Introduction and definitions
Strategic alliances among business, government, and civil society are an established feature of social development and policy development in both mature and emerging economies. Such multi-sector partnerships are necessary because it is increasingly clear that no one sector in society can address the complexities surrounding these issues on its own. Alcohol policy development is no exception.
There are many definitions of “partnership” in use today, and increasingly the term is used to describe almost any kind of collaboration. Collaborations can be called partnerships when the parties involved voluntarily share risks and pool resources and talents in order to optimize the delivery of outcomes that are viewed as mutually beneficial. Partnerships exist, in other words, when the parties recognize in their relationship a complementary commitment to contribute their core competencies in order to achieve a more complete solution to a given issue or problem.
The hypothesis underpinning a partnership approach is that an inclusive collaboration of stakeholders can contribute in a more positive way to initiatives and policy. Single-sector approaches have been tried and found wanting. Working separately, different sectors develop activities in isolation, sometimes competing with each other and/or duplicating effort and wasting resources.
Partnerships, on the other hand, provide new opportunity for doing policy development or risk-mitigation projects better. As partners, sectors recognize the qualities, contributions, and competencies of one another and find new ways of harnessing these for the public good.
Numerous statements from the United Nations and its specialized agencies, including the World Health Organization, have recognized the relevance of this approach to social development and public health. For alcohol policy development and alcohol harm reduction programs, partnership is also a useful tool for addressing complex issues.
Who are the partners in alcohol policy development?
A critical feature of effective partnership in the beverage alcohol field is the inclusion of all relevant sectors of society as equals. The key stakeholders include:
· governments;
· intergovernmental organizations (IGOs);
· the private sector;
· nongovernmental organizations (NGOs);
· the public health and research communities.
The potential partners for alcohol policy development and alcohol harm reduction activities are not much different from those involved in partnerships in other fields. The following is an outline of the generic roles that these key stakeholders might assume in a partnership process when addressing alcohol policies.
Governments
Governments have a clear role to play in the development of alcohol policies. One of their primary responsibilities is to ensure the safety of their citizens. They have the responsibility for formulating, implementing, and enforcing legislation and regulations about alcohol. To be both effective and acceptable, the government policies must reflect the views of the other sectors and take them into account. In recent years the concept of public-private partnership has gained a strong foothold in the development of government policy, and a growing role has emerged for the private sector as an active participant in the formulation and implementation of socially responsible policies. Governments, however, have a responsibility to ensure that a balance is struck between pursuing the safety and welfare of society as a whole and protecting the rights of the individual.
Intergovernmental organizations
The intergovernmental organizations have responsibility for trying to achieve some degree of consensus between the governments of the world (e.g., the United Nations) or a region (e.g., the European Union) that they serve. Primarily, IGOs provide a vehicle for communication; they may have more or less authority in the implementation process, but more often than not they have a powerfully persuasive advisory role, their recommendations requiring national (or local) government action for implementation.
The private sector
Beyond its responsibilities to its shareholders, the beverage alcohol industry has responsibilities to its consumers and the public at large. The beverage alcohol industry, like any commercial enterprise, has social responsibilities to its employees, its suppliers, and the wider communities in which it operates. In addition it recognizes that alcohol, if consumed responsibly, can enhance pleasure and quality of life, and it must ensure that the risks and harms associated with alcohol misuse are minimized. The beverage alcohol industry is active in supporting harm reduction organizations and programs around the world. ICAP’s A Suggested Framework for Responsibility outlines many areas for collaboration and examples of industry activities in emerging markets [2].
Corporate social responsibility (CSR) is being increasingly seen by companies around the world and in all industries as an essential part of business mission, strategy, and operations. This is equally true of the beverage alcohol industry.
Nongovernmental organizations
Nongovernmental organizations can also play a significant role in the formulation of alcohol policies and can be particularly important at the community level. The main strength of these organizations, in fact, lies in their local expertise and links with local actors and networks that can be mobilized quickly. NGOs, especially in the developing countries, often have the best access to poorly served constituencies that are hard to reach through official government channels. Some NGOs perceive health and social wellbeing policies as inherently at odds with the industry's interests to promote its products, and a number of them, implicitly at least, are against any form of alcohol consumption. Others differentiate between moderate alcohol use and its misuse, focusing on preventing such problems as alcohol-impaired driving, alcohol-related violence, and underage drinking, while accepting that alcohol can be part of a normal healthy lifestyle.
The public health and research communities
Research scientists are responsible for providing the best possible evidence for the development of approaches that encourage responsible drinking and for evaluating their success. The research should be conducted in a way that is free from ideological or political influences. Funding for research comes from a variety of sources, and funding organizations can in one way or another have some influence on the questions asked and on the way the results are presented. For this reason, it is important that sources of funding are declared when results are published. Certain principles have been set out that should govern the implementation of research on alcohol consumption when that research involves cooperation between the industry, governments, and the scientific and academic communities (see The Dublin Principles).
Dealing with conflicts
Although perceived conflicts of interest may make some potential partners shy away from collaboration with the beverage alcohol industry, those who are committed to the concept of partnership recognize that, although the goals of the public and private sectors may not always be identical and perhaps not even fully compatible, this does not have to rule out dialogue and joint action. ICAP’s work shows that partnership in the alcohol field can be an effective and viable approach. A process that excludes the industry could lead to a polarization of views and a result that serves no one’s interest, least of all those interested in promoting the public good. Experience has shown that even though the involved parties may start out as seemingly opposed, partnerships can develop from an adversarial relationship to one of trust and, eventually, productive collaboration.
The public expects corporations to live up to high standards of social responsibility and, at the same time, run profitable businesses. This balance is best achieved through the process of partnership and dialogue. The Dublin Principles and The Geneva Partnership on Alcohol provide frameworks for partnership and dealing with conflicts.
Working together
ICAP advocates a partnership approach because of its potential for considerable added-value and because, in some cases, it is the only way to handle key issues surrounding alcohol in society. The evidence is strong, although the practical problems of making partnerships work may require much trial and retrial. Some examples and case studies of existing partnerships are included in the ICAP Blue Book: Practical Guides for Alcohol Policy and Prevention Approaches. Lessons can be extracted from both successful and not-so-successful partnerships; these lessons then feed back into the partnership practice and the balanced dialogue among stakeholders.
Effective handling of partnerships is as much about managing relationships as it is about the concrete issues involved in alcohol policy. The process of partnering offers a set of activities and tools to better develop the relationships with relevant stakeholders.
Partnership, however, is not a panacea, nor is it appropriate in all circumstances. Early in the process of formulating a partnership, the added-value of the partnership model must be weighed against alternative approaches. In all cases, sound alcohol policy should be evidence-based and rely on proven prevention and policy approaches that can be tailored to fit the needs of a particular country, setting, or population.
ICAP’s Guide to Creating Integrative Alcohol Policies and Guide to Building Partnerships outline the steps involved in the development of practical and sustainable alcohol policies. The specifics of the partnership approach may well vary depending on the prevailing circumstances and on cultural and historical factors. Partnerships are both a process—of building trust, joint problem solving, and relationship management among key stakeholders—and a product, a set of agreements and projects designed to deliver a joint action or policy program.
Values in partnership
A partnership approach calls for stronger dialogue and collaboration between sectors of society and is based on the belief that partnerships are relationships built on mutuality of effort and shared contributions. It presupposes that those involved in the partnership have the right to be, and will be, fully engaged in all aspects of the partnership.
ICAP has been instrumental in developing two consensus documents that address the ground rules for effective partnership. These are:
The Dublin Principles refer particularly to cooperation in alcohol research, while the Geneva Partnership describes the rights and responsibilities that can guide consumers, producers, sellers, and others involved in policy-making, including governments, nongovernmental organizations, and the public health and research communities.
Both documents identify key principles that should underlie partnerships, whether formal or informal, at local and national levels, namely: mutual respect, trust, transparency, and shared benefits and accountability.
Mutual respect
No sector of society has exclusive ownership of alcohol policy. Many groups have a legitimate interest in alcohol policy development, and all have something relevant to contribute to the process. They are all potential partners, but they all also have their particular interests to promote, so that it is reasonable to expect that there will be conflicts among some of those interests. If all partners, however, demonstrate mutual respect, there should be ample space for legitimate differences.
Trust
As in the case above, it is not necessary for partners to agree for there to be trust. In the area of alcohol policy, there is a legacy of mistrust that needs to be addressed directly, but that should be a challenge—not an impediment—to partnership. Experience at ICAP has shown that, as people from different backgrounds and sectors actually work together, they learn to trust each other more. Not everybody is willing to join a partnership. Nobody who is unwilling should be forced to do so; yet, in absenting themselves, they lose the opportunity to build mutual respect and trust.
Transparency
It is the third principle—transparency—that fosters greater trust. There are, of course, self-interests, but the partners also have common interests in reducing the problems associated with harmful drinking. Transparency is crucial in the process of partnership; indeed, full disclosure was one of the key principles identified when developing The Dublin Principles. Transparency is essential—not just for reporting on research findings, but also for the whole process of building and sustaining alcohol policy partnerships.
Shared benefits and accountability
It is in everybody’s best interest to work for better and more comprehensive alcohol policies. Shared benefits do not mean identical benefits for everybody, and, indeed, it may be necessary to give up some intermediate benefits for the sake of a larger goal. Partnership calls for a reappraisal of values, but it is always worth the effort in the end.
Partnering skills
Successful partnering takes a range of skills—some may come naturally, and others may need to be acquired. Individuals from each sector will bring different skills and professional competencies to the partnership, and, at an early stage, tasks can be allocated to those who demonstrate that they are good at a particular kind of activity.
ICAP has created a series of tools to be used in the development of alcohol policies: ICAP Policy Tools. Of particular relevance to the area of partnership development are ICAP’s Guide to Building Partnerships and Creating Alcohol Policies in the 21st Century: A Best Practice Approach. These tools are intended as a basis for a sequential yet flexible approach for the different stages of policy development through a partnership approach. They highlight the areas partners and potential partners should consider in beginning their collaboration in policy development.
The ICAP Policy Tools offer a comprehensive but succinct guide to the key issues in alcohol policy development and implementation, and an integrated approach to best practice. It is centered on three principles that are fundamental to ICAP’s work, namely, drinking patterns, targeted interventions, and partnership.
Making partnerships work
What does a successful partnership look like? Who defines “success”? How is it measured? Alcohol policy development through using a partnership approach is invariably complex and can therefore be very challenging to evaluate. Outputs, outcomes, and impacts are usually diverse, sometimes quite subtle and often unexpected. Partners are likely to need to measure or assess some or all of the following:
- impacts of their partnership on how alcohol is viewed in society;
- the mitigation of risk from the consumption of alcohol;
- the relationship each partnering organization has with one another;
- costs and benefits of the partnership approach; and ultimately;
- whether to continue working together.
By examining these points, partners should be able to evaluate whether:
- the partnership has been effective in achieving its aims;
- partners have truly benefited from their involvement;
- the partnership approach was the best/most appropriate choice.
Collecting the information on which to make a judgment about the partnership’s effectiveness is in itself a challenging process but should not be avoided (even if the case when the partnership objectives have not been reached). Where partnerships are successful, and when key lessons are learned, spread the word. Sharing best practice in alcohol policy development and harm reduction programs is each partner’s responsibility.
Partnerships involving business are making a real contribution to alcohol policy development around the world. Taking this possibility seriously means maintaining a sense of openness, honesty, leadership, and innovation as one faces the issue of alcohol in society.