Opinion: Alcohol & Health

Understanding Illicit Alcohol

In December 2011, media outlets around the globe reported the shocking news that over 150 people had died in West Bengal, India, from toxic alcohol poisoning. According to most accounts, these deaths were related to the consumption of illegally produced alcohol. Tragedies like this one raise awareness in the public health community about the production and consumption of beverages that do not undergo quality controls.

According to the World Health Organization, about one third of all beverage alcohol consumed in the world is estimated to be unrecorded—either illegally made, home-produced, or traded outside government controls. This informal market includes a wide variety of products, ranging from fermented to distilled beverages. Unrecorded beverages are more prevalent, with a significant share of overall alcohol consumption, in some regions, such as South East Asia and Africa.

It is important to understand the social, cultural, political, and economic factors relating to the production and consumption of unrecorded beverages. Two major drivers of the informal beverage alcohol market are:

  • Culture – The production and consumption of some unrecorded beverages are deeply rooted in traditions. In many Sub Saharan African countries, for example, the production of a variety of fermented beverages such as sorghum and millet beers, as well as palm wine, dates from pre-colonial times. In some Asian countries like China, fruit and grain-based wines have been common for centuries.
  • Price – Locally produced unrecorded beverages tend to have significantly lower prices, which make them more accessible than their commercial counterparts.

Whether unrecorded beverages are defined as “illicit” or “illegal” depends on the laws of different countries. In particular, counterfeit and mass-produced illicit drinks are often the result of corruption, weak law enforcement, and poor legal protection for intellectual property. The production and sale of unrecorded beverages in many poor communities are also a vital source of income, meaning that governments can be reluctant to implement measures to restrict the market for them. At the same time, firm regulations of the formal market of beverage alcohol (such as price increases and availability) have often resulted in an expanded demand for unrecorded beverages.

Knowledge of illicit alcohol’s production, quality, drinking patterns, and related outcomes is limited. From a public health policy perspective, the first challenge is to expand the evidence base to inform policy decisions. Only with context-specific knowledge on the characteristics of this market can interventions be effective and sustainable.


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