Alcohol abuse is silently devastating communities across Southern Africa, but a groundbreaking initiative is finally shining a light on this crisis. The University of Cape Town (UCT) and the South African Medical Research Council (SAMRC) have joined forces to tackle the root causes of harmful drinking in South Africa and Botswana, launching a five-year study that promises to reshape how we address this issue. But here’s where it gets controversial: while many see alcohol harm as a personal choice, this project boldly argues that it’s deeply intertwined with political, economic, and social systems—and that’s just the tip of the iceberg.
Dubbed Collaboration for Harm Reduction and Alcohol Safety in the Environment in Southern Africa (CHASE-SA), this initiative brings together a powerhouse of institutions, including the University of Botswana, the London School of Hygiene & Tropical Medicine, and civil society groups like the Southern Africa Alcohol Policy Alliance (SAAPA). Co-led by UCT’s Division of Public Health Medicine and the SAMRC, the project aims to map the entire alcohol ecosystem—from industry supply chains to local drinking cultures—and link these factors to health and social outcomes. And this is the part most people miss: it’s not just about how much people drink, but why they drink and what systemic forces keep harmful patterns in place.
South Africa’s struggle with alcohol is alarming. With one of the highest rates of heavy episodic drinking globally, alcohol contributes to 7% of the country’s disease burden, fueling issues like gender-based violence, trauma, and heightened risks of HIV and tuberculosis. The Western Cape, in particular, has a staggering rate of fetal alcohol spectrum disorders—among the highest in the world. But why is this happening, and what can be done? CHASE-SA seeks to answer these questions by examining how political, commercial, environmental, and socio-cultural factors drive harmful drinking, especially in vulnerable communities.
Project lead Richard Matzopoulos, an honorary professor at UCT and head of the SAMRC’s Burden of Disease Research Unit, emphasizes the study’s uniqueness: “This is the first large-scale effort in Southern Africa to connect the dots between alcohol environments and health outcomes. We’re not just looking at who drinks, but why harmful drinking is so entrenched and what levers exist for change.”
The research unfolds across four interconnected streams: 1) analyzing the political economy of alcohol, including industry influence; 2) mapping where and how alcohol is accessed and consumed; 3) linking drinking patterns to health, social, and economic impacts; and 4) co-creating policies and interventions with communities and policymakers. This multidisciplinary approach ensures that the findings are actionable, not just academic.
Here’s a bold interpretation: the alcohol industry’s shift toward low- and middle-income countries, where regulations are often weaker, is exacerbating harm. South Africa’s COVID-19 alcohol sales bans, while controversial, demonstrated how quickly harm can be reduced—trauma-related hospital admissions plummeted. Yet, the industry fought back, highlighting the power dynamics at play. “This has provided a rare opportunity to rethink alcohol policy,” Matzopoulos notes. “But evidence alone isn’t enough. We need to build coalitions with communities and decision-makers to drive meaningful change.”
So, here’s the question for you: Is alcohol harm primarily a personal responsibility, or is it a systemic issue that requires collective action? Share your thoughts in the comments—let’s spark a conversation that could shape the future of public health in Southern Africa.
