FINDINGS FROM   THE GAMBIA, GHANA,  NIGERIA AND UGANDA      Monitoring Alcohol Marketing in Africa  MAMPA Project ALCOHOL MARKETING PRACTICES IN AFRICA FINDINGS FROM THE GAMBIA, GHANA, NIGERIA AND UGANDA BY AVALON DE BRUIJN ( AFRO Library Cataloguing-in-Publication Data Monitoring alcohol marketing in Africa 1. Alcohol Drinking 2. Alcoholic Beverages 3. Alcoholism 4. Social Marketing 5. Mass media 6. Africa South of the Sahara I. World Health Organization. Regional Office for Africa. ISBN 978 929 023 1844 (NLM Classification: WM 274) © WHO Regional Office for Africa, 2011 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. Copies of this publication may be obtained from the Library, WHO Regional Office for Africa, P.O. Box 6, Brazzaville, Republic of Congo (Tel: +47 241 39100; Fax: +47 241 39507; E-mail: CONTENTS 1. Introduction ............................................................................................................................................................. 6 2. Background .............................................................................................................................................................. 7 Alcohol use in the African region ................................................................................................................................. 7 Alcohol consumption in the participating African countries ....................................................................................... 8 Africa as emerging alcohol market and the role of marketing .................................................................................... 9 Alcohol advertising restrictions ................................................................................................................................. 10 Alcohol advertising restrictions in participating countries ........................................................................................ 11 3. Monitoring alcohol marketing activities in participating countries: the method used ......................................... 14 Selecting participating countries and organizations .................................................................................................. 14 Selecting marketing tools to be monitored ............................................................................................................... 14 Monitoring Alcohol advertising on television ............................................................................................................ 15 Alcohol advertising on radio ...................................................................................................................................... 15 Print advertising......................................................................................................................................................... 15 Alcohol advertising on the street .............................................................................................................................. 15 Monitoring other types of alcohol marketing ........................................................................................................... 16 An illustration of young people’s exposure to alcohol marketing ............................................................................. 16 4. The Gambia ............................................................................................................................................................ 17 An illustration of Gambian youngsters experiencing alcohol marketing ................................................................... 17 Alcohol companies that advertise in the Gambia: ..................................................................................................... 18 Alcohol advertising in Gambian Magazines & Newspapers ...................................................................................... 18 Alcohol ads on Gambian Television ........................................................................................................................... 18 Alcohol ads on Gambian Radio .................................................................................................................................. 18 Alcohol Outdoor Advertising in the Gambia .............................................................................................................. 19 Other types of alcohol marketing in the Gambia ...................................................................................................... 20 Adherence to alcohol marketing restrictions in the Gambia ..................................................................................... 21 5. Ghana ..................................................................................................................................................................... 22 An illustration of Ghanaian youngsters experiencing alcohol marketing .................................................................. 22 Alcohol companies that advertise in Ghana .............................................................................................................. 24 Alcohol advertising in Ghanaian Magazines & Newspapers ...................................................................................... 25 Alcohol ads on Ghanaian Television .......................................................................................................................... 26 Alcohol ads on Ghanaian Radio ................................................................................................................................. 29 Alcohol Outdoor Advertising in Ghana ...................................................................................................................... 30 4 | P a g e Other types of alcohol marketing in Ghana ............................................................................................................... 32 A Ghanaian case study: Branding Kasapreko products ............................................................................................. 32 Easy available and affordable alcohol ....................................................................................................................... 33 Event sponsoring ....................................................................................................................................................... 34 Media training journalists .......................................................................................................................................... 35 Adherence to alcohol marketing restrictions in Ghana ............................................................................................. 36 6. Nigeria .................................................................................................................................................................... 37 An illustration of Nigerian youngsters experiencing alcohol marketing .................................................................... 37 Alcohol companies that advertise in Nigeria: ............................................................................................................ 38 Alcohol Advertising in Nigerian Magazines & Newspapers ....................................................................................... 39 Alcohol ads on Nigerian Television ............................................................................................................................ 42 Alcohol ads on Nigerian Radio ................................................................................................................................... 44 Alcohol Outdoor Advertising in Nigeria ..................................................................................................................... 45 Other types of alcohol marketing in Nigeria:............................................................................................................. 47 Adherence to alcohol marketing restrictions in Nigeria ............................................................................................ 48 7. Uganda ................................................................................................................................................................... 49 An illustration of Ugandan youngsters experiencing alcohol marketing ................................................................... 49 Alcohol companies that advertise in Uganda: ........................................................................................................... 51 Alcohol ads in Ugandan Magazines & Newspapers ................................................................................................... 52 Alcohol ads on Ugandan Television ........................................................................................................................... 56 Alcohol ads on Ugandan Radio .................................................................................................................................. 59 Alcohol Outdoor Advertising in Uganda: ................................................................................................................... 62 Other types of advertising in Uganda: ....................................................................................................................... 64 Adherence to alcohol marketing regulations in Uganda ........................................................................................... 66 8. Conclusion .............................................................................................................................................................. 68 9. Discussion of findings ............................................................................................................................................. 70 10. Recommendations ................................................................................................................................................. 72 11. References ............................................................................................................................................................. 74 Annex 1: Project partners .......................................................................................................................................... 78 Annex 2. Overview Alcohol advertising in Magazines &Newspapers ........................................................................ 79 Annex 3. Outdoor advertising maps and ads ............................................................................................................. 85 5 | P a g e 1. INTRODUCTION Alcohol consumption and alcohol industry activities are rising throughout the African continent. Alcohol marketing is an important tool for the industry to create a favorable image around the product and to increase sales. This report describes the results of a first attempt to record alcohol marketing activities in the African region. In this pilot study, alcohol marketing activities in four Sub-Saharan African countries have been monitored, namely: the Gambia, Ghana, Nigeria and Uganda. By selecting countries, variation has been sought in terms of existing alcohol marketing regulations and established alcohol consumption patterns. Preference was given to countries which have English as (one of) the official national language(s). Public Health NGOs in the participating African countries have been trained to monitor alcohol marketing practices in their own country (see annex 1 for a description of collaborating parties). The report provides preliminary insight in alcohol marketing strategies used by the industry in some countries of the African region and in particular: • The character and size of types of alcohol advertising and promotion in the participating countries. • Knowledge of the benefits and disadvantages of possible alcohol marketing regulations. This includes both statutory as well as non-statutory regulations (self-regulation). This knowledge was actively gathered in the participating countries. Findings of this preliminary monitoring exercise, that took place in the first trimester of 2010, result in first recommendations on the effectiveness of existing and desired alcohol marketing regulations in order to protect young people against the harmful effects of exposure to alcohol advertising. This report is one of the outcomes of the MAMPA project. MAMPA stands for Monitoring Alcohol Marketing Practices in Africa and aims to provide insight into the impact of advertising and in the volume, frequency, and content of alcohol advertising and promotion in participating African countries. An important aim of the project was to develop a method to monitor alcohol marketing in low-income countries. The report with findings of the monitoring exercise in four participating countries is accompanied by a second report that highlights the method used. The MAMPA project is financed by the World Health Organization Regional Office for Africa, and is coordinated by the Dutch Institute for Alcohol Policy (STAP). For several years, STAP has been authorized by the Dutch Ministry for Health, Welfare and Sports to monitor alcohol marketing in the Netherlands. In recent European projects, STAP has been training NGOs to monitor alcohol marketing in other European countries. In 2007, STAP together with other NGOs initiated EUCAM (the European Centre for Monitoring Alcohol Marketing). This report was edited by Wim van Dalen of STAP and Per Ake of IOGT-NTO. 6 | P a g e 2. BACKGROUND ALCOHOL USE IN THE AFRICAN REGION Recently published data (5) show that less than half the world’s adult population drinks alcohol. Much of the variation in per capita alcohol consumption between countries and regions of the world indicates differences in abstention rates (6). Among drinkers there is less variation in alcohol consumption patterns. For low-income countries, a strong relationship has been found between economic wealth and alcohol consumption. A higher gross domestic product is related to a higher overall alcohol consumption and a lower proportion of alcohol abstainers (5). Consequently, abstention rates are highest in low-income countries and populations, especially in Africa (5). In Africa, levels of alcohol use differ greatly between countries (5, 7). This is due to differences between countries with respect to ethnic diversity, religion, level of welfare and industrialization, availability of alcohol, acceptability of alcohol in society, and political and economical stability (8). Increasing alcohol-related problems in African society are related to the use of home produced alcoholic beverages as well as the use of alcoholic beverages that are produced and distributed commercially (9). Although alcohol-related problems in African countries are quite heterogeneous, clear similarities can be found. Alcohol is a causal factor for intentional and unintentional injuries and social and physical harm to the drinker and people other than the drinker. This includes reduced job performance, absenteeism, family deprivation, interpersonal violence, suicide, homicide, crime, and fatalities caused by driving while under the influence of alcohol (drink-driving) (6). Furthermore, it is a contributory factor for risky sexual behavior, sexually transmitted diseases, and HIV infection (6, 7). In general, the lower income countries have a disproportionate great disease burden per unit of alcohol consumption compared with high-income populations and countries (5). Alcohol is the leading risk factor in those developing countries with low rates of child and adult mortality (7). In Sub-Saharan Africa 2.2% of all deaths and 2.5% of all adjusted life years (DALYs) are related to alcohol (10). 7 | P a g e ALCOHOL CONSUMPTION IN THE PARTICIPATING AFRICAN COUNTRIES Religious denominations in some countries, for example the large Islamic population in the Gambia and some of the Christian denominations in the other countries, are reluctant towards the use of alcohol. Reflecting the diversity in countries, the acceptability of alcohol use and drunkenness differs greatly in participating countries. Data from the 2004 WHO report (11) shows that Uganda is the highest drinking country in the world with its 19.47 liters of recorded alcohol consumed per capita. This data is aggregated from regional survey data, and provides an estimation of the national alcohol consumption. Wine (included fermented beverages) is the most drunken alcoholic beverage, followed by beer. Unrecorded alcohol is estimated an additional 10.7 liters. Less alcohol is consumed in the other selected countries. Reported alcohol consumed in Nigeria accounted for 10.4 liters with 3.5 liters of unrecorded alcohol, followed by Gambia (2.27 liters, unrecorded alcohol is not reported), and Ghana (1.54 liters) with 3.6 liter of unrecorded alcohol. In Nigeria, wine (including fermented wine) is the most consumed beverage in the country; beer is the most consumed alcoholic product in the Gambia and Ghana. 8 | P a g e AFRICA AS EMERGING ALCOHOL MARKET AND THE ROLE OF MARKETING Giant alcohol companies as SABMiller, Heineken, Diageo, Carlsberg and Anheuser-Busch Inbev promote their products globally. As a consequence, all continents are potentially a target of well-thought marketing strategies. Overviews from the World Health Organization (11) show that much alcohol is consumed in especially Western countries where the market is more or less saturated. Consequently, low-income countries and emerging markets with large populations such as South Africa, Nigeria, Malawi, Uganda, Brazil, India and China have been targeted recently by global alcohol corporations (12). Changes in social and cultural conditions together with increasing marketing efforts, are expected to raise alcohol consumption and consequently to increase alcohol-related harm worldwide (12). Consumption of commercial beverages is expected to rise in the next years as economic conditions continue to improve in some African countries and as a result of increasing alcohol marketing and promotion activities by the global alcohol industry (7). Especially the youth population, who constitutes the largest proportion of the population in African countries, has increased and is expected to further increase their alcohol consumption. Several authors have noted that adolescents and young adults have become the specific target audience for alcohol marketers (8, 13). Drinking and brand preferences of adolescents are an important predictor of preferences later in life: “If you hook them early, they are yours for life” An important risk of an increasing commercial market of alcohol is the growing dependence of society from alcohol producers and distributors (8). A specific alcohol economy is created which brings along some economic benefits. The sale of alcohol increases employment at the national and local level (9). The government can raise taxation on the sale of alcohol which is generally seen as easy revenue (14). Furthermore, alcohol producers are often willing to combine their introduction to a market or an extension within a market with investments that benefit the societal infrastructure or with projects that increase the image of these producers (see also page 65). In most developing countries, the mass media depends on multinationals, such as global alcohol companies, operating in their countries for revenue, which primarily originates from corporate sponsorship and advertising (15). Understandably, this development is perceived as most welcome in societies where economic benefits of alcohol sales are visible and tangible for society and especially within economic and societal highly vulnerable African societies. However, this development has large disadvantages that are difficult to measure directly. As written above, alcohol use will bring along enormous problems for society and health. Furthermore, developing countries are targeted disproportionately by a large burden of alcohol-related problems (5). As European data show, costs for health care can amount to billions of dollars (16). Furthermore, many problems will be created in private domains (home and work) as well as the public domain. In every country in which alcohol use is a generally accepted phenomenon, many people die every year in traffic due to alcohol use (17). 9 | P a g e Many African countries are not prepared to fight effectively against problems that are created by the availability of alcohol. To prevent these problems is even more challenging. In every society, easy available alcohol should be opposed by a strong national and local alcohol policy. Effective alcohol policy is a policy that limits alcohol- related health risks effectively and prevents young people from drinking alcohol. Characteristics of such a policy are limiting the availability of alcohol, limiting the affordability of alcohol and limiting the number of locations where alcohol is sold. Additionally, it is important to heavily restrict or to prohibit alcohol advertising to prevent a one-sided and positive image on the risks of alcohol and to restrict the volume. It needs to be prevented that young people are stimulated to experiment with alcohol by exposure to attractive alcohol advertising and event and sports sponsoring (see for details (18). The Members of the World Health Organization have emphasized the importance of limiting exposure to alcohol marketing, especially in low-income countries by endorsing the draft Global Strategy to reduce alcohol related harm in May 2010 (19). This point of view is also reflected by the Ministers of Health in the African Region endorsing a declaration that states the intensity of advertising promotes the harmful use of alcohol, and aggravates the situation and leads to excessive consumption of alcohol and undermines good policies and initiatives to limit consumption abuse of alcohol. Additionally, the declaration recommends special attention to a ban and or limitation of the marketing of harmful use of alcohol particularly about its effects on youth and vulnerable groups (10). Since it is already difficult for Western governments to enforce this kind of policy, it is problematic for vulnerable African societies to implement a national alcohol policy that reduces alcohol-related harm effectively. The infrastructure of preventing, regulating, and enforcing alcohol-related problems is often missing and limited resources prevent governments from taking adequate measures. Nevertheless, it is very important that the framework of effective alcohol policy is enforced in Africa as well. There is no time to waste, since the alcohol industry is already present in Africa on a large scale and is actively strengthening their position in the African market to increase the annual level of alcohol consumption in the continent. ALCOHOL ADVERTIS ING RESTRICTIONS The aim of effective alcohol policy is to prevent alcohol-related harm as much as possible. As written above, a ban or a restriction of alcohol advertising and promotion is one of the instruments to limit alcohol-related harm. The volume and content of advertising of alcoholic beverages contribute directly to the size of alcohol problems. Research conducted in the United States and Europe shows that alcohol advertising and promotion increase alcohol use, especially among new consumers (20-22). This means that even in 10 | P a g e