Alcohol is the only substance commonly used for intoxication that is not subject to an international agreement regulating its trade in the interest of public health and welfare [1]. Rather, it is commonly dealt with in international trade as an ordinary item of consumption and, indeed, is subject to fewer international regulations, for instance, on labelling of ingredients, than other foodstuffs [2]. In recent decades, the production and distribution of alcoholic beverages have become increasingly oligopolised, dominated by a relatively small number of transnational corporations [3]. Although only a small proportion of alcoholic beverage production is transported between continents, production, branding and distribution of the beverages are largely controlled by transnational corporations, and their marketing also increasingly reaches across borders with the growth of the digital economy and social media.

Like any other industry producing commodities for international trade, alcohol industry corporations and their industry associations have a strong interest in the terms of trade in their commodity, and also in the protection of their investment in each country they operate in. They are, therefore, commonly active in politics and policies affecting their interest not only internationally but also at the national level, although a transnational firm will often work through local affiliates or industry associations. Transnational firms, however, are well placed to use information or experience gained in one country elsewhere, as parallel issues come up in other countries.

Apart from exerting their influence directly on the conditions of importation, sale and promotion in a particular country, in the current era alcohol industry interests also have a strong focus on influencing international agreements governing trade and investment across national borders, which can have strong effects on what happens in a national market. Until fairly recently, however, relatively little attention was paid in public health research to this international aspect of the control of alcohol problems.

Seeking to extend scholarship on this and other aspects of the global governance of alcohol, an international conference of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS) was held in Melbourne from 30 September to 3 October 2019. Organised by the Centre for Alcohol Policy Research at La Trobe University and by the Melbourne Law School, and sponsored by the Victorian Health Promotion Foundation and the Foundation for Alcohol Research and Education, the conference brought together KBS researchers with relevant study interests and researchers in public health and international law to present and discuss papers on the conference topic of Public Health and Global Governance of Alcohol.

Forty participants, from 15 countries, presented papers at the conference. As customary at KBS conferences, most of the papers were pre‐submitted and were available on the conference website, with a designated commentator initiating discussion of the paper by participants. Panel discussion sessions considered research needs arising out of the meeting and what could be concluded for policy and advocacy initiatives. Paper authors were encouraged by the meeting organisers to revise their papers and submit them for review and publication in clusters of papers on particular topical areas.

The three papers in this special section of Drug and Alcohol Review constitute one of these clusters, concerned with the interplay between alcohol industry interests and the processes of determining, at both national and international levels, issues involving alcohol products and market interests in trade and investment agreements. Three further forthcoming papers in the Journal of Studies on Alcohol and Drugs consider issues around conflict of interest and alcohol industry submissions and involvement in national and international policymaking [4-6]. Eight forthcoming papers in the European Journal of Risk Regulation are concerned with issues in the global governance of alcohol in the context of the World Health Organization and other intergovernmental organisations and agreements [1, 2, 7-12]. Revisions of several other papers presented at the conference are also published or forthcoming in other journals [13-17].

In the 1990s, the focus of discussions of global governance of international trade would have been primarily on multilateral agreements on trade in commodities under the World Trade Organization (WTO) umbrella. In this context, alcoholic beverages are primarily regarded as just another set of items of consumption, subject to trade rules that sought to create an open international market for commodities, free of governmental restrictions, which in this context are conceived as ‘barriers to trade’. ‘Public health exceptions’ in trade treaties, in principle, offered some protection for measures that controlled and restricted imports in the interest of public health, but justifying exceptions for alcohol on these grounds has proven difficult and uncertain [18]. Recent decades have seen some fragmentation in the system, with multiple bilateral and regional trade agreements becoming the primary forums for negotiation, and the growth of ‘investor‐state dispute settlement’ provisions to protect private investments from state actions. Meanwhile, however, the WTO and its institutions remain an important part of the picture.

The paper by Miller et al [19] examines submissions to a national government agency by the alcohol industry and relevant business associations about alcohol issues in negotiations on free trade agreements. The submissions available for study are public documents, so the paper examines the public side of industry lobbying, not what goes on behind closed doors [20]. Not all of the issues raised in the submissions would be problematic from a public health perspective: whether European producers are granted a monopoly on the term ‘Prosecco’ does not have an obvious implication for public health. However, as the paper notes, a key priority for the submissions was the reduction or elimination of tariffs, which does have public health implications, as do efforts to harmonise regulations or reduce them. The paper thus makes a case for public health input to trade agreement negotiations.

The paper by Gleeson and O'Brien [21] examines some of the outcomes of negotiations like those that were the subject of the submissions studied by Miller and associates. They find that, although the Trans‐Pacific Partnership negotiated in 2015 did not go into effect in its original form, the innovation that it had included, a provision that government requirements for health warnings and other health information on containers of alcoholic beverages could be satisfied by putting the information on an ill‐defined ‘supplementary label’ was subsequently adopted in several other trade agreements. The authors found versions of this provision, clearly preferencing industry over public health interests, in five regional or bilateral trade agreements signed between 2016 and 2019. The authors close with several suggestions on how the adverse public health effects of such provisions might be neutralised or mitigated.

The paper by Janardhan [22] describes the issues for alcohol control in the more general context of building public health exceptions into free trade agreements. The article notes that, although bilateral and regional trade agreements have been pursued as a more flexible alternative to the WTO agreements, jurisprudence interpreting and applying them still falls back on rulings about WTO provisions. To limit, on public health grounds, the application of trade rules to alcohol, Janardhan suggests that one option is ‘carveouts’ specifically for alcohol, as has been done for tobacco in some agreements and for alcohol in one, the Pacific Island Countries Trade Agreement [23], but that a better solution would be ‘creating stronger and more legally defensible general health exceptions’ in the agreements.

These three papers are a timely contribution concerning issues in the global governance of alcohol, applying in the specific area of alcohol problems considerations that also arise more generally concerning how trade agreements may deter governments from pursuing public health and welfare interests [24]. Trade agreements, and the influence on them of alcohol industry interests, are of course only one topical area in the more general issue of the global governance of alcohol, and we also recommend to our readers the other papers from the conference that have been mentioned above.

酒精是唯一一种常用于致醉的物质，不受出于公共健康和福利利益而监管其贸易的国际协议的约束[ 1 ]。相反，它通常在国际贸易中作为普通消费品处理，并且事实上，与其他食品相比，它受到的国际法规（例如成分标签）较少[ 2 ]。近几十年来，酒精饮料的生产和分销日益寡头垄断，由相对少数的跨国公司主导[ 3 ]。尽管只有一小部分酒精饮料生产在各大洲之间运输，但饮料的生产、品牌和分销在很大程度上由跨国公司控制，而且随着数字经济和社交媒体的发展，其营销也越来越多地跨越国界。

与任何其他生产国际贸易商品的行业一样，酒精工业公司及其行业协会对其商品的贸易条件以及对其在每个经营国家的投资的保护有着浓厚的兴趣。因此，他们，尽管跨国公司通常通过当地分支机构或行业协会开展工作，但他们通常积极参与影响其国际利益和国家利益的政治和政策。然而，跨国公司可以很好地利用在其他国家获得的信息或经验，因为其他国家也会出现类似的问题。

除了直接影响特定国家的进口、销售和促销条件外，当前酒精行业的利益还重点关注影响跨国贸易和投资的国际协议，这会对全国市场发生了什么。然而，直到最近，公共卫生研究对酒精问题控制的这一国际方面的关注相对较少。

为了扩大全球酒精治理这一方面和其他方面的学术研究，Kettil Bruun 酒精社会和流行病学研究学会 (KBS) 国际会议于 2019 年 9 月 30 日至 10 月 3 日在墨尔本举行。此次会议由拉筹伯大学和墨尔本法学院的酒精政策研究中心主办，并由维多利亚州健康促进基金会和酒精研究与教育基金会赞助，汇聚了具有相关研究兴趣的 KBS 研究人员以及公共卫生和国际法领域的研究人员提交并讨论有关公共卫生和全球酒精治理会议主题的论文。

来自 15 个国家的 40 名与会者在会议上宣读了论文。按照 KBS 会议的惯例，大多数论文都是预先提交的，并可在会议网站上获取，并由指定的评论员发起与会者对论文的讨论。小组讨论会议考虑了会议产生的研究需求以及政策和宣传举措可以得出的结论。会议组织者鼓励论文作者修改他们的论文，并将其提交以供审查，并以特定主题领域的论文集群形式发表。

《药物和酒精评论》这一特殊部分中的三篇论文构成了这些集群之一，涉及酒精行业利益之间的相互作用以及在国家和国际层面确定涉及酒精产品和贸易和投资市场利益的问题的过程协议。《酒精和毒品研究杂志》即将发表的三篇论文考虑了围绕利益冲突、酒精行业提交的意见以及参与国家和国际政策制定的问题[ 4-6 ]。《欧洲风险监管杂志》即将发表的八篇论文涉及世界卫生组织和其他政府间组织和协议背景下的全球酒精治理问题[ 1,2,7-12 ]。会议上提出的其他几篇论文的修订版也已在其他期刊上发表或即将发表[ 13-17 ]。

20世纪90年代，国际贸易全球治理讨论的焦点主要集中在世界贸易组织（WTO）框架下的商品贸易多边协定。在这种情况下，酒精饮料主要被视为另一类消费项目，受旨在创造开放国际商品市场的贸易规则的约束，不受政府限制，在这种情况下，政府限制被视为“贸易壁垒” 。原则上，贸易条约中的“公共卫生例外”为出于公共卫生利益而控制和限制进口的措施提供了一些保护，但事实证明，以这些理由证明酒精例外的合理性是困难且不确定的[ 18 ]。近几十年来，该体系出现了一些碎片化，多个双边和区域贸易协定成为谈判的主要论坛，并且“投资者与国家争端解决”条款的增加以保护私人投资免受国家行动的影响。但与此同时，世贸组织及其机构仍然是这一图景的重要组成部分。

Miller等人的论文[ 19 ]审查了酒精行业和相关商业协会向国家政府机构提交的有关自由贸易协定谈判中酒精问题的意见书。可供研究的提交内容是公开文件，因此本文研究的是行业游说的公共方面，而不是幕后发生的事情[ 20 ]。从公共卫生的角度来看，并非所有意见书中提出的问题都会产生问题：欧洲生产商是否被授予对“普罗塞克”一词的垄断权，对公共健康没有明显的影响。然而，正如该文件指出的，提交材料的一个关键优先事项是减少或取消关税，这确实对公共卫生产生影响，协调法规或减少关税的努力也是如此。因此，本文论证了公共卫生对贸易协定谈判的投入。

Gleeson 和 O'Brien [ 21 ]的论文研究了一些谈判结果，例如 Miller 及其同事研究的意见书的主题。他们发现，尽管2015年谈判达成的跨太平洋伙伴关系协定并未以其最初的形式生效，但其所包含的创新条款，即政府对酒精饮料容器上的健康警语和其他健康信息的要求，可以得到满足随后，其他几个贸易协定也采用了将信息放在定义不明确的“补充标签”上的做法。作者在 2016 年至 2019 年签署的五项区域或双边贸易协定中发现了该条款的版本，明显优先考虑工业而非公共卫生利益。作者最后提出了关于如何抵消或减轻此类条款对公共卫生的不利影响的几项建议。

Janardhan 的论文 [ 22 ] 描述了在将公共卫生例外纳入自由贸易协定的更一般背景下的酒精控制问题。文章指出，尽管双边和区域贸易协定一直被视为世贸组织协定的更灵活的替代方案，但对它们的判例解释和适用仍然依赖于关于世贸组织条款的裁决。为了从公共卫生角度限制贸易规则对酒精的适用，贾纳尔丹建议，一种选择是专门针对酒精进行“排除”，就像一些协议中对烟草所做的那样，以及太平洋岛国贸易协定中对酒精所做的那样[ 23 ]，但更好的解决方案是在协议中“制定更强有力、更具有法律依据的一般健康例外”。

这三篇论文是关于全球酒精治理问题的及时贡献，适用于酒精问题的特定领域，这些考虑因素也更普遍地涉及贸易协定如何阻止政府追求公共卫生和福利利益[24 ]。贸易协定以及酒精行业利益对其的影响当然只是全球酒精治理这一更普遍问题中的一个主题领域，我们还向读者推荐上述会议的其他论文。