In Canada, the alcohol industry is not self-regulating but, with government, jointly funds the Canadian Centre for Substance Use. Warning labels on alcohol containers, mandated reporting on those
diagnosed with FAS, and court-ordered treatment for pregnant women originated in the Yukon; by- laws requiring warning signs at point of sale were established in some communities and key standards and policy directions and the development of a policy document, ‘FAS: Collective Action for
Collective Solutions’, recognised the need for policy change. Single (1993), a director of the Canadian Centre for Substance Abuse and a consultant to the alcohol industry’s International Center for Alcohol Policies wrote an opinion piece and argued the bias of policy advocates as the real problem. According to Single, policy advocates must be credible, communicate promptly and clearly, and consider all aspects of an issue. His argument is based on a perception that policy advocates are highly specialised and have technical knowledge but lack the ability to communicate well with the ordinary public; he
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noted that the ‘David and Goliath image of public health professionals against a huge alcohol industry may be appealing, but in the long run it is an over-simplification’ (Single, 1993).In a brief submitted on April 22, 1997 to the House of Commons Standing Committee on Health, the Brewers Association of Canada suggested the Federal Government keep the Canadian Centre on Substance Abuse as the national coordinating body linking federal and provincial efforts on substance abuse issues and concerns. The Brewers Association of Canada proposed the federal government’s role on issues of alcohol misuse should be to foster a public policy environment that encourages rather than discourages health partnerships among all stakeholders. The Brewers Association of Canada argued for ‘a national coordinating body on substance abuse’ taking advantage of the current
‘expertise, credibility, visibility and track record’ of the Canadian Centre on Substance Abuse with ‘no need to reinvent the wheel’ (Brewers Association of Canada 2001). Although the Brewers Association of Canada acknowledged the importance of broader public policies contained in a population health approach to health issues, it stressed that these were no substitute for ongoing, effective, targeted programming. While policymakers may choose to shape the environment so that it reinforces the adoption of moderate drinking practices, the Brewers Association of Canada argued policymakers could not afford to overlook the complementary role of more targeted programming, focused on those at risk. At this time the Brewers Association of Canada, as a founding partner in funding the Fetal Alcohol Resource Centre at the Canadian Centre on Substance Abuse, renewed its commitment to a further year of funding support and reported in their newsletter On Tap that it was supplying funds to support additional alcohol and pregnancy warning posters produced by Health Canada for display in Ontario, and that it had been supporting of this kind of initiative since ‘the late 1980s’. The
promotional content of the posters included information on the FAS Information Hotline, funded by the Brewers Association of Canada and operated by Motherisk, Ontario (Brewers Association of Canada 2001).
In 2002 Paul Szabo, Member of Parliament for Mississauga South from 1993 to 2011, reported that the alcohol beverage industry had made a profit of $700 million and spent $660 million on advertising; Health Canada in that time had invested 3.3 million in FAS. Szabo had been pushing for alcohol beverage labels for ten years when he tabled a private member’s bill, Bill C-206, in 2005. The media reported the labels he proposed were similar to ones found on cigarette packages, warning about the possible effects of alcohol including birth defects: ‘The beverage industry opposes the plan, claiming it would cost up to $20 million [Canadian dollars] a year to implement. Twenty countries have similar labels, including the United States’ (CBC Online 2005). Szabo defined warning labels as a
‘lighthouse, sending repetitive signals of impending danger’ (2007). Bill C-206 ‘died at committee level’ even though it had been approved in the House of Commons by 225 of 252 votes. Ten members of the alcohol industry were present at the committee meeting and ‘argued that labelling would not
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work’ unless part of a comprehensive strategy. Szabo was quoted as suggesting the failure of Bill C- 206 was linked to taxation: ‘Every time you take one dollar away from the alcohol industry, various levels of government lose $4.50’; which offered no incentive to change (Citizen Special 2005). The alcohol industry representatives counter proposed that public awareness about alcohol use inpregnancy and the risks of FASD was ‘very high and that labels were not effective’, and that funding ‘would be better spent on targeted programs’ (Loney et al. 1994, pp. 248–251).
Later in 2005, a motion to require Health Canada to table a comprehensive strategy to address FASD passed with the support of all parties. Mr Rob Merrifield (Member of Parliament for Yellowhead) stated:
[We do not need] more studies … or consultation. We … need to do something about it and Health Canada can do something about it … to move to action … It is something that needs to be done because failure to do it means that we will do nothing. Doing nothing on this issue is not appropriate … We did hear from the alcohol industry … It would cost a significant amount of dollars and dollars are not going to come out of thin air … they can come out of either the consumers who use it or the already existing programs that deal with fetal alcohol syndrome disorder … a paradigm shift … Peer pressure is a powerful thing (Alcohol Policy Network 2005).
6.9.
SUMMARY
The Canadian story began with diverse stakeholders in collaboration: parents, interested medical professionals and politicians, championing the cause because they had knowledge through shared clinical practices or had a personal stake. Collaboration was seen as critically important, involving women’s health, medicine and public health, who with a shared vision, created key policy documents considerate of gender. In the research arena, the NW FASD Partnership created network action teams reliant on collaborations with a clear agenda on research from the perspective of the social
determinants of women’s health. The innovative Canadian response to FASD was mobilised by powerfully persuasive women researchers who from the 1990s lobbied for FASD programs and interventions to take a didactic approach and recognise that preventing FASD means addressing holistically the life experiences of high-risk women who struggle with multiple issues. However, progress such as the higher availability of clinical services has not translated into higher numbers of people taking advantage of them. Accessibility in a remote country, or continued fear of the cause, diagnosis or stigma, have been suggested as possible reasons for this. If the Canadian experience is fraught with obstacles, what does this mean for Australia?