By Mary Assunta

Sophisticated advertising  sells beer in Asia

Carlsberg AS of Denmark, the world's seventh largest brewer in 1999, recently increased its Asian presence via a joint venture agreement with Thailand's best-selling beer producer, and is now the biggest brewer in Asia. Thailand is Carlsberg's biggest Asian market, and Malaysia is also emerging as a "very important and attractive market." Carlsberg has invested US$20 million to expand production by 25 per cent to 125 million liters a year. Carlsberg also has breweries or licensees brewing its beer in Indonesia, Vietnam, Nepal, Hong Kong, the Philippines, Sri Lanka, South Korea, Japan, Singapore and China.

Heineken is also widely brewed the region, including Hong Kong, Malaysia, Indonesia, Vietnam, Cambodia, Singapore, Thailand, Papua New Guinea and Tahiti (French Polynesia). About one quarter of Heineken’s sales comes from the Asia Pacific and African regions, which are its most rapidly growing markets.

With such a strong presence in Asia, one cannot escape the sleek advertising and sponsorship activities of Guinness (partnered with Heineken in Asia), Carlsberg, Heineken, and Heineken’s local brands, Anchor and Tiger.

While legal drinking ages are commonly 18 (and in some countries as high as 21), alcohol companies find many ingenious ways to promote their brands to young people. Alcoholic soft drinks (alcopops) have come to Asia, with drinks such as Hooch and Two Dogs packaged in bright colored bottles with cartoon drawings and names that children will find easy to remember. India's UB Group, one of the world's largest alcohol producers, has its own alcopop, the malt-based cola-flavoured "Spike."

Like tobacco companies, alcohol producers use sports, movie and rock concert sponsorships to introduce their brand names to young people. Web sites developed for specific markets, such as Bacardi's "Bat Club" oriented to young people in Mumbai, offer contests, streaming audio and video, top ten lists, and, until recently, a section titled "Get Drunk."

If you drink enough, the companies will even buy you a computer. Carlsberg Malaysia offered a computer as a prize on its web site, and claimed to support computer literacy by pledging to donate 10 cents (£.018) in exchange for a crown, cork or can-ring from small bottles or cans of Carlsberg.

The "Guinness Stout is good for you" campaign launched in Asia in the 1980s was successful in capturing the poorer working class. Promoted as a drink that "will put back what the day takes out," it appealed to the poor because it contained more alcohol than beer for the same price. The message was simple enough for the poor and easily translated into the many languages of Asia.

In Malaysia Guinness targets the poorer working class with special offers and redemption schemes. In one offer a person had to purchase 12 big bottles or 24 small bottles of stout to redeem a free plate. It would be much cheaper to purchase the plate than to buy all those bottles of stout. The sad irony is a plate of food, which the poor need badly, costs less than the bottle of stout they are cajoled to buy.

Indians are among Malaysia's poorest, and alcohol companies target them by sponsoring special concerts and offering scholarship programs for their children.

Alcohol transnationals exploit numerous Asian religious and cultural festivals to push sales. During these occasions advertising is intensified. The Indian festival Deepavali and the Chinese Lunar New Year have both become alcohol marketing opportunities. Alcohol companies misleadingly associate their brands and drinks with prosperity, longevity and good luck.

The indigenous peoples of East Malaysia celebrate a local rice harvest festival called "Gawai". Anchor beer ran adverts wishing these rural communities a plentiful harvest with its alcoholic drinks. While self-brewed rice wine is part of the traditional culture, beer of any kind, including Anchor, is totally alien to the indigenous people.

While countries such as the USA ban health claims in alcohol advertising, in Asia where laws are not so stringent such claims are not uncommon. In addition to the "Guinness is good for you" campaign described above, Yomeishu, with 14 per cent alcohol, claims medicinal properties, while Bacardi-backed Benedictine D.O.M., with 40 per cent alcohol, says it can restore health to mothers who have just given birth. Its advertisement states it is "simply full of goodness" and helps you "build up resistance to colds."

A recent advertisement for Guinness Stout went a step further to imply that Guinness enhances male fertility, showing a man pushing 10 prams. The company proudly explained that the concept of that campaign was to "demonstrate qualities of real men" and "manliness".

Mahatma Gandhi touched and inspired millions around the world, and he remains India's most revered figure. In Johnny Walker whisky's global "Keep Walking" campaign, Malaysian marketers used Gandhi along with eight other world leaders from around the world as part of an "inspirational contest" open to people of all ages. Contest participants were asked to choose the most inspirational from a list that also included Mother Theresa, Nelson Mandela and Martin Luther King.

Among his many achievements, Gandhi was well known for his fight against liquor, which today is still prohibited in his home state of Gujarat. His stand against liquor is enshrined in the language of India's Constitution. It is thus a complete betrayal of his life and legacy to use Gandhi's image and contributions in promotion of alcohol consumption.

International brands including Anchor, Guinness, Tuborg, Heineken, Carl's, Tiger, Hennessy have all used and continue to abuse women as sex objects in their promotions in Asia. Images of half-naked women posing seductively on poster advertising alcohol line the walls of coffee shops and restaurants. One of Guinness’s advertisements shows women hanging around a Guinness drinker while the non-Guinness drinker stands alone. In Malaysia, Guinness and Carlsberg employ young women dressed in the colors of their alcohol brand and stationed in restaurants, night clubs and bars to sell drinks directly to patrons.

Promoting excessive drinking as an advertising tactic is not uncommon. A Tuborg beer print advertisment had a man boasting how in one night he had 7 gins, 6 brandies, one AK-47, one Tombstone and two shots of whisky. One Tiger beer promotion showed a man with 10 beer jugs he presumably consumed. Carlsberg ran a " Carlsberg part of the game" promotion in Malaysia during Euro 2000 which said, "half-time, full-time, extra time, anytime" and to "enjoy the kick."

Today, Asia presents a huge market for alcohol transnationals. Many countries have few laws controlling advertising and marketing practices, making it easier for companies to engage in unethical and irresponsible tactics usually banned in the western world. There are many similarities between the alcohol and the tobacco industry, both in terms of marketing tactics and market expansion into Asia. Both industries take a heavy toll on society, bringing tragedy to Asia.

Mary Assunta is Media Officer for the Consumers Association of Penang, Malaysia. This article was adapted from a longer article of the same name by Mary Assunta published in the January, 2001 issue of The Globe at www.ias.org.uk/theglobe/

By Neiva Melamed

Itaipu Binacional funds health promotion programs for its staff aimed at alcohol abuse.

There are many different factors contributing to the development of alcoholism, including psychosocial factors. Political conflicts, personal problems involving professional and financial issues, relationship concerns, and a sense that society is living on the edge damage the individual’s mental health, so a "magical and quick" way out through the consumption of alcohol becomes an easily accessible alternative.

The consumption of alcohol is extremely common in Brazilian society. Alcohol is a must at most parties and meetings. "Go out for a drink!" is part of the Brazilian culture. Alcoholic drinks are easily found and prices are affordable. There is no effective control over the buying and selling of alcohol: although establishments are not allowed to sell alcohol to those under the age of 18, this law is rarely obeyed and there is no real punishment for those who disobey it.

Brazil is the fifth largest producer of beer in the world. A single brewing company (the third largest in the world) makes 70% of the total Brazilian production, 90% of which is destined for domestic consumption. This saturation of the market means that in Brazil the average age when alcohol consumption begins has been reduced to between 12 and 13 years old.

Although official statistics from the State Health Department show that 10% of the adult population in Brazil is alcoholic, recent research carried out by GREA – Grupo Interdisciplinar de Estudos de Álcool e Drogas (The Interdisciplinary Group of Studies of Alcohol and Drugs) and by the Psychiatry Institute of the Hospital das Clínicas of São Paulo shows that the rate of alcoholism is actually around 15%. Moreover, if we consider the collateral effects of alcoholism on family and friends, who are always damaged by alcohol addiction, the percentage of Brazilians immediately affected by alcoholism abuse rises to 45%.

Brazil spends 7.3% of its GNP per year to treat problems related to alcohol, whether treating addicts or dealing with the losses in productivity resulting from alcohol consumption. Considering that the alcohol brewing and distilling industry is responsible for 3.5% of Brazilian’s GNP, the country spends double the amount generated by production of alcohol trying to solve the problems caused by the abusive consumption of these drinks. Moreover, 90% of admissions to Brazilian psychiatric hospitals for treatment of substance abuse are alcohol-related.

Other statistics from the State Health Department show that round 40% of police events related to family conflicts and 30% of reported incidents of aggression against women are related to alcohol. Around 75% of car crashes with casualties in Brazil are involve alcohol consumption. Though the National Traffic Code regards drunk driving as an extremely serious violation to drive drunk, and provides for severe penalties, such as high fines, arrest, suspension of the driving license and of the vehicle registration, there are no effective programs aimed change in Brazilians’ alcohol consumption patterns, probably due to the social, political and economic contradictions extant in the country.

Alcoholism is also a great cause of absences from work, and the social welfare system of Brazil pays heavily in sickness benefits for illnesses related to alcohol abuse. Brazilian employment law tries to counter alcohol abuse: frequent drunkenness is a justified reason to fire an employee, while missing work on Mondays allows the employer to deduct the payment of that day and from the previous weekend from the employee’s salary, which means three days less in the paycheck.

Losses due to low productivity, the loss of materials, the absences, delays, diseases, relationship problems and accidents at work, expenses with dismissals and hiring of employees justify the implementation of programs for prevention and treatment of alcoholism.

Health Promotion

Although it is still a challenge to transform people’s prejudices about alcoholism into conceptualizing it as a disease, the relationship of cost/benefit of doing so has proved be favorable to the organizations. Certainly, the emotional benefits as well as the social ones, which are impossible to be quantified, maximize this relationship. The number of companies incorporating and understanding the concept of the responsible business behavior and developing health programs, including those to promote sobriety or sensible alcohol use, is increasing in Brazil. These companies certainly want to thrive economically, but they also wish to contribute to sustainable social, economic and environmental development.

It is clear, however, that these programs should focus on health promotion and on the valorization of life as fundamental factors. And, using this backdrop, they should specifically include prevention of the over consumption and addiction to alcohol, informing and raising everyone’s awareness through different approaches to communication. They should consider the human, financial and material resources of the company and aim as much at the prevention as at the identification of the problem, as well as the treatment orientation. Such treatment includes basically internment (if necessary), psychotherapy (individual and family), therapy groups focusing the improvement of quality of life and preventing relapses.

The results achieved by these sorts of programs are highly favorable when compared to other sort of motivation for treatment of alcohol abuse, even when we compare the rates of relapses. And beyond the statistics attesting to the effectiveness of such programs, there is the powerful human evidence:

"I thank forever the company and the team responsible for the program through which my will could be awaken, helping me to find a better way of life". (An employee of Itaipu Hydroelectric Power Plant)

"I will never forget what the company did for me and I want to pay that with my work..." (An employee of the Parana State Electrical Company)

Country Profile: Germany

By Kirstin Job

Germany is a European country with a surface area of 137,821 square miles and a population of around 82 million people. Germany’s ethnic groups are primarily German; with a Danish minority in the north, and a Sorbian (Slavic) minority in the east and seven million foreigners.

Germany is a wealthy country possessing a heavily structured social security system. This system represents a middle-of-the road approach between a state welfare system, as in Britain, and a primarily market economy welfare system, as in the United States. The social security system regulates those cases that include the most important social risks and emergencies. Almost two-third of all social benefits are covered by insurance systems, which are financed by premiums, except for accident insurance. All social benefits are financed by taxes, such as welfare, child and housing benefits except for employer’s premiums, which are part of the wages costs.

Germany’s health care is based on a federally mandated insurance system. Nearly everyone residing in Germany is guaranteed access to high-quality comprehensive health care. For that each employee contributes a certain percentage of his or her wages to a non-profit health insurance company. Statutory health insurance (GKV) has provided an organizational framework for the delivery of public health care and has shaped the roles for payers, insurance or sickness funds, and providers, physicians, and hospitals. Over the years the costs for health care and health insurance have steadily been grown. Reasons are the increasing percentage of elderly people in the German population, the growing number of chronic diseases as well as medical and technical progress.

Healthy lifestyle issues are part of the structural German health promotion approach, which primarily aims at influencing health-related living and working conditions. Since the mid-1980s, prevention and health promotion have gained importance in Germany. In 1989 health promotion was included in the catalogue of activity that could be financed by the statutory health insurance companies. As a result, corresponding infrastructures for health promotion were developed, including measures in the field of occupational health promotion, individual health education courses, as well as the support of self-help activities. In 1997 law canceled the health promotion activities financed by the insurance companies. Since 2000 a new health law reform has been forced, where health insurance companies are responsible for informing and educating their clients regarding prevention and health care, for establishing occupational health promotion programs and for supporting self-help groups again. The health promotion investments by health insurance companies are financially limited and should not be higher than 5DM (USD $2.70) per client a year.

In Germany, worksite health promotions hold a special position. Health promotion was included in the catalogue of tasks of the statutory accident insurance sector, which was previously responsible for regulating industrial accidents and occupational diseases. The reason for this was the change in the national occupational health and safety regulations necessitated by the European framework legislation.

Costs due to absenteeism are relatively high in Germany. Disease-related causes for absenteeism fell into the following six categories: (1) musculo-skeletal injuries (29.2%), (2) respiratory tract illnesses (16.8%), (3) injuries and intoxication (14.1%), (4) disorders of the digestive system (7.7%), (5) cardiac and circulatory illnesses (7.3%), (6) mental disorders (5.3%). For that reason economic incentives to introduce workplace health promotion programs in Germany are used based on the costs of sick leave. Through encouragement and support by the statutory health insurance funds many private and public enterprises have invested in health promotion. In Germany, the health circle approach, a specific health promotion concept consisting of a series of group meetings with aiming to improve working conditions and aspects of job design, has gained widespread acceptance as part of the corporate health and human resource management. General health promotion services, mainly primary health promotion outside the workplace are largely privatized. On the other hand, secondary and tertiary prevention is still be financed by the statutory health insurance funds.

Health education is in the interest of public health policy. In Germany it is performed as an ongoing, interdisciplinary responsibility at all levels, integrating all those involved. At the federal level, this task is undertaken by the Federal Center for Health Education as a specialist authority in the sphere of responsibility of the Federal Ministry of Health. Preventive health care and the preservation of health are the two prime objectives of the work. Here the focus is on the willingness of individuals to adopt responsible, health-oriented lifestyles and make proper use of the health system. The aim is to achieve a high level of public knowledge on fundamental and topical health related subjects, to achieve a responsible attitude towards matters of health as well as exert a positive influence on individual health-related behavior and action.

Global Initiatives

On November 22, 2001, the WHO joined with top athletes and sports organizations, including auto racing and soccer, to initiate a global effort to eliminate tobacco advertising in the sports world. The anti-advertising campaign seeks to break the link between smoking and the glamorous world of sports, where tobacco use becomes positively associated with the strength, speed, grace success, fun, and excitement of sports. Tobacco-free sports is the first step in what the WHO hopes will be a worldwide advertising ban on tobacco products. The ban in sports and the push for a global ban are opposed by the world’s three biggest tobacco companies, British American Tobacco, Philip Morris and Japan Tobacco.

Specialists from throughout the Americas and representatives of international agencies met November 19, 2001 at the Pan American Health Organization (PAHO) in Washington to evaluate progress in the "Healthy children: the goal of 2002" initiative in the region. At the inaugural session the signature of the regional Declaration on the medium-term results of the initiative took place.

The initiative seeks to reduce 100,000 deaths of children under 5 in the Americas by 2002, through the Integrated Management of Childhood Illness (IMCI) strategy.

The evaluation meeting aimed to determine progress in the reduction of infant mortality in the Americas and to analyze the strengths and weaknesses in the implementation of the IMCI strategy in the region. It also seeks to strengthen the community component of the strategy and to strengthen coordination between IMCI and other health interventions.

The IMCI strategy was designed to reduce mortality and morbidity associated with the leading causes of illness in infancy and to favor adequate growth and development of children under 5 through training, information and education. The strategy allows health professionals to take advantage of a child's visit to a health facility to assess his or her overall health status and identify any problems or disorders. It identifies critically sick children who require hospital treatment and improves referral practices and focuses attention on the child's integrated care, beyond the original reason for the consultation. It also evaluates the nutritional status, vaccination record, and growth and development of the child and preventive practices utilized in the home; and ensures treatment of all diseases the child may have, not just the one that prompted the health service visit.

For more information, please contact: Daniel Epstein, Office of Public Information, (202) 974-3459, epsteind@paho.org

International Institute for Health Promotion Newsflashes

by Vivian Blaxell

This issue of Global Perspectives is the first to be published in electronic format only.  I hope you enjoy this new format and continue to read and contribute to the publication.

IIHP member, Neiva Melamed, reports that HUMANA - Research, Consulting and Projects in Quality of Life (Curitiba, Brazil) is engaged with the University of Memphis, in the US state of Tennessee, in a study of factors associated with smoking among women in Brazilian worksites. The study will examine the socio-cultural factors associated with smoking initiation, maintenance, cessation, and relapse among Brazilian working women, and will take place in Curitiba, Parana, Brazil. 

The World Health Organization has released the 2001 World Health Report. This essential document is available at http://www.who.int/whr/

Conference Announcements

The 14th Annual Art and Science of Health Promotion Conference will meet February 17-21, 2003 at the Omni Shoreham, Washington, DC, USA. Further information may be obtained by visiting, http://HealthPromotionConference.org/

The International Institute for Health Promotion (IIHP) is a global center for the development and advancement of health promotion policies, programs, services, and research that maximizes multiple efforts across the globe.  It was established in 1994 as an addition to the National Center for Health Fitness at American University in Washington, DC, to assist in leading, facilitating, and coordinating the efforts of many international individuals and organizations.  More than 50 cooperating members from 25 nations form an extensive interdisciplinary health promotion network that includes ongoing dialogue, information exchange and project participation.  Email the IIHP at iihpaa@american.edu.  The IIHP website is http://www.healthy.american.edu/iihp.html.