/ 10 December 2010

Liquor Act serves largely the poor and not vested interests

South African drinkers consume on average 17 litres of pure alcohol a year, placing them among the heaviest drinkers in the world.

It is perhaps not surprising then that the response to legislation aimed at reducing alcohol-related harm by restricting unfettered access to alcohol has met with an emotional rather than a rational response.

Andrew Charman and Leif Petersen’s article “The inconvenient truth about the Western Cape Liquor Act” (December 3) is one of several such press articles that advance factually incorrect claims. These are creating public confusion about the objectives of the Act.

First, there is no need for drinkers to be alarmed. No one in the provincial government of the Western Cape (including the “powerful alliance of health professionals”) has ever suggested prohibition. Indeed, there is no evidence that banning any drug is a successful method of reducing harm. Yet there is ample evidence that alcohol is, at present, causing far greater harm than any other drug in South Africa, primarily because there are so many users.

The extent of this harm is significant: South Africa experiences 10 times the global burden of male interpersonal violence, twice the global average of road injuries and among the highest global incidences of HIV/Aids and foetal alcohol syndrome. Evidence from across the world indicates that the most cost-effective way to reduce alcohol-related harm is to restrict (not ban) access to alcohol — hence, the Western Cape Liquor Act.

Last week’s article is a gross misrepresentation of the Act and its proponents. Contrary to its claims, the Act was developed through a process of multi-party and public participation. Had Charman and Petersen attended the many hearings in 2008 and 2009, they would know that the final decision was the result of an overwhelming public outcry against the harm and nuisance caused by excessive access to liquor, particularly in poor areas, and the hundreds of complaints about the hazards and strains of having liquor outlets in residential areas.

It seems the authors are interested only in liquor outlet owners and not in the broader community. Would they consider raising their own families next to a shebeen or bar, or is this privilege reserved for the poor? Do they really support a situation where the areas with the highest number of alcohol-related murders and traffic crashes also provide the easiest and cheapest access to liquor? The poor bear most of the burden of alcohol-related harm while most of the economic benefits accrue to a minority. The Act seeks to address a situation in which the poor are differentially disadvantaged by living in areas with many drinking outlets, which harm the community at large.

The article falsely asserts that the Act regulates access to liquor outlets only in black and coloured areas. New liquor licences granted in any residential area and the trading hours of all liquor outlets have been reduced (and reduced further by the City of Cape Town’s proposed new by-laws).

Yet elite establishments have lobbied strongly for exemptions and, should these be granted, we would be in agreement that the Act was not being implemented in its intended manner — wealthy people also abuse alcohol, wealthy traders also serve people when they are clearly drunk, and expensive cars are also driven into poles. We would find it similarly unacceptable for large supermarket chains to begin selling liquor in residential areas.

The Act indeed precludes licensing in residential areas, but it is accompanied by measures to provide spaces for recreational facilities (including liquor outlets) in or next to townships within designated economic zones. Small, unproductive shebeen owners will be able to form cooperatives and diversify their businesses, increasing profitability and creating safer drinking environments that can be policed more easily. Where the envisaged economic zones are located and how they will be designated and planned should be debated; this is the truly pro-poor measure that considers all stakeholders.

Last, in terms of the cost of alcohol abuse in South Africa, claims that the Burden of Disease project has fabricated the figures are completely false. Before local evidence was available, international costing figures were referred to (common scientific practice in the absence of local evidence). Since then, Soul City has commissioned a costing report that showed approximately R17-billion is spent by the government annually on alcohol-related problems. This estimate excludes the major costs to tertiary hospitals, indirect governmental costs (such as school drop-outs) and the costs to business or individuals.

The article misleads the public about legislation that, if successfully understood and implemented, could reduce homicide in the province by 40% (based on evidence from similar measures adopted in Diadema, Brazil, and supported by local anecdotal evidence). The time has come to engage in a higher level of debate: as long as public dialogue is dominated by rabble-rousing based on misinformation, we will miss the chance to discuss the best ways of implementing the Act and identifying other evidence-based measures we could adopt.

Instead, Charman and Petersen merely punt their own 2009 research, which is not in the public domain and seems fundamentally flawed in that it promotes township liquor purveyors without any consideration of likely alcohol-related harm to the community. Ironically, this sits poorly with a sustainable-livelihood development model.

Dr Joanne Corrigall is a senior public health specialist at the Western Cape department of health. Professor Jonny Myers is the director of occupational and environmental medicine, School of Public Health and Family Medicine, UCT. Richard Matzopoulos is a senior scientist in the Burden of Disease Unit, Medical Research Council