Working for an alcohol-safe South Africa for all its people

Photo by hygor sakai from Pexels.

There has been a lot of opposition from the liquor industry and other commentators to government steps to control the sale and consumption of alcohol during the coronavirus pandemic. But there are many communities around the country that are pleased that the momentum to regulate alcohol is increasing. 

The natural experiment of Covid-19 has shown that the World Health Organisation (WHO) recommendations of 2010 still stand – regulate the price marketing and availability of alcohol as the best buys to reduce alcohol-related harm. The two temporary alcohol sales bans imposed in South Africa since the pandemic began have shown the potential benefits of reducing availability. 

Key amongst these is that hospital data showed reduced alcohol-related admissions during the bans while police reports indicated a reduction in alcohol-related contact crime. 

However, banning alcohol is – and indeed should be – only a temporary measure, a ‘suspension’, as President Ramaphosa put it in a virtual Presidential Imbizo last month. South Africa needs, in the long-term, not a ban but the introduction of regulations that favour public health and well-being, whilst also taking into account the issues of economic development and basic trading responsibilities and consumer rights. 

Regulation, as opposed to banning, acknowledges both the right of consumers and citizens to be protected and the right to trade. 

More importantly, it reaffirms the global view that businesses trading in alcohol need to operate within parameters requiring licensing, health and safety rules, verifiable record-keeping, acceptable opening and closing hours, age restrictions, location of outlets etc. 

People from communities across South Africa have indicated that they would welcome the adoption of such regulations. For example, Kedinametse Maluleke of Rock of Ages in Kuruman, Northern Cape says: “Even the chiefs should be on board to limit the number of taverns, if there are two licenses in a village it should be enough, not four and more.” 

Rosa-Linda Kock of the Support Centre for Land Change in the Western Cape is concerned that “we witness illegal shebeens purchasing bakkie-loads of alcohol, especially from Thursdays to Saturdays. Police are happy to confiscate their stock, but nothing happens to those who sell to the illegal trader”.

Communities, particularly women and children, find that their right to be protected is finally becoming part of the public debate around the sale of alcohol. This is because, unlike most other products which, in the main, only affect the individual consumer, alcohol impacts both on individual users and, even more so, on the people and society around them.

Alcohol can affect users themselves in many different ways. For example, alcohol is classified as a Group 1 carcinogen. This means that people who use alcohol can develop cancer. Global studies have shown that alcohol use increases the risk of mouth, pharynx and larynx cancers; oesophageal cancer (squamous cell carcinoma); breast cancer (pre- and post-menopause); colorectal cancer; stomach cancer and liver cancer.

Consuming alcohol can also affect mood, judgement, coordination and risk-taking behaviour, such as engaging in unprotected sex and exposing oneself to contracting STI and HIV or unwanted pregnancies. It can increase aggression and impair problem-solving.

While these are problems that affect an individual’s own life, the impact can also go beyond the user. In South Africa, more than 58% of drivers killed in car crashes, some of which result in injury or death for others as well, test positive for alcohol.60% of women who report abuse state that their abuser had drunk alcohol at the time of the incident. It is these impacts that are manifested time and again in the emergency trauma units of hospitals throughout the country.

The impact is also part of the lived experience of people at the neighbourhood level. In many communities, some alcohol trading is not licensed. In addition, with both licensed and unlicensed outlets, trading can take place from a home, shack or business premises and often happens 24/7; children and young people under the age of 18 buy alcohol openly; drinking happens anywhere – on the street, in parks, in school grounds. Communities have no say over the loud music next door; the broken glass and used condoms in school grounds or in the gutters after a street bash; the harassment of women and girl children by drunken men lounging outside alcohol outlets; the public urination and littering in the vicinity of drinking holes. This reality is not restricted to certain areas only – it manifests itself in one form or another in all communities across the country.

Regulating availability will help to change this. Under an improved regulatory regime, traders will have to be licensed, with unlicensed traders and those who sell to them closed down by the authorities; operating hours and days will be limited to cause the least disturbance to communities and to limit drunkenness and violence; every purchaser will have to produce an ID, thereby controlling sales and preventing children from buying alcohol; the number of outlets in a neighbourhood and their location will be managed. 

These measures, coupled with lowering the blood alcohol content (BAC) levels for drivers to 0.02 or below, tracking distribution and sales to avoid resale into the unlicensed sector, stopping production of large containers of alcohol, restricting advertising to the point of sale and increasing the tax on and price of alcohol, will usher in a ‘new normal’, an environment that promotes a drinking culture that values the quality of life above all. 

The long-delayed Road Traffic Amendment Bill of 2015 and the Liquor Amendment Bill of 2016 contain some of these suggestions. Processing the Bills through parliament will demonstrate that the government is prioritising reducing alcohol-related harm. Alcohol will finally be recognised for what it is: no ordinary commodity, but one which impacts on the health, safety and income of the individual, the community and the nation.

The Southern African Alcohol Policy Alliance in SA (SAAPA SA) is a non-profit civil society lobby group working for the introduction of legislation that will ensure an alcohol-safe South Africa for all. SAAPA SA has 15 Alliance Partners working in various sectors of civil society, including the SAMRC Centre for Health Economics and Decision Science – PRICELESS SA; the National Council Against Smoking; South Africans Against Drunk Driving; the Teddy Bear Foundation; Hlanganisa Institute of Development SA; the Smoking and Alcohol Harm Alleviation and Rehabilitation Association; and the Yeoville Bellevue Ratepayers Association.

By Aadielah Maker Diedericks, the Regional Coordinator SAAPA. Maker Diedericks has a Masters in Community Health from UNSW, Sydney; is a public health advocate with experience in developing and producing edutainment and multi-media interventions, training, social mobilisation and campaign management. She has worked in the civil society sector for over 25 years.