President Cyril Ramaphosa has acknowledged that alcohol is a risk factor for gender-based violence and announced that the Ministry of Social Development has been “tasked with increasing the visibility of substance abuse awareness and education”.
This our President believes will be sufficient in addressing the major role alcohol plays in this GBV Crises. I think not. It is outrageous that the Presidency believes that the crisis of violence that continues to affect women across the country can be addressed simply by running an education programme!
David Harrison aptly coined alcohol ‘the petrol on the GBV fire’ in his article (Daily Maverick, 2nd October 2019). Education is not enough to change anything! Not enough to change how people use the roads and whether they wear seatbelts! Not enough to reduce smoking and encourage healthy eating habits! Not enough to stop hate speech! Why then should dealing with alcohol, the product that 60% of women report had been used by their abuser at the time of a violent incident against them, be left to education?
In 2010, the World Health Organisation (WHO) Global Strategy to reduce the harmful use of alcohol recommended ten best-practice actions to member states. Education was not one of them! The three best-buy recommendations for effective action to reduce alcohol harm were: increased taxes and other pricing options; reduced availability, including density and trading hours; and increased regulation of marketing – legislative actions well within any government’s control. WHO agrees that education has its place, but only in support of effective, targeted legislative measures, not as a substitute for them.
Increased prices have two positive outcomes – it makes alcohol more expensive, especially for those who drink a lot, and it generates income for governments to channel towards prevention and alcohol harm reduction interventions.
In South Africa this is particularly important because we have some of the cheapest beer in the world available here, according to a 2018 Deutsche Bank report. The second reason is that it will help reduce South Africa’s binge drinking culture – we are ranked amongst the top six drinking nations in the world for this type of consumption.
Thailand introduced a 2% surcharge levy on alcohol and tobacco and directed it to ThaiHealth, a health promotion foundation tasked to reduce morbidity and mortality due to non-communicable diseases (NCDs), such as those caused by the harmful use of alcohol. ThaiHealth successfully lobbied for legislative changes, mobilised communities, and funded and implemented targeted interventions. Thailand has reported that the percentage of people using tobacco decreased from 22.5% in 2001 to 18.2% in 2014. The total annual per capita alcohol consumption decreased from 8.1 litres of pure alcohol in 2005 to 6.9 litres in 2014.
Recent evidence from Scotland, where government introduced Minimum Unit Pricing (MUP) on high-strength, cheap alcohol products that attracted problem drinkers, shows a drop in sales within just one year – a proxy for reduced consumption and associated harm.
International evidence shows that marketing of alcohol influences the age at which children start drinking and the amount they drink. This coupled with 250 000 legal and illegal alcohol retailers in South Africa, many of which are in residential areas and selling alcohol at unregulated hours, makes availability a key issue for the country.
Recent reports of the impact of Russia’s combined introduction of marketing restrictions, increased prices and reduced sales hours has seen a 43% drop in alcohol consumption and an increase in life expectancy with 10-15 years – a clear demonstration of political leadership making public health a priority. Interestingly, the Philippines has over the years introduced restrictions during elections, and recently announced the introduction of legislation to regulate trading hours and alcopops (flavoured alcoholic drinks designed to encourage drinking).
Policy measures are not a miracle cure – they can, however, create the conditions in which rational, unforced choices can be made on whether to drink at all or how much to drink how often. As such, they can significantly influence the culture of drinking in a positive, socially-beneficial way. Government is aware of this.
Hence, over the past six years, there have been three alcohol-related policy proposals on the table – the Department of Health’s Control of Marketing of Alcoholic Beverages Bill of 2013; the National Road Traffic Bill of 2015 from the Department of Transport, and the national Liquor Amendment Bill of 2017, driven by the Department of Trade and Industry - which together would comprise a significant step forward in addressing the WHO’s three ‘best buys’: price, availability and marketing.
The key ingredient for policy change is political will and leadership. And that is what South Africa requires to change the tide for girl children and women towards a safer society, not education and awareness programmes carried out in a legislative vacuum.
Government leaders across the world are making the call to their administrations to introduce legislative changes to better regulate alcohol production, distribution, marketing and trading in the interest of the public health and wellbeing of their citizens. I appeal to President Ramaphosa, as we head towards 16 days of activism can he steer South Africa in the same direction, please!