In a News24 article Alan Winde, premier of the Western Cape, draws on provincial research that illustrates the heavy burden of alcohol-related trauma on hospitals but argues that a long-term ban on alcohol is a blunt instrument that will not solve South Africa’s alcohol problem.
The alcohol ban announced by President Cyril Ramaphosa on 12 July 2020 understandably resulted in many emotionally charged responses.
On the one hand, excessive and dangerous alcohol consumption is resulting in trauma that is impacting on 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 – writes Winde in the News24 article published on 25 July.
With COVID-19 infections rising across the country, it is vital to ensure there are hospital beds available – especially in ICUs and high care units. Removing alcohol from the equation can have an almost immediate impact in freeing up beds in the 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, Winde argues in News24.
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 healthcare systems.
The Western Cape Department of Health has tracked 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.
Its reports show a significant decrease in people presenting to 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, Winde continues for News24.
In the two months before the alcohol ban, 974 people were brought to the 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 the healthcare system 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, Winde writes in News24. He described the economic devastation wreaked by the initial nine-week ban – for instance, 18,000 jobs lost in the wine industry – and anticipates that almost 240,000 jobs will be lost in the Western Cape across the agriculture, tourism and hospitality industry.
Mitigating alcohol harms and economic damage
It is essential to mitigate alcohol harms while also supporting jobs, argues Winde in the News24 article.
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. Behavioural changes are needed.
The Western Cape government has established an Alcohol Harms Task Team, which will drive initiatives aimed at reducing the harms of alcohol on society. The team will be led by the Department of Community Safety.
In the News24 article, Winde outlines thinking around four focus areas: alcohol pricing, with the possibility that introducing a minimum price per unit of pure alcohol could reduce consumption among heavy and binge drinkers; reducing the availability of alcohol; legislation and enforcement; and social support including education on and treatment for addiction, and support for victims of gender-based violence.
As a caring government, it is important to provide the healthcare services required during this pandemic while at the same time not ignoring the job losses that will result from a long-term alcohol ban and its impact on families.
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 society 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, Winde concludes in News24.
Indeed, it is time for South Africa to act smarter in addressing alcohol harms in the country.
Alan Winde – Alcohol ban: South Africa needs to act smarter