News analysis

No drinking
  • At least one cabinet minister wants to see proposal before Parliament to limit the alcohol industry in South Africa – permanently.
  • Restrictions on the table would include raising the drinking age, and an outright ban on advertising.
  • Coronavirus prohibitions have presented plenty of data and anecdotes on what happens in hospitals without booze.
  • And nearly a year of focus on Covid-19 has government leaders thinking in terms of saving lives, rather than jobs.
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If 18-year-olds lose the legal right to drink in South Africa at some point in the not-too-distant future, they may have the coronavirus pandemic to blame.

Policymakers are considering new – permanent – restrictions on the alcohol industry, inspired by recommendations and data derived from the temporary bans on alcohol sales imposed to combat Covid-19.

Three ideas in particular are metaphorically on the agenda in cabinet: banning alcohol advertising outright, better ways to track unlicensed alcohol sales, and raising the drinking age.

As of last week, all three have the official seal of approval of at least one minister.

"All of these I consider to be useful medium to long term tools to reduce South Africa’s high rate of alcohol consumption to be considered by the legislature in due course," said co-operative governance and traditional affairs minister Nkosazana Dlamini Zuma in an affidavit.

Dlamini Zuma was responding to the legal challenge from South African Breweries (SAB) against the last outright prohibition, as it seeks to prevent the state from summarily halting booze sales again, in the future.

Before the July 2020 iteration of the coronavirus alcohol ban, lobby group the Southern African Alcohol Policy Alliance had called for such interventions to last beyond the pandemic.

It is not alone. The emergency alcohol bans have galvanised a range of players who fiercely believe that the social cost of South Africa's current approach to booze is too high – but which have suffered regular defeats at the hands of those who argue that the economic cost (measured, among other things, in jobs) of tougher rules would be too high.

Dlamini Zuma's opposition to SAB suggests that lives rank higher than jobs in current thinking, with the national executive of the opinion that policy effects on livelihoods are temporary and reversible, but lives are lost for good.

"Government takes any loss of life seriously and more so with loss of life that is preventable," says Dlamini Zuma, in the context of keeping a hospital system functioning amid a virus-driven surge in demand.

On alcohol-related trauma admissions in hospitals specifically, she points to reams of data and anecdotes around what happened when SA turned off the alcohol taps. The likes of SAB argue that such data is at best clouded by not separating other restrictions, such as curfew, from bans on alcohol sales. With fewer people on the roads there will be fewer car accidents, this argument holds, and it is not just a reduction in drunk drivers that kept hospital beds empty.

Dlamini Zuma, on the other hand, sees "unequivocal correlation" and numbers "consistent with the 'lived' realities of HCWs [healthcare workers] in trauma units throughout South Africa": less booze means fewer deaths. 

Central to her legal argument is that nothing works as well as a complete prohibition, but that given time, behavioural changes can be encouraged with less blunt instruments.

One tool with a point sharper than denying 18-year-olds booze is already under discussion locally. 

The Western Cape is pushing for a minimum unit price (MUP) for alcohol, which makes the cheapest form of alcoholic drinks more expensive. Research suggests that raising prices overall, typically by increasing sin taxes, don't have much impact on binge drinkers, but a MUP pushes drinkers to alternatives with less alcohol. If it does not get those heavy drinkers to slow down, at least it taxes them disproportionately.

See also | The Western Cape wants minimum booze prices. Those worked elsewhere – after big legal fights

But the executive is being pushed by doctors, and social campaigners on issues such as gender-based violence, to take more direct action on alcohol than merely adjusting pricing.

Dlamini Zuma summarised one approach to thinking about the cost of alcohol (versus the tax it brings in, among other things), in her affidavit.

"The first category of costs are the direct economic costs of alcohol consumption e.g, hospitals and the health system the police and criminal justice system, the unemployment and welfare systems. The second major category of social costs is indirect costs.  These are the result, for example, of lost productivity due to absenteeism, unemployment, decreased output, reduced earning potential and lost working years due to premature pension or death. A third category, which is difficult to measure, is intangible costs. Intangible costs are those assigned to pain and suffering, and more generally to diminished quality of life. Such intangible costs are borne by the heavy drinkers, as well as their families and potentially by other individuals linked to the drinker."

That approach may see a fresh airing in Parliament as soon as the coronavirus dust settles, some now suggest.

And the combination of fresh data from what amounts to an experiment in outright prohibition; an alcohol industry that has seen the worst government can do and is preoccupied with preventing a repeat; acceptance by the public of extreme measures to save lives; and general confusion in the aftermath of a disaster, that may just present a unique opportunity for radical change. 

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