这一点更加突出。在接下来的五年里,更详细地研究这种力量在多大程度上得到了体现,以及实现变革的必要性和可能的方法,将是可能的,也是有价值的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Framing alcohol harm in the UN context - the importance of language.

Background: Alcohol is a global health issue with a high level of controversy. After being absent from World Health Organization (WHO) global governing body discussions for about 20 years, alcohol re-entered the agenda in 2005. The expression 'harmful use of alcohol' became the compromise language after hard negotiations, an example of 'adopted language" that has remained for almost 20 years. This article analyses the background and use of the expression 'harmful use of alcohol' in the context of WHO governing bodies, current challenges and implications for public health.

Methods: The article is based on textual analysis of source documents from the time periods 2004-2010 and 2019-2022 and the authors' experience from involvement in the global alcohol policy scene for more than 20 years: WHO governing body records and other documents were analysed, as well as Member State and Non-State Actors' positions and contributions in consultations and statements in WHO governing body debates.

Results: The introduction of the concept 'harmful use of alcohol' in WHO documents from 2005 onwards was a political compromise between approaches focussed either on 'alcohol abuse' or a wider concept of harm from alcohol consumption. It has permeated into national alcohol policy documents, academic literature about alcohol harm and UN documents, and been embraced by the alcohol industry. However, it has not prevented and some would argue that it has enabled development of normative statements from WHO that include recommendations for population wide interventions. The relatively new evidence of harm from alcohol at low levels and questioning of evidence suggesting a beneficial effect of moderate use of alcohol together with industry appropriation of 'harmful use' have led to increasing critique of the framing implied by 'harmful use of alcohol'.

Conclusions: The language used in WHO documents holds political power in that it may influence the subsequent course of events. This is accentuated by the normative role of WHO in global health policy and the uptake of negotiated language beyond WHO documents. In the next five years it will be possible and valuable to examine in more detail the extent to which this power was made manifest and the need and possible ways to effect change.

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来源期刊
Globalization and Health
Globalization and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
18.40
自引率
1.90%
发文量
93
期刊介绍: "Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health. The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.
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