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Expert Q&A

A Time to Reset the Conversation around Alcohol: Q&A with Jacqui Drope

Jacqui Drope joined Vital Strategies in 2022 as Director of RESET Alcohol, a groundbreaking $15 million initiative to reduce alcohol-related harms in hard-hit countries through policy change. Led by Vital Strategies, it convenes partners across national governments, civil society, research organizations, and global leaders in public health and alcohol policy to develop and implement evidence-based alcohol policies. RESET Alcohol’s primary focus is increasing alcohol taxation and other pricing policies.

From 2010 to 2020, Jacqui led the global cancer prevention program at the American Cancer Society, where her programs contributed to comprehensive tobacco control legislation and increases in tobacco taxation and HPV vaccination coverage in countries in Africa, Asia and South America.

With experience rooted in collaboration with a wide range of multi-sectoral stakeholders, she has sought a diverse range of perspectives throughout her career to help stakeholders—from governments and multilateral bodies to academia and medical societies—achieve public health results and prevent noncommunicable diseases. Her particular emphasis has been on tobacco control, HPV vaccination, nutrition, physical activity and cancer screening.

Jacqui spoke with Vital Strategies about the shift from tobacco to alcohol control work, and the parallels between the two. 

Tobacco control has been a critical pillar of your career for 20 years. How did you make the transition to alcohol policy with RESET?

On tobacco control, I’ve worked in a lot of different settings including research, civil society and government. It’s allowed me to see the issues from a range of different perspectives. Now I’m working with many of the same stakeholders, and the policies we pursued with tobacco control are very similar to what we are doing now on alcohol.


My tobacco work started at the University of California at San Francisco in 2001, where I researched recently released tobacco industry documents. That opened up my eyes to what the commercial industry was doing behind the scenes to get people to smoke. This, in turn, led me to my work with the International Development Research Centre (IDRC), at a time when the organization had received the first Bill and Melinda Gates Foundation investment in tobacco control work in Africa. I spent my time there partnering with local researchers and advocates to conduct situational analyses in 12 African countries. We gathered data on tobacco use, tobacco farming and tobacco control policies so that governments, academia and civil society in these countries could use the information to understand opportunities for and obstacles to tobacco control, and pursue a range of policy changes.

Are there many similarities between your experience with tobacco control and your vision for RESET Alcohol?

One of the main similarities is that the tobacco and alcohol control work both focus on taxation. For both, it is one of the strongest interventions, and—even though it is the most effective—it is also the most underused.


I think a lot of the resistance is political. The way the public looks at taxes, and raising taxes—as a whole, they don’t see that some may be beneficial. But now that we are starting to implement tobacco and sugar taxes in many countries, I think people are beginning to understand the benefits of a health tax. That’s what we are trying to do for alcohol as well.


Another similarity, for me, personally, is that when I started working on tobacco control with colleagues in Africa, the development and implementation of these policies were quite new and we had the experience of starting something from scratch and making important progress on policy change. With the GiveWell investment in RESET, we are now also working to support countries where a crucial initial investment will help build the momentum for strong alcohol policies.

What do you regard as the challenges related to implementing alcohol control policies?

There are a number of challenges we face—not the least of which are cultural norms. In many countries, people see their wine, beer or spirits with national pride. The alcohol industry is inundating us with marketing that associates alcohol with everything fun, and strategically deflects from the harms it causes. It seems unlikely people are going to stop using alcohol altogether, but I am interested in harm reduction and the health, social and economic harms we can decrease through policies that help people drink less. That’s good for all of us.


Another challenge around alcohol is the lack of awareness of the link between alcohol and illness. Alcohol is linked to 200 diseases, including several cancers. It’s quite shocking, actually, to realize how few people know that the more you drink, the higher your risk of developing cancer of the mouth and throat, larynx, esophagus, colon, rectum, liver and breast. On top of this, alcohol affects the many people who don’t use it, through vehicle crashes and violence. I don’t fool myself that this work isn’t going to be tough; we are starting at the point similar to where tobacco was in the 1950s, where drinking alcohol is glamorized.

These are the early days of RESET, and you are working on identifying partner countries. What is the most exciting aspect of this process?

I’m delighted that a funder has come along and recognized that alcohol is a harm that has been neglected. All I could think was—it’s about time. And it’s nice to see an investment that directly addresses equity issues by launching in middle-income and low-income countries.


If we can show how effective alcohol taxation can be on reducing alcohol harms—along with other measures, such as limiting availability and restricting advertising—then people will start to see these policies as positive change. We know these policies work. We just have to do it.