The Demand for Alcohol in South Africa
The sale, dispensing and distribution of liquor was prohibited in the nationwide lockdown on levels 5 and 4 (DMA, 2002; Amendment Regulations 2020:22). The alcohol ban that was imposed during these levels highlighted the erratic behavior where looting of alcohol outlets in South Africa was observed (BusinessTech, April 2020). This behavior that was observed demonstrated that the demand for alcohol in South Africa is an ongoing problem (Peltzer, et al., 2011:36). The national disaster in which the fight against the novel virus COVID-19, became the priority for South Africa, also saw the demand for alcohol as a priority too. Online sales for alcohol also saw a strong increase in demand despite those buyers to receive their alcohol in level 3 of the lockdown (Mavundza, 18 May 2020). This revealed that alcohol was in high demand during the lockdown especially in levels 5 and 4.
The alcohol ban was lifted at level 3 of the nationwide lockdown; this meant that businesses with a liquor license could sell liquor or through e-commerce from Monday to Thursday, between 9h00 and 17h00 and that the consumption of liquor at the place of sale is not permitted (DMA, 2002; Amendment of Regulations 2020:15). Despite the enormous pressure on the health system with the pandemic the alcohol ban that was lifted saw trauma cases increase at hospitals with intoxication, violence and motor vehicle accidents (Medical Brief, 10 June 2020). Research noted that alcohol abuse has been associated with domestic violence and intra-family violence (Setalentoa, et al., 2010:12 & Guebaly, 2005:36). In South Africa, 58% of deaths on South African roads can be attributed to alcohol consumption (NDMP, 2019:15). Despite the available research the South African government was blindfolded to the potential risk and consequence that comes with alcohol consumption as the ban was lifted.
The estimated burden of disease attributable to alcohol in South Africa in 2000 was 7.1% of all deaths and 7% of the total disability adjusted life years (Peltzer, et al., 2011:30). Alcohol remains the primary substance of abuse in South Africa, between 7.5% and 31.5% of South Africans have an alcohol problem or are at risk of developing one (NDMP 2006-2011). The per capita consumption of alcohol in South Africa is 11 litres, the most in Africa (NDMP, 2019:29). The levels of fetal alcohol syndrome (FAS), in South Africa are the highest ever recorded (Parry, 2005:426). This is a devastating disability that is totally preventable by not consuming alcohol while pregnant (NIAAA, 2000:38). South Africa female drinkers each consume 16 litres of pure alcohol per year on average which is estimated 80% above the world average of 8.9 litres (WCARHR White Paper, 2017:15). This proves that the demand for alcohol in South Africa has become a noteworthy concern.
There is a strong link between drug use and social disadvantage which includes, low educational attainment, increased difficulty in finding and remaining employed, financial instability and poverty (WDR, 2020:09). The socio-economic factors such as poverty, inequality and unemployment remain key elements for the increased use of drugs and the development of substance use disorders (NDMP, 2019:14). The age restriction for alcohol consumption in South Africa is 18 years; however, there are no proper measures to ensure adherence and some of the unregulated outlets operate according to the demand (Setalentoa, et al., 2010:12). In a study that was done by South African Demographic and Health Survey (SADH), Medical Research Council and Marco International in 1998, it was found that 41.5% of male and 17.1% female age 15 years and older acknowledge consuming alcohol (Parry, 2001cited in Van Heerden & Parry, 2001:71). The prevalence of male alcohol consumption is more than double that of female consumption and underage drinking in South Africa is not only alarming, but that the demand for alcohol begins at a young age.
The demand for substances in South Africa has increased and more funds are allocated to address the demand for substances especially in the Western Cape (Meyer, et al., 2012:667). There is a direct link between alcohol related problems and the improved economic opportunities in South Africa since 1994 (Smook, et al., 2014:60). These alcohol related problems includes road traffic accidents, mental illness, violence and severe crime committed under the influence of substances (Van Heerden, et al., 2009:2). One of the causes of alcohol abuse and misuse in South Africa can be associated with the availability, in terms of location, time and affordability (Setalentoa, et al., 2010:12). This is an indication that the demand for alcohol use in South Africa is readily met.
Despite alcohol control measures implemented by South African government alcohol consumption remains high (Vellios & Van Walbeek, 2018:33). Demand reduction has been noted in the NDMP 2013-2017, as a recognized strategy along with Supply and Harm reduction. Demand reduction is aimed at preventing the onset of substance abuse and eliminating or reducing the effect of conditions conducive to the use of dependency forming substances (NDMP 2013-2017). Demand reduction is also highlighted as one of the intervention to combating substance abuse in The Prevention of and Treatment of Substance Abuse Act 70/2008. According to the NDMP 2019, the previous edition of the NDMP 2013-2017, did not provide policy clarity on broad strategies of demand, supply and harm reduction and that it lacks implementation plan (NDMP, 2019:22).
In conclusion, the demand for alcohol use in South Africa is considerably high and a state of national disaster confirmed how problematic this issue is. We cannot continue to be oblivious the problem relationship between South Africa and the alcohol use. The results show that South Africa has the highest number of alcohol consumption and highest rates of FAS in the world. There is an imbalance for the demand of alcohol use and the demand for treatment for alcohol use in South Africa. The ineffective demand reduction strategies are a breach to address the demand for alcohol use in South Africa. The burden of disease will continue to grow significantly if there is no action taken against the underage drinking in South Africa and the unlicensed liquor outlets that meet the demand for underage drinking.
- More emphasis should be placed on the demand for alcohol use in South Africa as a problem.
- The burden of disease of alcohol and other substances places on the health care system should be acknowledged.
- The severe medical, economic and social consequences of alcohol and other substance should be taken into account.
- The problematic relationship that exists between South Africa and alcohol use should be highlight as a concern.
- The mothers of FAS children should be investigated and if negligence is found they should be prosecuted.
- More attention should be given to underage drinking including unlicensed and unregulated liquor outlets.
- Demand reduction strategies should be revisited and implemented aggressively.
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