# Presentation: 872119

## .

- Alcohol and Substance Abuse: Regional Activities
- 2006
- Janis Dawson
- Consultant

## What is PAHO?

- The Pan American Health Organization (PAHO) is an international public health agency with over _[100 years of experience](http://www.paho.org/English/DPI/100/english.htm)__ working to improve health and living standards of the people of the Americas. It enjoys international recognition as part of the United Nations system, serving as the Regional Office for the Americas of the __[World Health Organization](http://www.who.org/)__, and as the health organization of the Inter-American System. _

## PAHO’S MISSION

- To strengthen national and local health systems and improve the health of the peoples of the Americas, in collaboration with Ministries of Health, other government and international agencies, nongovernmental organizations, universities, social security agencies, community groups, and many others.

## PAHO Structure

- Headquarters in Washington DC and offices in 27 countries
- Nine scientific centers, largest library in LA
- _[PAHO Member States](http://www.paho.org/english/paho/fieldoffices.htm)_ include all 35 countries in the Americas; Puerto Rico is an Associate Member. France, Netherlands, UK and Northern Ireland are Participating States, and Portugal and Spain are Observer States.
- The health authorities of PAHO's Member States set PAHO's technical and administrative policies through its _[Governing Bodies](http://www.paho.org/English/GOV/govbodies-index.htm)_.

**Notes:**
Latin American and Caribbean Center on Health Sciences Information (BIREME) 
Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS) 
Latin American Center for Perinatology and Human Development (CLAP) 
Pan American Institute for Food Protection and Zoonoses (INPPAZ) 
Pan American Foot-and-Mouth Disease Center (PANAFTOSA) 
Caribbean Epidemiology Centre (CAREC) 
Caribbean Food and Nutrition Institute (CFNI) 
Institute of Nutrition of Central America and Panama (INCAP) 
Regional Program on Bioethics 

## ALCOHOL AND OTHER SUBSTANCE ABUSE

- Our work consist in design and develop investigations, trainings and projects related to alcohol and other substance abuse under the public health point of view. Also give support to the Ministries of Health.
- Goal: reduce the burden of disease and the disability – adjusted life years (DALYs) in the Americas caused by psychoactive substances

**Notes:**
We work together with researchs from countries. 

## Leading risk factors for the burden of Disease in the Americas- 2000

**%  total DALYS**

- Very Low Mortality

**AMER D**

**AMER B**

**AMER A**

- Lack of sanitation

- Overweight

- Low intake fruits/veg

**Notes:**
Alcohol consumption caused a considerable disease burden in the Americas. 
Is this table it is shown the leading risk factors for the burden of disease for different regions in the Americas, which was defined by the WHO on the basis of high, medium or low levels of adults and infants mortality.
This table compares the impact of alcohol and another risk factors in the disease burden. As you can see, Alcohol was the risk factor that caused the greatest burden of disease in the two less developed regions, to be surpassed by smoking only in North America. In the developed countries the illicit drugs has 2.6%. 
Because of that the prevention of alcohol- related harm should therefore be a mayor public health priority in this region. 
Region D: Peru, Bolivia, Ecuador, Haiti, Guatemala and Nicaragua
Region B: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Brazil, Chile, Colombia, Costa Rica, Dominica, Dominican Republic, El Salvador, Grenada, Guyana, Honduras, Jamaica, Mexico, Panama, Paraguay, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay and Venezuela
Region A: USA, Canada, Cuba  

## Burden of Disease in the Americas  (DALYs en 1000s) attributable to alcohol by disease category - 2000

**Notes:**
In this table we can see that 9.7% of all disability – adjusted life years (DALYS) lost in the year 2000 were attributable to alcohol.
Also the neuropsychiatric conditions has 50.1% of DALYS attributable to alcohol, a category almost made up of alcohol use disorders.

## Burden of Mortality in the Americas (deaths en 1000s) attributable to alcohol by disease category - 2000

**Burden of Mortality in the Americas (deaths en 1000s) attributable to alcohol by disease category - 2000**

**Notes:**
Here it is exposed the burden of mortality which is 4.8% of all deaths were attributable to alcohol.
Also, Injury was the category which accounted for most deaths (59.8) (unintentional and intentional injuries). 

## PAHO ACTIVITIES 2005 - 2006 

- Multicentric Study on Alcohol, Gender, Culture and Harm
- Training on Brief Interventions
- Advocacy on alcohol: PSAs and Red Salud
- Support countries with alcohol policy implementation
- Brasilia Conference: Alcohol Public Policies
- Manual on treatment and care for HIV positive drug users in LA and the Caribbean.
- Translation into Spanish of: Neuroscience of Psychoactive substance use and dependence.

**Notes:**

Our activities of 2005 and 2006 are:
Multicentric Study: In 2004 PAHO began this study, which consist in the collection of new data, using similar indicators and the GENACIS (Gender, Alcohol and Culture and International Study) survey questionnaire, of general population samples in Peru, Nicaragua and Belize.  The data from these countries will be compare with the GENACIS country data.
Since 2004, training has been provided on the identifications of patients and brief interventions in different countries such as Cuba, El Salvador, Panama and Dominican Republic. These trainings are directed to some 30 health professionals working in primary health care: psychiatrics, general practitioners, nurses, social workers, and psychologists. They are also designed so that those trained can then train other professionals. 
PSAs: In 2005, PAHO commissioned the Art Center College of design in Pasadena, California to develop a series of Public Services Announcements to produce awareness into the population, including general population and policy makers for distribution to over 300 major television networks in the Americas region. 4 PSAs were developed and two were selected for distribution. 
Red Salud is a virtual network of 700 journalist, media companies and civil organizations. They work to improve the media coverage and handling of health issues to foster social change in the Region. In this year they are going to work in alcohol under a public health standpoint. 
Its website will contain information on alcohol weekly and monthly bulletins and an interactive platform for members. In addition, PAHO will finance and support Red Salud through an annual Journalism Award, with technical support from the Fundacion Nuevo Periodismo Iberoamericano for the best articles on alcohol in the print or electronic media. 
We bring support to countries when they ask for: such as helping them with evidence for being a support for their policies proposals (Panama), or in parliamentary sessions (Uruguay)  or in reports to the governments (Mexico). 
The Brazilian Government, with support from the Pan-American Health Organization organized the 1st Pan-American Conference on alcohol public policies, held in Brasilia. Over 110 participants attended from 26 countries of the Region. 
Guidelines for care and comprehensive managements of Drug Users Living with HIV/ AIDS in Latin America and the Caribbean. The objective of this Manual is to provide health professionals in Latin America and the Caribbean with Guidelines for care and managements of HIV+ drug using patients. It includes descriptions of psychoactive substances dependency, effective harm reduction actions and coordinating HIV/ AIDS treatments with mental health care . It also presents brief information on the most common co infections found in HIV/AIDS patients such as tuberculosis, hepatitis, and sexually transmitted infections. 

## Issues to think about

- Understanding the drug problem requires understanding the alcohol problem at all levels: from basic research to policy.
- Drug surveys and studies must include appropriate questions/assessment of alcohol consumption, patterns and problems
- Treatment research/ health service research need to integrate all substances
- Professional training must integrate all substances
- Separating the fields is counterproductive for public health

**Notes:**
It is necessary to understand the drug problem the understanding of the alcohol problem. For that reason we recommended to add alcohol questions in to the questionnaires of researches, epidemiology. Do more research in health service as well in treatment. Work the co-morbidity with alcohol and other drugs. 
Also to trained health professionals that work with drugs in alcohol. 

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