MIKE Nesbitt looks set to be the fifth health minister to have attempted to introduce minimum unit pricing for alcohol and failed.

He announced last week that the policy was “no longer deliverable” before the next Assembly election.

Nesbitt made no attempt to hide his frustration, describing it as a missed opportunity which would have allowed the Assembly to make a meaningful difference to alcohol-related harms.

Primary legislation had been planned for introduction in 2026-27, but without the agreement of the DUP this timeframe was no longer realistic.

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A minimum unit price (MUP) sets a floor below which alcohol cannot be sold to consumers.

This means that the minimum price is directly linked to the amount of alcohol in the product.

Significantly, MUP only directly affects products sold below the floor price. This means the price of a pint in the pub would not be impacted, nor would most other drinks sold in pubs, restaurants or nightclubs. All of these already cost well above 50p per unit.

The main impact would be on alcohol sold in supermarkets and off-licences, particularly multi-packs of beer and cider, cheaper spirit brands and strong ‘white’ ciders.

Northern Ireland looks set to be the only jurisdiction on the island of Ireland and in the United Kingdom without MUP for alcohol. It has already been introduced in Scotland and Wales and policy is being developed in England.

Beyond this, Armenia also has a MUP that applies to all alcohol, while Russia, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Slovakia, Ukraine, Uzbekistan and several Canadian provinces all have forms of minimum pricing in place that cover at least some alcoholic products.

There is a strong, and growing, body of research evidence showing that MUP policies are effective at reducing alcohol consumption and associated harms.

An important aspect of the appeal to policy makers is the fact that it effectively targets the cheap alcohol, that is drunk disproportionately by heavier drinkers, while having relatively little impact on moderate drinkers.

Findings from the evaluation of the introduction of MUP in Scotland have indicated that the largest reductions in deaths from alcohol-specific causes are being seen in the most deprived groups.

Mike Nesbitt has said it is a matter of public record that the UUP, Sinn Féin, Alliance and SDLP all support the legislation, and it is being blocked by the DUP.

This is somewhat bizarre given that historically the DUP were supportive. MUP was first proposed by then health minister Edwin Poots in 2012.

What has changed? What explains the DUP’s resistance to MUP, in the face of compelling evidence and the support of a broad range of health professionals?

During Covid-19, a distinct libertarian-leaning faction emerged within the DUP, primarily driven by opposition to lockdowns, face-mask mandates, and economic restrictions. This wing opposes anything perceived to be a nanny state approach.

MUP is not about the state curtailing personal freedoms, but about implementing an important evidence-based public health intervention.

This is not about self-discipline, willpower and knowing when to say no. The most effective public health changes at a population level require legislation and policy change.

No-one is suggesting that MUP is a panacea that will address alcohol-related harms, but it is a tool to help prevent damage and tackle health inequalities.

It would be a key part of a multi-pronged strategy focused on prevention and early intervention. Those who are already dependent on alcohol will require other interventions.

MUP may not initially be popular with the public, but political leadership is about spelling out the implications of cheap drink and the societal costs of dealing with the fallout. Dispelling the myths and explaining the objectives.

There is a strong and proven link between alcohol consumption and price. Alcohol is 60% more affordable than it was in 1980 and cheap, high-strength products are readily available.

This is about doing the right thing, not the popular thing. Alcohol-specific deaths in Northern Ireland have reached a 20-year high, with recent data showing a two-thirds increase over the decade from 2013 to 2023.

Think of other legislation to improve health such as seat belts in cars, speed limits, or not being allowed to smoke in public places. Who would now question the validity of these interventions?

Once again, our political system with its inbuilt veto means the health and wellbeing of the population are secondary to party politics.

For the sake of our collective wellbeing, the so-called libertarian wing of the DUP must be robustly challenged.

The amateur attempts to discredit and deflect from the indirect modelling and evaluation evidence are risible. The DUP either are not aware of the research, don’t understand it, or are refusing to engage with it.

The BMA, the CMO, GPs, Royal Colleges, health professionals, academics, voluntary and community groups should demand answers.

Claiming that evaluations are not robust is a smokescreen. The position against a proven targeted health intervention is nonsensical and one which will cost the health service, cost families, cost communities and will cost lives.

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