Alcohol Sales Ban in South Africa: Benefits and Big Alcohol Opposition

The South African government implemented an alcohol sales ban early on when COVID-19 hit the country, as part of its public health response to contain the spread of the virus. The ban is intended to reduce the heavy alcohol burden on the country and specifically on the healthcare system. From the beginning of the ban Big Alcohol has been unrelenting in their opposition. The government’s strong stance in not giving into the opposition is proving fruitful as reports show the ban is benefiting South African society.

The alcohol sales ban was first tested for three weeks beginning in April. As positive results streamed in, the ban was extended until May 2020. From the beginning it was a struggle to implement the ban with alcohol industry opposition, including contravening and undermining the government policy.

South Africa: The Struggle over COVID-19 Alcohol Sales Ban

Already before the current public health crisis, alcohol was a heavy burden on South Africa.

In 2015, an estimated 62,300 South Africans died from alcohol-related causes, according to research published in 2018 in BMC Medicine.
The combined total tangible and intangible costs of alcohol harm to the economy were estimated at 10 – 12% of the 2009 gross domestic product (GDP). The tangible financial cost of alcohol harm alone was estimated at R37.9 billion, or 1.6% of the 2009 GDP, according to a 2014 article in the South African Medical Journal.

In the face of the additional and growing healthcare burden due to the pandemic, the government took an evidence-based decision in the public interest and in order to save as many lives as possible to ban alcohol retail along with the level 5 lockdown initiated in April.

As benefits from the ban come in, the government has decided to prolong the alcohol sales ban during the level 4 lockdown initiated from May.

There are proven links between the sale and consumption of alcohol and violent crime, motor vehicle accidents and other medical emergencies at a time when all public and private resources should be preparing to receive and treat vast numbers of Covid-19 patients,” said South Africa’s President Cyril Ramaphosa.

Alcohol is a hindrance to the fight against coronavirus,” President Ramaphosa added, as per The New York Times.

Multiple benefits of the alcohol sales ban

Some of the benefits of the current alcohol restrictions as shared by @profparry during @SAAPA7 and @PublicHealthSA webinar today #AlcoholSafeSA #Covid19SA pic.twitter.com/SFBU8jiIaC

— SAAPA (@Saapa7) May 7, 2020

1. Reduced violence

As Movendi International previously reported, weeks into the lockdown, movement restrictions and the alcohol sales ban, police minister Bheki Cele reported on the positive outcomes regarding violence reductions comparing to the same time period, last year.

Crime statistics revealed, between March 29 and April 22 last year compared with March 27 and April 20 this year,

Murder cases dropped from 1542 to 432 showing a decrease of 72% (1110 decrease),
Rape cases dropped from 2908 to 371, showing an 87,2% decrease (2537 decrease),
Attempted murder decreased from 1300 to 443, showing a 65,9% decrease (857 decrease),
Assault GBH decreased from 11,876 to 1 758, showing a 85,2% decrease (10,118 decrease), and
Robbery with aggravating circumstances decreased from 6654 to 2022, showing a 69,6% decrease (4632 decrease)

For trio crimes:

Carjacking dropped from 1146 to 219, showing a 80,9% decrease (927 decrease),
Robbery at non-residential premises decreased from 1345 to 464, showing a 65,5% (881 decrease),
Robbery at residential premises decreased from 1437 to 664, showing a 53,8% decrease (773 decrease).

According to police minister Cele, domestic violence cases have also reportedly dropped 69,4% from 9990 cases between March 29 and April 22 last year to 3061 since the lockdown until April 20, meaning a difference of 6929.

South Africa: Alcohol Sales Ban Leads to Violence Reduction

2. Reduced violent death rate

Reduced overall violence as reported by crime statistics goes hand in hand with reductions in violent deaths since the COVID-19 lockdown and alcohol sales ban.

The rapid mortality reporting system developed by the burden of disease unit at the South African Medical Research Council (SAMRC) and the University of Cape Town’s Centre for Actuarial Research, report unnatural deaths in the country have halved since lockdown measures and the alcohol sales ban.

Unnatural deaths are mainly homicides and road fatalities, but also include other unintentional-injury deaths, which could be fueled by alcohol.

Expected figures were 800 deaths a week with a 1000 deaths peak in Easter. Actual deaths were in line with the expectation till lockdown and the alcohol retail ban, after which, actual deaths reduced to 400 per week.
This means at least 2000 lives were saved in the first five weeks of the level 5 lockdown and alcohol sales ban.

While many other countries are experiencing an excess of deaths due to the pandemic, in South Africa fewer lives have been lost than normal.

Richard Matzopolous, co-director of the SAMRC unit says the two interventions, lockdown at homes and the alcohol retail ban has interacted positively to reduce unnatural death in the country.

The first intervention [lockdown in homes] forces people into a more confined social space and one would expect to see an increase in other forms of violence as a result, for example, domestic abuse, child abuse, and others,” said Matzopolous, as per Sunday Times.

…the second intervention [the alcohol retail ban] has had a dampening effect on this. So although we see an increase in domestic abuse, for example, this would likely be much worse if there wasn’t also a simultaneous alcohol ban,” he added.

The crime statistics of reduced violence and the data showing reduced deaths have incentivised the government to maintain the alcohol sales ban during level 4 lockdown in the country.

3. Drop in trauma cases in hospitals

Hospitals in South Africa are reporting dramatic drops in trauma cases. Before the lockdown and the alcohol availability restrictions in the country, modelling by the SAMRC suggested trauma units nationwide saw about 35,000 weekly admissions. Since the lockdown and alcohol sales ban SAMRC modelling suggests hospital trauma admissions have decreased by 66%.

For instance, the Groote Schuur Hospital usually sees about 1,100 patients a month, and about 60% of these cases are related to interpersonal violence. The facility usually dealt with 70% of its cases between a Friday afternoon and Monday morning. About 50% of the trauma cases over the weekend are predominantly alcohol related.

Groote Schuur Hospital has seen a drop of two-thirds in trauma cases since the lockdown and alcohol sales ban.
On a normal weekend, the trauma unit received at least 150 patients but over the past weekend, staff dealt with only 37 trauma cases.

About 80 to 85% of cases every month used to come from gunshot injuries. This used to be a heavy burden for the Groote Schuur Hospital.

To suddenly have that taken off our hands is a huge relief as that takes up a huge amount of our resources, patients needing intensive care, needing admission and obviously a lot of operating,” said Dr. Andrew Nicol, Head of Groote Schuur Hospital’s trauma unit, as per Eyewitness News.

Dr Fallin van Rooyen, who works in the trauma unit at Mitchells Plain District Hospital in Cape Town, said in normal times almost every patient at the weekend has consumed alcohol or has been injured by someone under the influence of alcohol.

Dr. Rooyen supports the ban as it has allowed her and her team to care for patients who are sick and not injured.

Learning from the positives and moving forward

In South Africa, trauma units have been accustomed to mass casualties many of which are linked to alcohol on weekends and public holidays. It has become so commonplace that it has escaped the attention of the country. With the lockdown measures and the alcohol sales ban the depth of the problem has become uncovered, giving the country a chance to change for the better and address alcohol harm more coherently in future.

Data collected during the lockdown and alcohol sales ban period is needed to drive the necessary change in evidence-based alcohol policy making in the future. South African public health practitioners and policymakers should use this time to gather detailed data on what is being faced in healthcare facilities. Disentangling the impact of the lockdown and the alcohol sales ban, respectively, on violence is essential. This data will help in responding to and debunking of alcohol industry arguments.

Easy availability of alcohol is a major problem for South Africa. A 2017 study in Khayelitsha commissioned by the Western Cape government found 1045 outlets, of which only 11% were trading legally, with people living within three to five minutes walking distance from their nearest alcohol outlet.

Some measures to restrict alcohol use in the future as suggested through a study by SAMRC, which will be beneficial in preventing and reducing alcohol harm even after the lockdown include:

Reducing alcohol outlet density,
Restrictions on trading volumes and times, and
Mass media awareness campaigns on alcohol harm.

The pandemic has shown that the government can take action in the interest of the public when needed and wanted. The police and the provincial liquor authorities have enforced laws and South Africans have said alcohol needs to be regulated.

The Southern African Alcohol Policy Alliance South Africa calls on the government to reactivate the Inter-Ministerial Committee on Substance Abuse, for collaboration to strengthen alcohol control in the country.

Better alcohol control would be a win for the South African government and people. There will be more revenue from excise tax, less cost in dealing with alcohol harm, the health department will spend less on alcohol harm and have more resources to for health promotion, social development will have less alcohol related violence and domestic violence to deal with and the police will have less alcohol-related crime and can focus on other crimes. Most importantly more South African lives will be saved.

The alliance calls on the government to urgently process the draft Liquor Amendment Bill of 2017 which is awaiting submission to parliament. The bill will harmonise alcohol regulation at the national, provincial and local government level with regard to operating hours, infrastructure, health, density and zoning.

Big Alcohol’s opposition to the COVID-19 alcohol sales ban

Big Alcohol’s exploitation of the entire African region is well documented. In Oliver van Beemen’s book “Heineken in Africa” some of the major unethical business practices of Big Alcohol company Heineken are documented, including, sexual exploitation of women, support to the apartheid, genocide and other grave human rights violations.

Big Alcohol has been exploiting the lack of regulations in the region to make inroads and aggressively drive an alcohol norm – which does not yet exist – in the African region.

Africa: Big Alcohol Making Inroads

Therefore, it is no surprise that Big Alcohol is opposing the alcohol sales ban during COVID-19 as aggressively as possible. The alcohol industry does not want the government or the people to realize the benefits of alcohol control because their profits depend on South Africans consuming alcohol, even at the risk of death.

Despite the ban on alcohol sales, the alcohol industry has been running alcohol advertisements. Everyday South Africans are shown different alcohol promotions to fuel psychological availability even though alcohol is physically not available.

The Advertising Regulatory Board (ARB) – an industry funded self-regulation body – has said this does not break the current alcohol ban as its a sales ban and not an advertising ban. The ARB is defending this unethical advertising during a time when alcohol retail is banned in the country because of the health implications it can have along with the pandemic. The World Health Organization has advised people to avoid alcohol use.

The alcohol industry wants to keep brand loyalty going even during the lockdown. Science has found brand loyalty to be linked with alcohol consumption from a specific brand.

More aggressive opposition to the ban has been reported with Big Alcohol breaking the law and transporting alcohol. Vehicles owned by AB InBev SA found leaving depots with goods worth millions of rand. AB InBev has claimed they have permission to transport the alcohol to inventory.

South African Breweries (SAB) are among the alcohol companies lobbying the government to lift the alcohol ban. One of their notorious talking points is that the ban is increasing illegal alcohol sales. But the most stringent answer to illegal alcohol trade is enforcing alcohol laws, not reducing restrictions on legal alcohol.

Prof Charles Parry, the Director of the Alcohol, Tobacco and Other Drug Research Unit at SAMRC explained the facts, based on very recent data:

If alcohol was so widely available we would have seen a return of patients to trauma units. But based on latest available data (April 22) from Groote Schuur and George Hospitals this is not the case. Nor is it the case that we have seen any dramatic increase in the incidence of non-natural deaths,” explained Prof Parry.

Obviously things could have changed since then as we have moved into Level 4 [lockdown] but I have not seen data to suggest otherwise.”

Prof Parry also cited state-of-the-art research showing “overwhelming compliance with the lockdown” measures, according to the Human Science Research Council.

A comprehensive national survey found that only 2.5% of respondents said that alcohol was accessible during the lockdown compared to 11.7% vis-à-vis cigarettes. It does not seem to be widespread. The highest level of availability was 5% in rural (traditional tribal) areas and 4.2% in informal settlements,” Prof Parry said in an e-mail conversation.

The evidence seems to be clear that illegal alcohol sales are not widespread and that people are not aware of easy alcohol availability.

Citing that people may die from consuming hazardous illicit alcohol – ignoring that people getting sick and dying from legal alcohol consumption on epidemic levels in South Africa – SAB is pushing for the relaxation of the alcohol sales ban and the permission to start selling alcohol with restrictions on the amount that can be purchased as well as trading hour restrictions. It remains unclear why these restrictions would not fuel the black market. Hidden among the lobby requests is the permission for online sale.

But as Prof Parry explained, excess deaths are actually dropping in South Africa during the lockdown and alcohol availability restrictions – citing another state of the art study by the SAMRC, until as recent as April 28.

Alcohol industry front group the Beer Association of South Africa (BASA), representing transnational beer giants Heineken and South African Breweries, are using the livelihood argument to lobby the government to lift the ban during the pandemic, despite the obvious benefits of the alcohol restrictions.

The alcohol industry claim that banning alcohol retail during the pandemic will cause more harm is baseless considering the reduction of alcohol related problems since the lockdown and alcohol sales ban, specifically considering that there has been less excess deaths in South Africa than normal.

Big Alcohol brand Carling Black Label, owned by AB InBev, has started a Corporate Social Responsibility (CSR) initiative named #NoExcuse to reduce domestic violence during the lockdown. This is a cynical initiative since Carlin Black Label is associated with aggressive price promotions and excess bottle sizes – fueling heavy and high-risk alcohol consumption in South Africa. Both the product itself and brand practices are clearly fueling violence and specifically domestic violence. Nevertheless, the initiative has endorsements from celebrity figures in TV, such presenter and medical doctor, Dr Musa Mthombeni; sports presenters, such as Thomas Mlambo and Andile Ncube; radio DJ Moeti Tseki and former footballer Phumudzo Manenzhe.

But public health experts explain that the alcohol sales ban has probably reduced the extent of domestic violence more than could have happened with lockdown in homes and no ban.

Scientific evidence shows that alcohol industry CSR activities actually don’t benefit society and only work to benefit the alcohol industry through commercial strategic advantage while at the same time appearing to have a public health purpose.

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