Alan Winde | Alcohol ban: South Africa needs to act smarter

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The Western Cape is considering some solutions to ensure the alcohol industry survives the Covid-19 pandemic and is not hit by an unemployment pandemic, writes Alan Winde. 

The new alcohol ban announced by President Cyril Ramaphosa last week has understandably resulted in many emotionally charged responses.

On the one hand, excessive and dangerous alcohol consumption is resulting in trauma that is impacting our hospitals at a time when the country must ensure Covid-19 patients receive care.

On the other hand, the ban is likely to result in a major economic impact and severe job losses in a second, equally dangerous "unemployment pandemic".

These two seem like the opposite ends of a see-saw - you cannot change one without having a significant impact on the other side.

Across the country, Covid-19 infections are rising. As the first province to experience a rapid increase in cases, we know how vital it is to ensure we have those beds in place - especially in our ICUs and high care units. Removing alcohol from the equation can have an almost immediate impact in freeing up beds in our healthcare system.

But a sustained, long-term ban is a blunt instrument that does not address the root problems and will not solve the alcohol problem that this country faces.

We must also find evidence-led and long-term solutions for these problematic behaviours that are so prevalent in South Africa and which impact on crime, violence, addiction, and our healthcare systems.

Trauma reports 

The Western Cape Department of Health has prepared reports which track trauma admissions to five hospitals in the province, comparing admissions before the alcohol ban, during the alcohol ban, and after the alcohol ban was lifted again.

These reports show a significant decrease in people presenting to our hospitals for trauma during the alcohol ban, and a significant rise in the numbers again after the ban was lifted on 1 June.

The ban on alcohol effectively reduced trauma presentations to these hospitals by between 40 and 50%.  

Before the ban, the province would consistently report weekend spikes of about 140 to 160 trauma cases, with a daily average of about 89.

Without alcohol, weekend spikes dropped to about 60 to 80 cases and a daily average of 46. Immediately after the ban was lifted, the daily average spiked to 81 cases per day.

If we look at some of the reasons for trauma presentations to hospitals, we see similar trends.

In the two months before the alcohol ban, 974 people were brought to our five hospitals for stabbings, 389 for motor vehicle accident injuries, 35 for sexual assault, and 20 for gender-based violence.

For the two months during the alcohol ban, those same hospitals received 360 stabbing, 125 motor vehicle accident, 17 sexual offences and four gender-based violence cases.

Major job losses 

The Western Cape saw an almost immediate surge in trauma cases as soon as alcohol was unbanned on 1 June, putting additional pressure on our healthcare systems at a time when Covid-19 cases were rapidly increasing.

The re-introduction of the ban may alleviate more of that pressure. But it will also result in major job losses in the Western Cape and elsewhere.

Wine industry body Vinpro estimates the initial nine-week ban on local sales, and five-week ban on exports will result in 18 000 jobs lost and 80 wineries and 350 wine grape producers closing their businesses over the next year. 

The Western Cape's hospitality industry is also under extreme pressure, with the restaurant industry in particular feeling the pressure of closures, alcohol bans and the introduction of the evening curfew.

Stats SA food and beverage data for April and May shows a decline in revenue of this sector of 94 and 87%, respectively, from 2019 revenues.

Agriculture, tourism and hospitality are the leading job creators in this province and a prolonged ban on alcohol sales will further contribute to the jobs pandemic taking shape in the Western Cape and across the country.

We anticipate almost 240 000 jobs will be lost in the province across all sectors as a result of the coronavirus pandemic and lockdown, creating a massive humanitarian crisis by putting hundreds of thousands of people at risk of food insecurity.

Emerging hunger hotspot

International organisation Oxfam has identified South Africa as an emerging hunger hotspot, saying many of the country's poor would be "tipped over the edge" by the inability to earn or job losses as a result of the pandemic.

Alcohol harms have a significant effect on the state and economy but at the same time, a ban will also result in job losses at a time when we can least afford them.

This is why we must work to address both of these issues by mitigating alcohol harms and at the time, supporting jobs. We must balance how we respond to this pandemic so that our healthcare systems have sufficient beds to cope, while ensuring people in this province are able to work, earn a salary and put food on the table for themselves and their families.

We need to be frank: alcohol and violence are intrinsically linked but a long-term, outright ban is not the solution. The problem is complex and multifaceted and will require a multifaceted response.

In order to succeed, we need to bring about behaviour change and how producers, distributors, retailers and consumers can all play their part in achieving this.

This is why the Western Cape government has established an Alcohol Harms Task Team, which will drive initiatives aimed at reducing the harms of alcohol on our society. The team will be led by the Department of Community Safety in the province, and invitations to participate will be issued shortly.

Its focus areas will include:

  • Alcohol pricing:

An independent study, through to determine the potential impact and feasibility of implementing a provincial excise tax and minimum price per unit of pure alcohol (MUP) in the Western Cape.

The research evidence advised against a provincial excise tax, with its primary impact being on moderate drinkers, with little significant impact on the most problematic categories of heavy and binge drinking. 

It did, however, indicate the introduction of a minimum price per unit of pure alcohol would have the desired impact on these targeted heavy and binge drinkers.

We have obtained a legal opinion in this regard and it advised an MUP would fall within the legislative competence of the Western Cape government and would not violate either the Constitution or competition laws. This is something we are carefully considering, as a province, as a potential step towards reducing alcohol harms in our society.

  • Alcohol availability:

Reducing the availability of alcohol by reducing the density of liquor outlets, trading times and limiting the sale of alcohol in large containers (such as 1l bottles of beer) have been shown to reduce the harms associated with alcohol in studies around the world.

  • Legislation and enforcement:

The Western Cape government is currently boosting enforcement capacity by deploying Law Enforcement Advancement Programme (LEAP) officers to enforce liquor-related regulations.

The province will also be tabling Liquor Act amendments which will address key enforcement issues, such as the confiscation and destruction of illegally sold liquor and enhancing the Liquor Authority's capacity to hear enforcement cases.

Currently, liquor which is confiscated from illegal traders is returned to them after paying an admission of guilt fine, rather than being destroyed. Similarly, licencing fees are the same whether you are a small trader, or a wholesaler, essentially creating a situation where there are few consequences for illegal trade, and few incentives for illegal traders to become licenced.

  • Social support:

Any legislative changes need to be made in conjunction with the provision of social services, including education on addiction, addiction treatment and support to the victims of gender-based violence (GBV), which is commonly linked to alcohol abuse in the home.

The Western Cape Department of Social Development is the lead department in this area. It currently funds 36 of the 61 substance abuse treatment centres and community-based treatment programmes registered in the province.

These include six funded in-patient centres and 30 community-based centre programmes. The department will also enable residents in the Central Karoo and Garden Route districts to access treatment and rehabilitation services.

In addition to substance abuse programmes in all of our child and youth care centres, the department will continue to fund school-based drug treatment programmes at high-risk schools.

The mainstreaming of GBV prevention interventions into substance abuse programmes is also an imperative as the correlation between substance abuse and GBV is widely recognised.

The Western Cape government's safety plan, which was introduced last year, focuses on interventions aimed at reducing violence in our society over the long term. These strategies carefully consider the role of alcohol and substance abuse in violent behaviour and set out safety priorities for each department. Both the departments of community safety and social development have been assigned priorities aimed at reducing alcohol and substance abuse harms.

Long-term solutions

These are just some of the interventions the Western Cape is considering in a multifaceted response to alcohol harms. As a caring government, it is important to us that we are able to provide the healthcare services which are currently required during this pandemic but at the same time we cannot ignore the job losses that will result from a long-term alcohol ban and the impact this will have on families in our province.

The only way South Africa will ever balance this see-saw is to focus on finding long-term solutions to the problematic use and abuse of alcohol in our societies in an evidence-led way that includes all the role players, including all three spheres of government, alcohol manufacturers and retailers, and users of alcohol products.

Indeed, it is time for South Africa to act smarter in addressing alcohol harms in the country.

 - Alan Winde is the premier of the Western Cape.

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