Wow, Neil this is a powerful contribution to this discussion, especially your recount of very personal and family unfortunate experience caused by alcohol use disorder. Thank you for the decision to share it because it brings the issue to the human level. Often when we quote statistics they are mere numbers whereas Infact each statistic is about people: individuals, families, the society.
Your reference to the medical student life on the UK reminds me of when I landed in UK for postgraduate specialist medical education in the 1980s and quickly observed that alcohol was so pervasive in every medical meeting and conference. It was different where I came from in Nigeria whether by medical students or qualified doctors. Surely there are many reasons for the difference, cultural, religious, but also economic! Nigeria is a low income country whereas UK is a high income one. But even then the harm of alcohol was similar in both countries especially regarding death from road traffic accidents. I recall that fast forward to 1997 after we started publishing the BMJ West Africa edition in Lagos, Nigeria we received a manuscript from the surgeons in Calabar on the impact of motor cycle accidents often ridden by drunk persons.
There is the paradox in the difference in behaviour between how the rich and poor use alcohol, which needs explaining because one often hears that poverty predisposes people to drink more alcohol.
But is that really the case, or is it just that poor people drink cheaper, less refined more concentrated alcohol, whilst the richer people drink the reverse. But both cohorts are over drinking alcohol.
The message it seems to me should be to highlight the fact that no alcohol is the best status that everyone should aim for.
HIFA Profile: Joseph Ana is the Lead Senior Fellow/Medical Consultant at the Centre for Clinical Governance Research and Patient Safety (CCGR&PS) with Headquarters in Calabar, Nigeria, established by HRI Global (former HRIWA). He is the Country Coordinator for PACK Nigeria (Practical Approach to Care Kit) which is specifically designed to improve clinical competence (improving accuracy of diagnosis and treatment) in primary health care. He is also a Member of the World Health Organisation’s Technical Advisory Group on Integrated Care in primary, emergency, operative, and critical care (TAG-IC2). As the Cross River State Commissioner for Health (2004-2008), Joseph Ana led the introduction of the evidence based, homegrown quality tool, the 12-Pillar Clinical Governance Programme (12-PCGP) in Nigeria, which also suitable for lower-, low-, and middle income countries (LLMIC) with similar weak health sector and system. To ensure sustainability of 12-PCGP, the ‘Department of Clinical Governance, Servicom & e-health’ was established in Cross River State Ministry of Health in 2007. His main interest is in ‘Whole health sector and system strengthening in LLMICs’. He has written six books on the 12-Pillar Clinical Governance Programme, including the TOOLS manual for its Implementation, currently in its 2nd Edition. He served as Chairman of the Nigerian Medical Association’s Standing Committee on Clinical Governance (2012-2022), and he won the Association’s ‘Award of Excellence’ on three consecutive occasions for the innovation of 12-PCGP in Nigeria. He served as Chairman, Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act 2014. He was Member, National Tertiary Health Institutions Standards Committee (NTISC) of the Federal Ministry of Health, 2017-2022. He is the pioneer Secretary General/Trustee-Director of the Charity, NMF (Nigerian Medical Forum UK) which took the BMJ to West Africa in 1995. Joseph is a member of the HIFA Steering Group; the HIFA working group on Community Health Workers, and the Working Group on HIFA-WHO Collaboration (http://www.hifa.org/support/members/joseph-0 http://www.hifa.org/people/steering-group). Email: info AT hri-global.org and jneana AT yahoo.co.uk