The Government of India, has funded 483 detoxification and 90 counselling centres country-wide, under the auspices of the National Drug Deaddiction Programme, to treat people with substance abuse disorders. 45% of people seeking treatment in these centres are for alcohol dependence. Most of these are defunct as they received a onetime grant. Paradoxically, the rates of help seeking in these centres are the lowest in states with the highest prevalence of alcohol use and the overall efficacy of treatment programmes provided is low.

The evidence from India is substantial that the direction for policy is to focus on macro environments and make them more conducive to promoting health behaviours than bank on individual behavioural change. But that is hardly likely as state governments publicly recant their beliefs in prohibition and alcohol control and try to extricate themselves from public funding of health care. Private expenditure already accounts for 82% of the total expenditure on health.

The popular media favour lurid descriptions of alcohol related violence and heroic accounts of sporadic, short-lived anti-alcohol agitations by women’s groups. These paradoxically serve to further marginalize the issue and detract from a balanced public discourse. Since the subject is of low priority, funding for research is low; there is little by way of a body of published literature, which can inform public policy, by projecting the socio-economic impact of alcohol misuse on a national scale.

Social aspect organizations of the liquor majors advocating safe drinking and sections of the mainstream English language media extolling the health benefits of alcohol have invaded that space. Hopefully, the impetus for a rational public health approach to alcohol policy will stem from the efforts of non-governmental organizations which are waking up to the sizeable negative impact that harmful alcohol use has on the delivery of their health and development programmes.