Methods document to report on the GATHER checklist for indicator Total alcohol per capita (15+ years) consumption, projected estimates for 2016

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1 Methods document to report on the GATHER checklist for indicator Total alcohol per capita (15+ years) consumption, projected estimates for 2016 This document summarizes WHO methods used to calculate total alcohol per capita consumption, projected estimates for The document is organized in line with the GATHER check list. Objectives and funding Item 1: Define the indicator(s), populations (including age, sex, and geographic entities), and time period(s) for which estimates were made. Total APC is defined as the total (sum of recorded APC and unrecorded APC) amount of alcohol consumed per adult (15+ years) over a calendar year, in litres of pure alcohol. Data are available for 189 countries. Recorded alcohol consumption refers to official statistics at country level (production, import, export, and sales or taxation data), while the unrecorded alcohol consumption refers to alcohol which is not taxed and is outside the usual system of governmental control, such as home or informally produced alcohol (legal or illegal), smuggled alcohol, surrogate alcohol (which is alcohol not intended for human consumption), or alcohol obtained through crossborder shopping (which is recorded in a different jurisdiction). Projected estimates were made for the year Item 2: List the funding sources for the work. WHO, WHO Member States. Data Inputs Item 3: Describe how the data were identified and how the data were accessed. In the Global Survey on Alcohol and Health, alcohol focal points officially nominated by the Ministry of Health provide data or links or contacts through which the data can be accessed. These focal points provide national government statistics. In addition, data were accessed from country-specific industry data sources in the public domain: Canadean, International Wine and Spirit Research (IWSR), Wine Institute; historically World Drink Trends. Also, data were obtained from the following databases: International Organisation of Vine and Wine (OIV); the Food and Agriculture Organization of the United Nations' statistical database (FAOSTAT). Item 4: Specify the inclusion and exclusion criteria. Identify all ad-hoc exclusions. Recorded alcohol consumption Inclusion: From any of the sources indicated below, sales or taxation data, or production, import, export data need to be available on an annual basis, disaggregated by the different beverage types (beer, wine, spirits, other) with indication of the beverage strength. If there are new government national statistics the data need to be over at least five consecutive years and expected to be available also in the future. Exclusion: Survey data for alcohol consumption. Data for each country are selected as follows:

2 The first priority in the decision tree is given to government national statistics; second are countryspecific alcohol industry statistics in the public domain based on interviews or fieldwork (Canadean, International Wine and Spirit Research (IWSR), Wine Institute; historically World Drink Trends) or data from the International Organisation of Vine and Wine (OIV); third is the Food and Agriculture Organization of the United Nations' statistical database (FAOSTAT), and fourth is data from alcohol industry statistics in the public domain based on desk review. For countries, where the data source is FAOSTAT the unrecorded consumption may be included in the recorded consumption. As from the introduction of the "Other" beverage-specific category, beer includes malt beers, wine includes wine made from grapes, spirits include all distilled beverages, and other includes one or several other alcoholic beverages, such as fermented beverages made from sorghum, maize, millet, rice, or cider, fruit wine, fortified wine, etc. The data source by country is available on GISAH with the display of the data in the Table View ( Unrecorded alcohol consumption For unrecorded APC, the first priority in the decision tree is given to nationally representative empirical data; these are often general population surveys in countries where alcohol is legal. Second are specific other empirical investigations (empirical data and investigations are identified through the WHO Global Survey on Alcohol and Health or literature review), and third is expert opinion supported by periodic survey of experts at country level (50 countries with significant estimates of unrecorded alcohol consumption) using modified Delphi-technique. Item 5: Provide information on all included data sources and their main characteristics. For each data source used, report reference information or contact name/institution, population represented, data collection method, year(s) of data collection, sex and age range, diagnostic criteria or measurement method, and sample size, as relevant. Please see Annex. Item 6: Identify and describe any categories of input data that have potentially important biases (e.g., based on characteristics listed in item 5). None. Item 7: Describe and give sources for any other data inputs. In circumstances in which the number of tourists per year is at least the number of inhabitants, the tourist consumption is also taken into account and is deducted from the country's recorded APC. The data on the number of tourists is from UN Tourist Statistics. Item 8: Provide all data inputs in a file format from which data can be efficiently extracted (e.g., a spreadsheet rather than a PDF), including all relevant meta-data listed in item 5. For any data inputs that cannot be shared because of ethical or legal reasons, such as third-party ownership, provide a contact name or the name of the institution that retains the right to the data. The data as of May 2016 are currently the latest on GISAH. Once an update is being made, the data as of May 2016 are going to be archived on GISAH. Data analysis Item 9: Provide a conceptual overview of the data analysis method. A diagram may be helpful.

3 Total APC is calculated as the sum of recorded APC and unrecorded APC. Recorded alcohol consumption is obtained from official, industry or FAO statistics at country level (production, import, export, and sales or taxation data). Unrecorded alcohol consumption is estimated using data from empirical investigations or, if not available, expert opinion. In circumstances in which the number of tourists per year is at least the number of inhabitants, the tourist consumption is deducted from the country's recorded APC. Total alcohol consumption was projected to 2016 using a country-specific regression model. Item 10: Provide a detailed description of all steps of the analysis, including mathematical formulae. This description should cover, as relevant, data cleaning, data pre-processing, data adjustments and weighting of data sources, and mathematical or statistical model(s). The data used for calculating the projected estimates for 2016 were those available at the last update of the Global Information System on Alcohol and Health (GISAH) in May Data on recorded alcohol per capita (15+ years) consumption were taken from the Global Information System on Alcohol and Health (GISAH), with data closure of May Establish time series in total alcohol per capita consumption (=recorded + unrecorded) from 2005 to 2015 (all years available). Unrecorded consumption was based on the World Health Organization monitoring efforts (please see Annex for sources); including country-specific efforts and ongoing nominal group Delphi study which asked experts from more than 50 countries to estimate the unrecorded consumption in their country for 2015 and to provide references including grey literature and documents supporting the estimates. 1 Based on these efforts, unrecorded consumption was available for the years 2000, , 2010 and 2015, 3 and was linearly interpolated between these years. Unrecorded was handled on a percentage (of total) basis (included the interpolation). For the estimation for 2016, the proportion (%) of tourist consumption of the total consumption (= sum of recorded plus unrecorded) was taken from the Global Status Report on Alcohol and Health ( and applied to the total (=sum of recorded plus unrecorded) APC predicted estimate for 2016 where applicable. For the estimation for 2016, linear regression was used on the time series of total (= sum of recorded plus unrecorded) consumption for all WHO Member States, based on the available data from 2005-, or between 2005 and the last available year. The following procedure was used: 1) Test via linear regression, if there is a linear trend upward or downward (y = a + bx + e; where y is total alcohol per capita consumption, X the years and b the trend coefficient; i.e., if the trend coefficient is significantly different from 0 (either positive, or negative). Significance was determined on the p = 0.05 level. 2) If there is no significant trend -> carry last year forward. 3) If there is a significant trend, determine how many years were predicted. If only two years, take the estimate for 2016 as per regression equation. If three years or more, take the lower 95% CI for increases or the upper 95% CI for decreases as a conservative estimate. 1 [Rehm J, Poznyak V. On monitoring unrecorded alcohol consumption. Alkoholizm i Narkomania (Alcoholism and Drug Addiction). 2015;28: Rehm J, Larsen E, Lewis-Laietmark C, et al. Estimation of unrecorded alcohol consumption in low-, middle-, and high income economies for Alcohol Clin Exp Res. 2016;40(6): ]. 2 [Rehm J, Room R, Monteiro M, et al. Comparative quantification of health risks: global and regional burden of disease due to selected major risk factors. In: M.Ezzati, A.D.Lopez, A.Rodgers, C.J.L.Murray, eds. Alcohol. Geneva, Switzerland: WHO, 2006.] 3 Global Status Report on Alcohol and Health. ; Geneva: World Health Organization; GISAH

4 Item 11: Describe how candidate models were evaluated and how the final model(s) were selected. Additional predictors such as GDP-PPP were tested, but they proved not significant. Item 12: Provide the results of an evaluation of model performance, if done, as well as the results of any relevant sensitivity analysis. Recorded alcohol per capita consumption is available for more than 90% of the countries for almost any year after It is relatively slow changing from one year to another. Unrecorded, the smaller component of alcohol per capita consumption, is not that available with higher bias. As only one to three years were predicted, based on 10 years, not many other models can be estimated with sufficient power. Thus, no sensitivity analyses were conducted. Item 13: Describe methods for calculating uncertainty of the estimates. State which sources of uncertainty were, and were not, accounted for in the uncertainty analysis. The main uncertainty to alcohol per capita consumption are from the sources, i.e., recorded vs. unrecorded. Please see the uncertainty on the unrecorded in the Annex (as from p.23). The uncertainty of the regression can be added to these, but is negligible compared to the uncertainty from the estimate of unrecorded production. Item 14: State how analytic or statistical source code used to generate estimates can be accessed. R code used to project is as follows: # Set working directory and read in data setwd("c:/...") input <- read.csv("data.csv") # Set up data frame for results nrow <- length(unique(input$iso3)) output <- data.frame(country= unique(input$country), ISO3 = unique(input$iso3), intercept = numeric(nrow), beta = numeric(nrow), SE = numeric(nrow), tval = numeric(nrow), pval = numeric(nrow), year = integer(nrow), fit = numeric(nrow), lwr = numeric(nrow), upr = numeric(nrow)) # Loop over all countries to # fit a linear regression model # store the regression results # make a prediction for 2015 including 95% prediction interval for ( iso in levels(output$iso3) ) { output[output$iso3 == iso, "year"] < # predicts for year 2016 lmfitted <- lm(total ~ year, data = input[input$iso3 == iso,]) lmresults <- summary(lmfitted) output[output$iso3 == iso, "intercept"] <- lmresults$coefficients[[1,"estimate"]] output[output$iso3 == iso, "beta"] <- lmresults$coefficients[[2,"estimate"]] output[output$iso3 == iso, "SE"] <- lmresults$coefficients[[2,"std. Error"]] output[output$iso3 == iso, "tval"] <- lmresults$coefficients[[2,"t value"]] output[output$iso3 == iso, "pval"] <- lmresults$coefficients[[2,"pr(> t )"]] output[output$iso3 == iso, c("fit", "lwr", "upr")] <- predict(lmfitted, interval = "prediction", newdata = output[output$iso3 == iso,], level = 0.95) } ## Save output write.csv(output, "predictions.csv")

5 Results and Discussion Item 15: Provide published estimates in a file format from which data can be efficiently extracted. Item 16: Report a quantitative measure of the uncertainty of the estimates (e.g. uncertainty intervals). Please see Annex (as from p.23). Item 17: Interpret results in light of existing evidence. If updating a previous set of estimates, describe the reasons for changes in estimates. Given the relatively small time frame of the projection, and the overall slow change of the indicator, the results should not be too far off. We will have real data within the next months and intend to do a formal analyses. Item 18: Discuss limitations of the estimates. Include a discussion of any modelling assumptions or data limitations that affect interpretation of the estimates. As indicated above, the main uncertainty with alcohol per capita consumption is unrecorded consumption, which is often based on expert estimates. The projection model does not add a lot of uncertainty.

6 Annex Data sources recorded Country Years available Algeria Angola Benin Botswana Burkina Faso Burundi Cabo Verde Cameroon Central African Republic Chad Comoros Congo Côte d Ivoire Democratic Republic of the Congo Equatorial Guinea Eritrea Ethiopia Gabon Gambia Ghana Guinea Guinea-Bissau Kenya Lesotho Liberia Madagascar Malawi Recorded Alcohol (15+) Source World Drink Trends (WDT) ; merged data (FAO, CANADEAN, OIV) (FAO, Canadean, Wine Institute, IWSR) (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO), ; merged (FAO, Canadean) (FAO, Canadean) (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) merged (FAO, WI) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Insltitute) (FAO,Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine institute) (FAO, Canadean. Wine Institute) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine institute) Food and Agriculture Organization of the UN (FAO) , merged (FAO, Canadean) Food and Agriculture Organization of the UN (FAO) (Canadean, Wine institute, IWSR) (FAO, Canadean, Wine Institute (FAO, Canadean, Wine Insltitute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, OIV) (FAO, Canadean, Wine Institute) 2000-

7 Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sao Tome Principe Senegal Seychelles Sierra Leone South Africa South Sudan no data no data Swaziland Togo Uganda United Republic of Tanzania Zambia Zimbabwe (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine institute) (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine Institute, IWSR) (FAO, Canadean) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) World Drink Trends (WDT) ; SAWIS Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) (FAO, Canadean, Wine industry) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) (WHO Global Survey on Alcohol and Health 2008 and 2012, sales data) ; with Wine Institute Antigua and Barbuda Argentina Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (sales) ; Estadisticas de Productos Industriales (EPI) - Bahamas Barbados Belize Bolivia (Plurinational State of) Brazil Canada Chile (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) (Canadean, OIV, IWSR) World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) World Drink Trends (WDT) ; Statistics Canada World Drink Trends (WDT) ; Global Survey on Alcohol and Health 2012 (sales, production, import, export) ; merged data (Canadean, OIV, IWSR) -

8 Colombia Costa Rica Cuba Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Nicaragua Panama Paraguay Peru Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Suriname Trinidad and Tobago United States of America Uruguay Venezuela (Bolivarian Republic of) Afghanistan Bahrain Djibouti Egypt Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; merged (Canadean, OIV,IWSR) (Canadean, Wine institute, IWSR) World Drink Trends (WDT) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) (FAO, Canadean, IWSR) (Canadean, Wine Institute, IWSR) (FAO, Canadean, IWSR) Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) (Canadean, Wine Institute, IWSR) Canadean, Wine Institute, IWSR) World Drink Trends (WDT) ; Consultores Internacionales ; merged (Canadean, OIV, IWSR) (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) World Drink Trends (WDT) ; Food and Agriculture Organization of the UN (FAO) World Drink Trends (WDT) ; Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, Wine Institute, IWSR) (Canadean, Wine institute, IWSR) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) National Institute on Alcohol Abuse and Alcoholism (NIAAA) World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (sales) ; Statistics Uruguay - World Drink Trends (WDT) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Wine Institute, IWSR) (Wine Institute, IWSR) (Canadean, OIV, IWSR) 2000-

9 Iran (Islamic Republic of) Iraq Jordan Kuwait Lebanon Libya Morocco Oman Pakistan Qatar Saudi Arabia Somalia Sudan Syrian Arab Republic Tunisia United Arab Emirates Yemen Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic (FAO, IWSR) (FAO, Wine Institute, IWSR) (Canadean, Wine Institute, IWSR) (FAO, Wine Institute, IWSR) (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) (FAO, Wine Institute, IWSR) (FAO, Canadean, IWSR) (Candean, Wine Institute, IWSR) (FAO, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) (FAO, IWSR) World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) ; merged (IWSR) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) Average of France and Spain Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) Handbook on Alcohol (Anton Proksch Institute) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) ; Statistical Yearbook, - Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2015 (sales) World Drink Trend (WDT) ;Food and Agriculture Organization of the UN (FAO) ; Belgium Tax Administration Department Food and Agriculture Organization of the UN (FAO) ; Merged (Canadean, OIV, IWSR) World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) ; merged Canadean, OIV, IWSR ) World Drink Trends (WDT) ; Statistics Cyprus World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (Sales) recalculated for 4% beer strength; Czech Statistical Office -

10 Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco no data no data Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino no data no data World Drink Trends (WDT) ; Statistics Denmark (sales) World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (Alcohol Market Yearbook, including tourist consumption) National Research and Development Centre for Welfare and Health (STAKES) ; Statistics Finland World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (taxation, OFDT based on INSEE data) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) World Drink Trends (WDT) ; Destatis ; WHO Global Survey on Alcohol and Health 2012 (sales data from alcohol industry converted to 15+) ; BSI - World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) World Drink Trends (WDT) ; Hungarian Central Statistical Office ; 2012 WHO Global Survey on Alcohol and Health ; Hungarian Central Statistical Office World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (sales) ; merged (Canadean, OIV, IWSR) World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (taxation) (Canadean, OIV, IWSR) World Drink Trends (WDT) ; Assobirra Annual Report Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) World Drink Trends (WDT) ; StatisticsLatvia Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health ; Statistics Lithuania Average of France and Germany consumption Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) merged (Food and Agriculture Organization of the UN (FAO), OIV, IWSR) World Drink Trends (WDT) ; Statistics Netherlands World Drink Trends (WDT) ; Norwegian Institute for Alcohol and Drug Research (SIRUS) ; Statistics Norway World Drink Trends (WDT) ; Statistics Poland ; WHO Global Survey on Alcohol and Health ; Statistics Poland - World Drink Trends (WDT) ; merged (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) ; Merged data (Canadean,OIV,IWSR) World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (production, import, export) World Drink Trends (WDT) ; Rosstat (sales data) 2000-

11 Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine 1975, United Kingdom of Great Britain and Northern Ireland (the) Uzbekistan Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste Australia WHO Global Survey on Alcohol and Health 2012 with IWSR for spirits World Drink Trends (WDT) ; Statistics Slovakia (consumption converted to 15+) ; Slovstat - Food and Agriculture Organization of the UN (FAO) ; Statistics Slovenia (converted to 15+) ; WHO Global Survey on Alcohol and Health World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012 (sales, taxation) World Drink Trends (WDT) ; Centre for Social Research on Alcohol and Drugs (Alcohol Use in Sweden 2010) World Drink Trends (WDT) ; Swiss Alcohol Board Food and Agriculture Organization of the UN (FAO) Statistics Macedonia World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2015 (government statistics) Food and Agriculture Organization of the UN (FAO) ; merged (Canadean, OIV, IWSR) World Drink Trends (WDT) 1975, ; Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2012 (sales converted to 15+) with Canadean for beer World Drink Trends (WDT) ; 2012 Global Survey on Alcohol and Health (customs and excise converted to 15+) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) (FAO, Wine Institute, IWSR) - spirits adjusted for recorded Country liquor) (Canadean, Wine Institute, IWSR) merged (Food and Agriculture Organization of the UN (FAO), Wine Institute) (FAO, Canadean, Wine Institue) (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2012 (customs and excise) ; Sril Lanka Customs and excise Department - Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; WHO Global Survey on Alcohol and Health 2012(production, import, export, taxation) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) World Drink Trends (WDT) ; National Drug Research Institute (NDRI) ; Australian Bureau of Statistics (taxation; sales data for wine) 2000-

12 Brunei Darussalam Cambodia China Cook Islands Fiji Japan Kiribati Lao People's Democratic Republic Malaysia Marshall Islands no data no data Micronesia (Federated States of) Mongolia Nauru New Zealand Niue Palau no data no data Papua New Guinea Philippines Republic of Korea Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) Canadean, OIV, IWSR) - Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine Institute) World Drink Trends (WDT) ; Japan National Tax Agency (adjusted to 15+) Food and Agriculture Organization of the UN (FAO) Food and Agriculture Organization of the UN (FAO) , merged (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; merged (Canadean, Wine Institute, IWSR) Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2012 ( imports) Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2012 (production, import, epxort) Food and Agriculture Organization of the UN (FAO) World Drink Trends (WDT) ; Statistics New Zealand Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine institute) (Canadean, OIV, IWSR) Food and Agriculture Organization of the UN (FAO) ; WHO Global Survey on Alcohol and Health 2012 (production, import, export) Samoa Singapore Solomon Islands Tonga Tuvalu Vanuatu Viet Nam (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; Singapore National Statistics (taxation) Food and Agriculture Organization of the UN (FAO) ; merged(fao, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; merged (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) (FAO, Canadean, Wine Institute) Food and Agriculture Organization of the UN (FAO) ; World Drink Trends (WDT) ; Statistical Yearbook 2000-

13 Data sources unrecorded Codes 1 from Global Status Report on Alcohol and Health (GSRAH) 2 changes including retrospective changes (if experts indicated changes including retrospective changes to 2010) 3 other sources -> specified country recorded unrecorded recorded plus unrecorded % sources (GSRAH had only o Afghanistan % 2 Angola % 1 Albania % 1 Andorra % 3 mean from France United Arab Emirates % 2 Argentina % 1 Armenia % 1 Antigua and Barbuda % 2 Australia % 1 Austria % 3 local experts indica in litres Azerbaijan % 2 Burundi % 3 local experts indica in litres Belgium % 1 Benin % 1 Burkina Faso % 1 Bangladesh % 1 percentage slightly reporting 0) Bulgaria % 1 Bahrain % 1 Bahamas % 2 Bosnia and Herzegovina % 1 Belarus % 2 based on NGT and Belize % 1 Bolivia % 1 Brazil % 1 Barbados % 1 Brunei Darussalam % 3 local experts indica in litres Bhutan % 2 Botswana % 2 Central African Republic % 1 Canada % 1 Switzerland % 3 local experts indica in litres

14 Chile % 1 China % 2 Côte d'ivoire % 2 Cameroon % 1 Democratic Republic of Congo % 2 Congo % 2 Cook Islands % 3 local experts indica in litres Colombia % 2 Comoros % 2 Cape Verde % 2 Costa Rica % 2 Cuba % 1 Cyprus % 3 local experts indica in litres Czech Republic % 1 Germany % 2 Djibouti % 2 Dominica % 1 Denmark % 1 Dominican Republic % 1 Algeria % 2 Ecuador % 2 Egypt % 1 Eritrea % 2 Spain % 1 Estonia % 2 estimates by the Es Ethiopia % 2 Finland % 2 Fiji % 2 France % 1 Micronesia, Federated States of % 1 Gabon % 1 United Kingdom % 2 Georgia % 2 Ghana % 1 Guinea % 1 Gambia % 2 Guinea-Bissau % 2 Equatorial Guinea % 2 Greece % 1 Grenada % 1 Guatemala % 1 Guyana % 1 Honduras % 1 Croatia % 1 Haiti % 1

15 Hungary % 3 local experts indica in litres Indonesia % 1 India % 2 Ireland % 3 local experts indica in litres Iran % 1 overall unrecorded litre per capita but it is almost excl Iraq % 1 Iceland % 2 Israel % 1 Italy % 2 Jamaica % 1 Jordan % 1 Japan % 1 Kazakhstan % 2 Kenya % 2 Kyrgyzstan % 2 Cambodia % 1 Kiribati % 2 Saint Kitts and Nevis % 1 Korea, Republic of % 2 Kuwait % 1 total consumption Laos % 1 Liberia % 2 Libya % 1 Saint Lucia % 1 Lebanon % 1 Sri Lanka % 1 Lesotho % 1 Lithuania % 1 Luxembourg % 3 mean of France and Latvia % 1 Morocco % 2 Moldova % 2 Madagascar % 2 Maldives % 2 Mexico % 1 Republic of Macedonia % 2 Mali % 1 Malta % 1 Myanmar % 2 Montenegro % 2 Mongolia % 3 local experts indica in litres Mozambique % 2 Marshall Islands no data Mauritania % 1

16 Mauritius % 2 Malawi % 2 Malaysia % 2 Namibia % 1 Niger % 1 Nigeria % 2 Nicaragua % 1 Niue % 2 Netherlands % 1 Norway % 2 Nepal % 1 Nauru % 3 local experts indica in litres but it is almost excl New Zealand % 1 Oman % 2 Pakistan % 1 total consumption Panama % 1 Peru % 2 Philippines % 1 Palau no data Papua New Guinea % 2 Poland % 1 Democratic People's Republic of Korea % 2 Portugal % 1 Paraguay % 2 Qatar % 2 Romania % 2 Russian Federation % 2 Rwanda % 2 Saudi Arabia % 1 Sudan % 1 Senegal % 1 Singapore % 3 local experts indica in litres Solomon Islands % 1 Sierra Leone % 2 El Salvador % 1 Somalia % 1 Serbia % 1 South Sudan no data Sao Tome and Principe % 2 Suriname % 1 Slovakia % 1 Slovenia % 2 Sweden % 2 Swaziland % 1

17 Seychelles % 2 Syrian Arab Republic % 1 Chad % 3 local experts indica in litres Togo % 1 Thailand % 1 Tajikistan % 1 Turkmenistan % 2 Timor-Leste % 3 local experts indica in litres Tonga % 1 Trinidad and Tobago % 2 Tunisia % 1 Turkey % 2 Tuvalu % 2 Tanzania % 2 Uganda % 2 Ukraine % 1 Uruguay % 1 United States % 1 Uzbekistan % 1 Saint Vincent and Grenadines % 2 Venezuela % 1 Viet Nam % 2 Vanuatu % 1 Samoa % 1 Yemen % 2 South Africa % 2 Zambia % 1 Zimbabwe % 1 GISAH metadata Alcohol, recorded per capita (15+ years) consumption (in litres of pure alcohol) Indicator name Indicator type Alcohol, recorded per capita (15+ years) consumption (in litres of pure alcohol) Ebola data source Name abbreviated Data Type Representation Recorded APC Rate Similar indicators Topic Risk factors

18 Rationale Definition Associated terms Preferred data sources Other possible data sources Method of measurement The recorded APC is part of a core set of indicators, whose purpose is to monitor the magnitude, pattern and trends of alcohol consumption in the adult population. Recorded APC is defined as the recorded amount of alcohol consumed per capita (15+ years) over a calendar year in a country, in litres of pure alcohol. The indicator only takes into account the consumption which is recorded from production, import, export, and sales data often via taxation. Numerator: The amount of recorded alcohol consumed per capita (15+ years) during a calendar year, in litres of pure alcohol. Denominator: Midyear resident population (15+ years) for the same calendar year, UN World Population Prospects, medium variant. Government statistics Recorded alcohol per capita (15+) consumption of pure alcohol is calculated as the sum of beverage-specific alcohol consumption of pure alcohol (beer, wine, spirits, other) from different sources. The first priority in the decision tree is given to government statistics; second are country-specific alcohol industry statistics in the public domain (Canadean, IWSR- International Wine and Spirit Research, OIV-International Organisation of Vine and Wine, Wine Institute, historically World Drink Trends); and third is the Food and Agriculture Organization of the United Nations' statistical database (FAOSTAT). For countries, where the data source is FAOSTAT the unrecorded consumption may be included in the recorded consumption. As from the introduction of the "Other" beverage -specific category, beer includes malt beers, wine includes wine made from grapes, spirits include all distilled beverages, and other includes one or several other alcoholic beverages, such as fermented beverages made from sorghum, maize, millet, rice, or cider, fruit wine, fortified wine, etc. Also, there has been a change in the data source for some countries in the early 2000's. Updates for this indicator are made on an ongoing basis as data become available.

19 Method of estimation M&E Framework Method of estimation of global and regional aggregates Disaggregation Unit of Measure Unit Multiplier Expected frequency of data dissemination Expected frequency of data collection Recorded alcohol per capita (15+) consumption of pure alcohol is calculated as the sum of beverage-specific alcohol consumption of pure alcohol (beer, wine, spirits, other) from different sources. The first priority in the decision tree is given to government statistics; second are country-specific alcohol industry statistics in the public domain based on interviews or field work (Canadean, International Wine and Spirit Research (IWSR), Wine Institute, historically World Drink Trends) or data from the International Organisation of Vine and Wine (OIV); third is the Food and Agriculture Organization of the United Nations' statistical database (FAOSTAT); and fourth is data from alcohol industry statistics in the public domain based on desk review. In order to make the conversion into litres of pure alcohol, the alcohol content (% alcohol by volume) is considered to be as follows: Beer (barley beer 5%), Wine (grape wine 12%; must of grape 9%, vermouth 16%), Spirits (distilled spirits 40%; spirit-like 30%), and Other (sorghum, millet, maize beers 5%; cider 5%; fortified wine 17% and 18%; fermented wheat and fermented rice 9%; other fermented beverages 9%). Since different data sources may use different conversion factors to estimate alcohol content, the beverage-specific recorded APC may not equal the total provided, in some cases. Alcohol per capita (15+) consumption data exist for almost all countries. Regional and global estimates are calculated as a population weighted average of country data. Alcoholic beverage type Litres of pure alcohol per person per year Annual Annual

20 Limitations Links Comments Contact Person Family of Indicator Reporting Unit Domains Factors, such as stockpiling, waste and spillage, as well as cross-border shopping (recorded in different jurisdiction), tax free alcohol, surrogate alcohol and variations in beverage strength, cannot be accounted for. This may influence the accuracy of recorded consumption as an indicator for alcohol consumed. Also, administrative data does not enable the disaggregation of recorded adult per capita by gender - to this end, other data sources such as survey data are needed. Global Information System on Alcohol and Health (GISAH) NMH/MSD/MSB Indicator ID 462 Alcohol, unrecorded per capita (15+ years) consumption (in litres of pure alcohol) Indicator name Indicator type Ebola data source Name abbreviated Data Type Representation Similar indicators Topic Rationale Definition Associated terms Preferred data sources Other possible data sources Method of measurement Alcohol, unrecorded per capita (15+ years) consumption (in litres of pure alcohol) Unrecorded APC Rate Risk factors Alcohol consumption can be recorded through production, export, import, and sales/taxation data. However alcohol can also be produced and consumed outside of governmental control, and remain unrecorded. In some cases, unrecorded APC represents an important proportion of a country's alcohol consumption, so it is vital to take this factor into account, in addition to recorded APC, when investigating a country's level of alcohol consumption. Unrecorded APC is defined as the unrecorded amount of alcohol consumed per adult (15+ years) in litres of pure alcohol. Unrecorded consumption refers to alcohol which is not taxed and is outside the usual system of governmental control, such as home or informally produced alcohol (legal or illegal), smuggled alcohol, surrogate alcohol (which is alcohol not intended for human consumption), or alcohol obtained through cross-border shopping (which is recorded in a different jurisdiction). Numerator: The amount of unrecorded alcohol consumed per adult (15+ years) during a calendar year, in litres of pure alcohol. Denominator: Midyear resident population (15+ years) for the same calendar year, UN World Population Prospects, medium variant. Special studies The first priority in the decision tree is given to nationally representative empirical data; these are often general

21 Method of estimation M&E Framework Method of estimation of global and regional aggregates Disaggregation Unit of Measure population surveys in countries where alcohol is legal. Second are specific other empirical investigations, and third is expert opinion. Survey questions on consumption of unrecorded alcohol are converted into estimates per year of unrecorded APC. Usually surveys underestimate consumption. However, in countries where survey based estimates exceeded the recorded consumption, unrecorded was calculated as total consumption estimated from survey minus recorded APC. In some countries, unrecorded is estimated based on confiscated alcohol confiscated by customs or police. Regional estimates are derived from population weighted averages of countries with data on unrecorded APC. Litres of pure alcohol per person per year

22 Unit Multiplier Expected frequency of data dissemination Expected frequency of data collection Limitations Links Comments Contact Person Family of Indicator Reporting Unit Domains Periodic Periodic The calculation of unrecorded APC remains an estimate. However, together with recorded APC, this indicator leads to a more accurate assessment of the total amount of alcohol consumed per person per year in a given country. Global Information System on Alcohol and Health (GISAH) Preferred data sources: Representative surveys, specific empirical investigations, expert opinion. Other possible data sources: Indirect estimation based on alcohol poisoning or other injury indicators. NMH/MSD/MSB Indicator ID

23 Uncertainty Alcohol, unrecorded per capita (15+) consumption (in litres of pure alcohol) with 95%CI Country 2010 Afghanistan 0.7 [ ] Albania 2.1 [ ] Algeria 0.3 [ ] Andorra 1.4 [ ] Angola 1.6 [ ] Antigua and Barbuda 0.4 [ ] Argentina 1.0 [ ] Armenia 1.5 [ ] Australia 1.8 [ ] Austria 0.6 [ ] Azerbaijan 1.0 [ ] Bahamas 0.5 [ ] Bahrain 0.1 [ ] Bangladesh 0.2 [ ] Barbados 0.5 [ ] Belarus 3.2 [ ] Belgium 0.5 [.] Belize 1.7 [ ] Benin 1.0 [ ] Bhutan 0.3 [ ] Bolivia (Plurinational State of) 2.1 [ ] Bosnia and Herzegovina 2.5 [ ] Botswana 3.0 [ ] Brazil 1.5 [ ] Brunei Darussalam 0.3 [ ] Bulgaria 1.1 [ ] Burkina Faso 2.5 [ ] Burundi 3.0 [ ] CÃ te d'ivoire 2.0 [ ] Cabo Verde 2.9 [ ] 23

24 Cambodia 3.3 [ ] Cameroon 2.6 [ ] Canada 2.0 [ ] Central African Republic 2.0 [ ] Chad 4.0 [ ] Chile 2.0 [ ] China 1.7 [ ] Colombia 2.0 [ ] Comoros 0.1 [ ] Congo 2.2 [ ] Cook Islands 0.5 [ ] Costa Rica 1.0 [ ] Croatia 2.0 [ ] Cuba 1.0 [ ] Cyprus 1.0 [ ] Czechia 1.2 [ ] Democratic People's Republic of Korea 0.5 [ ] Democratic Republic of the Congo 1.3 [ ] Denmark 1.0 [ ] Djibouti 0.2 [ ] Dominica 0.5 [ ] Dominican Republic 0.7 [ ] Ecuador 3.0 [ ] Egypt 0.2 [ ] El Salvador 1.0 [ ] Equatorial Guinea 0.8 [ ] Eritrea 0.6 [ ] Estonia 0.7 [ ] Ethiopia 3.5 [ ] Fiji 1.0 [ ] Finland 2.3 [ ] France 0.4 [ ] Gabon 2.0 [ ] Gambia 1.0 [ ] Georgia 2.3 [ ] Germany 0.5 [ ] Ghana 3.0 [ ] Greece 2.0 [ ] 24

25 Grenada 0.7 [ ] Guatemala 1.6 [ ] Guinea 0.5 [ ] Guinea-Bissau 1.5 [ ] Guyana 1.0 [ ] Haiti 0.6 [ ] Honduras 1.0 [ ] Hungary 2.0 [ ] Iceland 0.5 [ ] India 2.2 [ ] Indonesia 0.5 [ ] Iran (Islamic Republic of) 1.0 [ ] Iraq 0.3 [ ] Ireland 0.5 [ ] Israel 0.3 [ ] Italy 0.2 [ ] Jamaica 1.5 [ ] Japan 0.2 [ ] Jordan 0.2 [ ] Kazakhstan 3.5 [ ] Kenya 2.5 [ ] Kiribati 2.0 [ ] Kuwait 0.1 [ ] Kyrgyzstan 1.9 [ ] Lao People's Democratic Republic 1.1 [ ] Latvia 1.8 [ ] Lebanon 0.5 [ ] Lesotho 3.7 [ ] Liberia 1.6 [ ] Libya 0.1 [ ] Lithuania 2.5 [ ] Luxembourg 0.5 [ ] Madagascar 1.0 [ ] Malawi 1.0 [ ] Malaysia 1.0 [ ] Maldives 0.5 [ ] Mali 0.5 [ ] Malta 0.4 [ ] 25

26 Marshall Islands Mauritania 0.1 [ ] Mauritius 1.0 [ ] Mexico 1.8 [ ] Micronesia (Federated States of) 1.0 [ ] Monaco Mongolia 2.0 [ ] Montenegro 3.9 [ ] Morocco 0.5 [ ] Mozambique 1.0 [ ] Myanmar 0.6 [ ] Namibia 4.0 [ ] Nauru 2.5 [ ] Nepal 2.0 [ ] Netherlands 0.5 [ ] New Zealand 1.6 [ ] Nicaragua 1.5 [ ] Niger 0.2 [ ] Nigeria 1.0 [ ] Niue 1.0 [ ] Norway 1.0 [ ] Oman 0.2 [ ] 0.0 [ ] 0.0 [0.0- Pakistan 0.1] Palau 1.0 [ ] Panama 0.8 [ ] Papua New Guinea 1.5 [ ] Paraguay 1.5 [ ] Peru 2.0 [ ] Philippines 0.9 [ ] Poland 1.6 [ ] Portugal 1.9 [ ] Qatar 0.6 [ ] Republic of Korea 2.5 [ ] Republic of Moldova 10.5 [ ] Romania 4.0 [ ] Russian Federation 3.6 [ ] Rwanda 3.0 [ ] 26

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