Making South Africa alcohol safe can be Covid-19 legacy

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Alcohol has been banned for level 4 & 5, of the Covid-19 lockdown. File photo.

Alcohol is a legal drug and classified by the International Agency for Research on Alcohol as a group 1 carcinogen linked to 7 cancers, road crashes and interpersonal violence. As a professor of Community Medicine and Health Care at the University of Connecticut, Thomas Barbor has noted, alcohol is, therefore ‘no ordinary commodity’ and requires effective regulation. 

Consuming alcohol is a choice. Within a democracy, the choice is a fundamental right. But democracy also comes with basic rules of governance and all businesses, whether they sell alcohol or not, should be required to follow basic business rules such as having a business license, a health and safety certificate with opening and closing hours and paying taxes Government made the right choice to ban availability of alcohol.

The South African Alcohol Policy Alliance South Africa supports increased restriction of alcohol availability in line with the World Health Organisation Global Strategy to Reduce Alcohol Harm of 2010 as a means to reduce alcohol-related health and social harm. 171 people die every day due to alcohol Alcohol attributable harm costs South Africa between R246 and R280 billion annually.

SAAPA SA supported the government’s decision for 3 key reasons. Firstly, most people access alcohol where they live, from shebeens which are too small to promote physical distancing and do not have running water or ablution facilities to ensure hygiene.

Secondly, the well-documented binge drinking culture in SA results in the intoxication that has been shown to impact on inhibitions and judgement which could lead to drinkers not following Covid-19 protective measures; it is also the norm for drinkers to share drinking bottles and glasses which again would make them vulnerable. Thirdly, the health system needed to be ‘freed’ up. Prior to Covid-19, as much as 30% of hospital admissions were alcohol-related.

Alcohol availability would, therefore, have taken people out of their homes, going against the very message of ‘Stay Home’ in the attempt to contain the virus.

The ban on alcohol sales has shown benefits and valuable lessons for regulation. The health system has had fewer alcohol-attributable hospital admissions. For example, Groote Schuur Hospital has reported 66% fewer trauma admissions. According to statistics released by the Minister of Police on 25 April 2020, there was a reduction in contact crime i.e. attempted murder cases from 1300 to 443, rape cases from 2908 to 371, assault GBV cases from 11 876 to 1758 and domestic violence cases by 69.4%. Whilst these positive outcomes cannot be fully attributed to the ban on alcohol sales and the gains have not been translated into rands and cents, it has contributed significantly.

While these are enormous positives we are concerned about the manner in which the police and defence force monitored and implemented the ban on alcohol sales. The brutality of, and illegal confiscations, the beatings meted out to people drinking in public resulting in at least 1 documented death have violated the rights of ordinary people. This is in stark contrast to how industry violations were managed. For example, the industry transported cargo worth millions of rands and was subject to the laws, the South African Breweries employees arrested were not treated with the brutality that so many ordinary South Africans contended with.

The Rights of the industry were respected as the Gauteng Liquor Forum, who despite acknowledging that some of their members were operating illegally, threatened court action demanding the right to trade.

Covid-19 also highlighted a festering problem long ignored by the government as a whole and it’s enforcement agencies. There are too many liquor outlets in general and a large number of illegal outlets in residential areas selling alcohol 24/7 making life for residents intolerable, who feel unable to challenge this ‘de facto’ phenomenon. Thus, shebeens and taverns have become part of ‘township culture’.

A 2017 study in Khayelitsha commissioned by the Western Cape government found 1045 outlets, of which only 11% were trading legally, with people living within 3- 5 minutes walking distance from their nearest alcohol outlet. Research shows that easy access to alcohol encourages consumption. One of the questions that should be asked is who and how are these outlets supplied with alcohol.

The government has demonstrated that it can take action in the interest of public health. The police have shown that they can enforce liquor laws – although they need training in restraint, in people management, and in respecting human rights. The provincial liquor authorities have revoked the licenses of those who contravened the State of Disaster regulations. Most importantly, South Africans have said they need alcohol to be better regulated.

The regulation of alcohol is not the competence of only one government department but requires a reactivation of the Inter-Ministerial Committee on Substance Abuse. This is how the whole of government can win.

The treasury will have more income via excise tax if all liquor outlets are brought into the regulatory environment. There will be less stress on the fiscus for dealing with alcohol-attributable harm and more resources for development and service delivery. The health department will spend fewer resources on alcohol-attributable trauma and have resources for health promotion that educates the public about alcohol-attributable harm which is essential and overdue. 

Social development will have less alcohol-attributable domestic violence and welfare to respond to. The police will have more time and resources to respond to other non-alcohol related crime.

Trade, industry and economic affairs have a special role as custodians of the draft Liquor Amendment Bill of 2017 which will harmonise alcohol regulation at the national, provincial and local government level with regard to operating hours, infrastructure, health, density and zoning. The meaningful participation of public health professionals and communities in licensing decisions, monitoring and renewals need to be institutionalised. An adequate number of appropriately placed officials at all levels of government must be trained, resourced and empowered to carry out effective compliance monitoring and enforcement. Alternative opportunities for decent livelihoods that does not involve selling alcohol needs to be part of this regulation of alcohol and re-imaging the economy by the Department of Small Business Development.

This is not a new work, as the Liquor Amendment Bill has already gone through a public participation process and is awaiting submission to Parliament for further processing, adoption and implementation.  It is unclear why it has not been processed into law in all of this time.  

The phasing out of the lockdown began on 1 May. In the months to come, the Covid-19 crisis will pass and we will return to a semblance of normality. As part of that, alcohol will once again be produced, transported, traded, distributed, marketed and consumed.

It cannot be business as usual with regard to harmful drinking and its negative impacts, the gains made in creating an alcohol safe South Africa during this period need to be held and we implore the government to seize the moment and adopt the Liquor Amendment Bill.