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

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.