Third World's Drinking Rate Rises
As traditional restraints decline, alcohol consumption takes a huge social and economic toll
WASHINGTON — ALREADY burdened by poverty, massive debts, and mismanagement, the nations of the third world are discovering another obstacle to economic growth: alcohol.In underdeveloped nations across Africa, Latin America, and the Pacific, more people are drinking more often and spending more money on alcohol than ever before. The consequence is spiraling costs for health care and social services that poor countries can ill afford to pay. The main problem is men, more of whom drink in many third-world countries than in industrialized nations. The main victims are women and children, who go to bed hungry when meager personal incomes are spent to buy liquor instead of food. Behind the individual lives affected are the huge social costs of alcohol consumption, which have eaten away at productivity, agricultural production, and the national budgets of underdeveloped countries around the world. "The rising drinking rate has touched on every aspect of third-world development," says Lori Heise, author of a widely noted article in the current issue of World Watch magazine about alcohol consumption in poor countries. The dimensions of the problem are suggested by research in various developing countries. In Chile, for example, drinking cost $1.7 billion in lost productivity alone in 1981, the same amount earned from copper exports and twice what Chile spends on public education. In one village in Guatemala, personal income diverted to alcohol was the cause of nearly one-third of all cases of malnutrition. In Papua New Guinea, a Pacific island nation with no history of indigenous alcohol use or production, the average household now spends 30 percent of its income on liquor. In several Mexican communities studied by the World Health Organization (WHO), alcohol-related problems accounted for up to 70 percent of workloads of local police, church officials, and social welfare agencies. In nearly all developing countries, governments have been forced to pay huge sums for the treatment of alcohol-related disorders, now one of the main contributing factors in the death of working-age men. "It's a terrible, understudied problem," comments Lenn Murrelle of the Department of Psychiatry and the Center for Alcohol Studies at the University of North Carolina. "It's analogous to the problem in the United States, but the developing countries simply can't afford it." Alcohol is not new in developing countries, but the traditional customs that govern its use have changed dramatically. Once confined largely to ceremonial occasions like weddings and harvest celebrations, drinking has become a recreational pastime, with few remaining societal constraints to limit its use. The trend toward indiscriminate use has been hastened by aggressive advertising campaigns by large alcohol multinationals. Responding to flat sales at home, companies like R. J. Reynolds and American Brands, once exclusively tobacco giants, began expanding in developing countries a decade ago. Researchers say ad pitches that have linked alcohol to social status have helped undermine traditional value systems. "Advertising promotes the notion that consumption of alcoholic beverages is associated with a lifestyle that only a small minority can ever hope to realize," says Marcus Grant, the senior scientist at WHO's drug and alcohol program in Geneva. Alcohol use has also been stimulated by the proliferation of brewing and moonshining in urban slums by individuals with no other source of income. Often unwittingly, third-world governments themselves have added to the problem by actively promoting the production and use of alcohol. As one of the few dependable sources of revenue, breweries have been built or licensed by third-world governments as part of an overall development strategy. With income from sales and taxes helping to pay the bills for educa tion and public services, alcohol has come to be regarded as an asset, especially in Africa. Researchers say it is just that assumption that has blinded third-world leaders to the longer-term implications of alcohol use. Against short-term profits, they say, governments need to weigh the increasing costs of everything from imports to health care imposed by widespread alcohol consumption. "There are a lot of hidden costs," Ms. Heise says. "Governments are making decisions about the promotion of alcohol without having a true sense of the costs and benefits." Among the hidden costs are the kinds of effects on individual lives that have long been documented in industrialized nations. "There's an incredibly high relationship between alcohol consumption and rates of clinical depression and serious suicide attempts," explains Dr. Murrelle, who has conducted extensive research on alcohol and drug use in Colombia and several other Latin American nations. A few third-world governments are striving to reduce rather than promote alcohol use and their mixed success has provided useful guidelines. After spending millions on barley and malt imports at the expense of needed social services, Nigeria, for example, cut imports and banned construction of breweries in 1988, according to Heise. Other nations have set minimum drinking ages and regulated where and when alcohol can be purchased. More direct measures have included production limits and price hikes, though the prevalence in some countries of home brewing - what Heise calls the "informal alcohol economy has made such limits easy to circumvent. A WHO study that was released privately in the mid-1980s calls on developing countries to require multinationals to limit advertising and make contributions to national health programs before granting production or distribution rights. Public health officials say the most hopeful development is the growing awareness of the economic and social costs imposed by alcohol consumption. "Just getting the issue on the agenda is an important thing," says the WHO's Marcus Grant. "People are just beginning to wake up to the fact that, despite the seriousness of the drug problem, alcohol is probably associated with more health and social problems than all illicit drugs put together."