/ 7 March 2014

Alcohol industry still calls the shots

It's past midnight in Montshiwa in the North West – and the shebeens are still open. Residents in the surrounding homes know that patrons will pour out of the venues at all hours; noise levels will be unregulated and hardly any security will be available to monitor any violence that might take place.

When Soul City's PhuzaWize campaigners did a community mapping exercise there in 2013, they found 2 305 households, one community library, a cultural village, a soccer stadium, an arts school, two clinics, 10 schools, five creches and 14 churches. And 28 liquor outlets; 24 were illegal.

When campaigners were mapping the township and its shebeens, they found children – in school uniform – openly consuming alcohol. Among these were grade 12 pupils who were supposed to be attending a catch-up camp ahead of the matric exams.

It's not unusual to find liquor outlets on the doorsteps of schools: in some cases, there were several shebeens around the schools we surveyed. School principals complain that they experience alcohol-related problems among schoolchildren. It is an issue that schools often lack the capacity – in both skills and human resources – to deal with.

Imagine then if these issues were prevalent in Johannesburg's northern suburbs. Imagine if those parents found a shebeen on the doorstep of the school to which they entrusted their children for safekeeping and education. Imagine if northern suburbs residents had to deal with liquor outlets staying open at all hours, not having any security on the premises and continuing to serve their increasingly rowdy and drunk customers through the night.

Economic divides
Few issues illustrate the economic divide that haunts South Africa as well as the double standards employed when it comes to regulating the alcohol industry. Even as the billion-rand industry – with the few at the top raking in massive incomes – protests people's right to choose what and how much they consume, it is the small, survivalist trader whose entrepreneurial endeavours are positioned as the positive, post-apartheid (usually female) face of the alcohol industry. 

Alcohol's contribution to the economy is lauded; the cost of alcohol's harm to the economy is laundered.

A study published in the South African Medical Journal last month, The Cost of Harmful Alcohol Use, based on research commissioned by the department of trade and industry, found that current policies around the sale and cost of alcohol are designed to maximise industry profits, taxes and job creation, but don't mitigate the harmful effects of alcohol on society.

In fact, the updated research puts the tangible financial costs of harmful alcohol use a year at R39.2-billion and the intangible cost at R245-billion. The total budget allocated for health in 2014 was R145.7-billion.  

Cost of alcohol harm
If the cost of alcohol harm to taxpayers is not persuasive enough to galvanise concrete and meaningful action, then what about the immense personal harm experienced by thousands of South Africans each day?

Consider, for example, the high road death toll with 1 357 deaths between December 1 and January 7. Government has identified drink-driving as one of the major causes of this avoidable carnage. But knowing who – or what – is to blame is cold comfort for those who have experienced the loss or disability of loved ones.

Alcohol abuse is the third-largest contributor to death and disability in South African after sexually transmitted infections and interpersonal violence. In fact, it is the most abused drug among South Africans – contributing 7% of the total disease burden, according to the authors of the South African Medical Study, which include the Medical Research Council's Richard Matzopoulos and Joanne Corrigall from the University of Cape Town's School of Public Health.

The cost does not end there. We divert much-needed funds not just into fixing the harm at both the societal and individual level but also towards the cost of alcohol consumption at an individual level. In a country that can ill-afford it, the researchers found that up to 13% of discretionary disposable income is spent on alcohol. 

Existing alcohol use and abuse is exacerbated by cheap and easily accessible alcohol, a lack of recreational facilities, lack of law enforcement and the proliferation of alcohol marketing.

Holistic approach
It is in this context that a holistic approach towards dealing with alcohol use and abuse is needed. This approach should include a range of interventions such as life orientation for young people, training for owners and employees who run alcohol outlets, increased taxation to reduce consumption, a minimum price, trading hour restrictions, drink- driving restrictions and improved enforcement as well as a review of the minimum drinking age and content of alcohol that young people are allowed to consume. 

Banning alcohol advertising is another essential step in this holistic approach towards addressing alcohol-related harm. We know that exposure to alcohol advertising encourages young people to start drinking at an earlier age and in greater quantities, both at the onset of drinking and throughout the life cycle. 

This motivates our call to minimise the impact of alcohol marketing by allowing advertising only at the point of sale, thereby protecting both the young and those who are trying not to drink alcohol from the constant temptations that adverts bring.

We believe there is enough evidence to support a swift implementation of the basket of proposed policies such as the proposed norms and standards, a ban on alcohol marketing and others already in the pipeline, which aim to reduce alcohol-related harm. 

Alcohol consumption has been repeatedly shown to be significantly related to South Africa's major health challenges such as interpersonal violence and HIV. 

There is also clear evidence of the role alcohol plays in promoting risky sexual behaviour and in reducing compliance to medication such as antiretroviral treatment among people with HIV.  

The draft bill
The draft National Liquor Norms and Standards Bill will see bottle stores closed on Sundays, prohibits the sale of alcohol to someone who is already intoxicated and includes the need to check the age of patrons with official documentation such as an identification document.

 It proposes increased security with the actual outlet being a gun-free zone. Its practical recommendations include the availability of free water. All of these proposals move towards creating an environment in which there is increased safety in places where people socialise and alcohol is sold.

But in many ways the proposals do not go far enough. For example, the norms should include fines for traders who do not comply and specific action should be taken against repeat offenders. 

The proposed hours of sale are still too lax and not enough responsibility is given to the owners of outlets to create a safer trading environment. 

Those who point to "difficulties" in implementing these norms and standards in townships promote the view that it is acceptable to have different standards for different South Africans, and that those who live in townships should not expect to see a reduction in the hours of sale or an improvement in safety and security around alcohol outlets, but should rather accept that the alcohol industry will continue to support unrestricted alcohol sales in their residential areas. 

The South African Medical Journal research notes that "regulatory and policy interventions have the potential to substantially curtail the costs of harmful alcohol use, and in doing so make a direct contribution to the wellbeing of the average SA citizen, and to the economy". 

There must be an urgent implementation of a holistic strategy to tackle this issue, with full awareness of the unconscionable developmental consequences of allowing the alcohol and advertising industries to promote a continuation of the status quo. 

Savera Kalideen is the senior advocacy manager at the Soul City Institute for Health and Development Communication