Solving South Africa’s Drinking Problem
As part of their response to the COVID-19 pandemic, South Africa was one of very few countries to ban the sale and transportation of alcohol completely, imposing this restriction for more than 4 months. This was an attempt to reduce the effect of certain externalities associated with alcohol abuse, specifically:
- Related trauma cases in hospitals that use up essential healthcare resources.
- Large disorderly gatherings to consume alcohol that lead to a steep rise in COVID-19 cases.
The ban was successful in decreasing the number of trauma cases considerably, particularly in overcrowded low-income areas. However, one could say that this government intervention was not entirely effective because it only treated symptoms of widespread alcohol abuse, rather than addressing the problematic social and cultural factors from which it arises. As a result, many simply turned to the rapidly expanding black market to purchase alcohol at exorbitant prices, transactions from which the government could not collect any revenue through its existing tax schemes. Additionally, legal suppliers suffered severe losses, further harming the economy. The alcohol industry provides more than a million jobs and represents approximately 3% of the South African GDP. Some poorer individuals also resorted to drinking methanol and other toxic concoctions (possibly with even more negative health risks than alcohol itself).
The outcome of this intervention not only highlighted the magnitude of South Africa’s alcohol abuse problem, but also demonstrated that anything resembling a complete ban has as many negative consequences as benefits. What then is the best way to eliminate this toxic culture permanently? How have other countries approached this issue?
In this post, I will explore which alcohol-related policies and initiatives are most popular internationally as well as which have been implemented in countries where alcohol abuse is less prevalent. Through this analysis, my goal is to reveal which alternative interventions may be the most helpful in promoting a more responsible drinking culture in South Africa.
Data
The visualizations and statistics presented in this post were created with a range of packages in R. The data used are from the Google Trends API and the World Health Organization’s Global Information System on Alcohol and Health (GISAH). The GISAH database provides access to information regarding various alcohol-related health indicators at the global, regional and country levels.
For the purposes of this analysis, countries where alcohol is banned completely or consumption is extremely low as a result of religious abstinence (i.e., those that are predominantly Muslim) have been excluded.
South Africa vs. the Rest of the World
According to the Alcohol, Tobacco and Other Drug Research Unit at the South African Medical Research Council, 40% of the country’s trauma-related cases prior to the COVID-19 pandemic were alcohol-related, translating to at least 13,846 cases per week. Additionally, 62,300 people died from alcohol-attributable causes in 2015. These shocking figures are a result of a countrywide binge drinking culture.
The average South African (aged 15 and older) consumes 7.26 liters of pure alcohol annually, compared to the global average of 4.72. Additionally, approximately 59% of drinkers in the country are classified as heavy drinkers by the World Health Organization (WHO), consuming more than six alcoholic beverages in a single serving at least once a month.
Which interventions are the most common globally?
There is a wide range of government interventions designed to regulate the sale and consumption of alcohol. In recent years, possibly as a result of their revenue generating potential, methods involving taxation have been most popular internationally. Other common policies include legislation to limit illegal sales and advertising restrictions.
Recognizing the social and cultural factors that contribute to one’s alcohol consumption, some governments have also started to implement subsidized community action programs to raise awareness about the negative effects of overconsumption.
Which interventions are in place in countries with much lower heavy drinker rates?
Interestingly, many of the countries with the lowest heavy drinker rates have comparable average consumption levels with South Africa. This suggests that while the citizens of these countries typically drink a fair amount of alcohol, they are doing so in a more sensible manner with fewer binge sessions.
The ten countries with the lowest heavy drinkers rates are Ukraine, Chile, Argentina, Italy, Canada, Uruguay, Belarus, Malta, Greece and the United States. As these states vary considerably in terms of geographical location, economy size, population and culture, it is possible that their comparable low heavy drinker rates are linked to similar alcohol-related government interventions.
The charts below depict the level of restriction imposed on the internet, movie, and television advertising of alcohol in the ‘low’ heavy drinker countries identified. The predominance of ‘no restriction’ in the case of internet and movie advertising and the range of restriction levels observed across all three mediums indicate that this intervention may not be the best option for South Africa to pursue or modify. South Africa’s current advertising restriction levels are ‘voluntary/self-restricted’ for internet and television, and ‘no restriction’ for movies.
Further, while most of the ‘low’ heavy drinker countries have legislation in place to prevent illegal alcohol sales, this is a measure South Africa has already implemented and thus, will not help solve the country’s persistent alcohol abuse problem.
However, the average VAT or sales tax for alcohol in ‘low’ heavy drinker countries is approximately 7% higher than in South Africa and such a substantial difference should be investigated more thoroughly. Finally, the South African government is yet to fund any education programs about alcohol consumption. As one can see in the right-hand chart below, 7 out of 10 of the ‘low’ heavy drinker countries support the provision of information and training programs specifically, and half subsidize data dissemination and technical tools in local communities. South Africa could reap similar benefits from a more grassroots level approach.
Moving Forward
While the findings presented in this post cannot provide a completely conclusive recommendation for the best way to address South Africa’s drinking problem, they can serve as a starting point for further research and help ensure that this issue is not simply forgotten and ignored in the future. Encouraging the South African government to fund more community action programs and possibly revise the sales tax on alcohol could be effective ways of initiating a permanent positive shift in the country’s relationship with binge drinking.
