Alcohol-related harm causes an estimated 2.6 million deaths each year and remains one of the most preventable, and most neglected, threats to health and development. A new WHO report, implementing what works in alcohol policy: progress report on the SAFER initiative , documents how countries are moving from commitment to delivery, and sets out the priorities for the next phase.
Launched at the 2018 United Nations High-Level Meeting on Noncommunicable Diseases and formally mandated through the Global Alcohol Action Plan 2022–2030, SAFER has become WHO's main platform for action across five high-impact areas: restricting availability, drink-driving countermeasures, screening and treatment, marketing restrictions, and pricing through taxation.
Countries translating SAFER into national and community action
Country-level implementation highlights how partnerships and coordinated action can drive policy and health system change. Uganda, the first country to adopt SAFER as a national platform, integrated screening, brief intervention and referral to treatment into primary care, and supported reforms to its Excise Duty Acts. In Nepal, the Supreme Court upheld the national ban on alcohol advertising, and a federal directive now tasks all local governments with alcohol and tobacco control measures.
The report also notes that SAFER is increasingly being delivered at the subnational level, anchored in national legislation and frameworks. Ireland offers the clearest example through its Building SAFER Communities initiative, launched in 2024, which connects the national Public Health (Alcohol) Act to delivery across 10 communities reaching roughly 190 000 people. Local steering groups co-design action plans tailored to their own needs, supported by accredited university-level training and the i-Mark standard, which safeguards communities from alcohol industry influence. The initiative shows how a national framework can be translated to community level while maintaining local ownership, and confirms that SAFER remains relevant in high-income settings, where strong legislation still depends on sustained local delivery. Similar subnational efforts are emerging elsewhere: Thailand's SAFER Province Project is testing governance and enforcement models across five pilot provinces, and in the United Kingdom, Greater Manchester adopted SAFER as the framework for its 2025–2030 alcohol harms strategy.
Regional action through structured collaboration
Regional efforts are also expanding across WHO regions, with SAFER delivered through structured pathways that link peer learning with practical implementation planning. In the African Region, intercountry learning grew from seven countries in 2023 to 15 in 2025. In the South-East Asia Region, five Member States have been supported to develop national delivery plans. In the European Region, all 53 Member States unanimously endorsed the WHO European Framework for Action on Alcohol 2022–2025, placing SAFER at the centre of the regional response. In the Region of the Americas, the Pan American Health Organization has scaled up capacity-building and trained nearly 4800 participants. In October 2025, the Western Pacific became the first WHO region to formally embed SAFER as its organizing framework for regional cooperation.
Momentum has also grown across the United Nations system. At the end of 2024, the WHO Director-General wrote to a number of heads of UN agencies, encouraging them to scale up their actions on alcohol harm. Partners are now working through the United Nations Inter-Agency Task Force on the Prevention and Control of Noncommunicable Diseases (UNIATF) to develop a model UN system policy on preventing alcohol harm and addressing industry interference. Yet gaps remain: a UNIATF review found that only nine of 135 UN Sustainable Development Cooperation Frameworks rolled out between 2020 and 2023, just 7%, included alcohol policy as a priority. Resource limitations, fragmented governance, weak data systems and persistent industry interference also continue to constrain progress.
"Alcohol harm is not inevitable. This report shows what becomes possible when countries lead and partners line up behind them, and our task now is to make sure that progress reaches the people and communities who stand to benefit," said Dr Jeremy Farrar, WHO Assistant Director-General for Health Promotion and Disease Prevention and Control.
The next phase of the initiative will embed SAFER in governance and financing structures, strengthen enforcement and monitoring, protect policy-making from commercial influence, and ensure progress translates into tangible benefits, including safer roads, fewer hospitalizations, reduced violence and healthier communities.
Read the full report: here
