Investigating child-friendly alcohol policy in South Africa

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The Impact of Alcohol on Children in South Africa

In South Africa, alcohol exposure significantly impacts children, often beginning before birth. South Africa has the highest rate of fetal alcohol spectrum disorder (FASD) globally, with prevalence rates estimated between 29 and 290 per 1,000 live births (Olivier, Viljoen & Curfs, 2016).

Children exposed to alcohol prenatally face severe developmental, physical, and behavioral challenges that continue throughout life. Postnatal exposure to alcohol, such as through breastmilk, also poses risks, affecting physical and neurological development and impairing cognitive abilities, including grammatical comprehension and memory (Choi et al., 2016).

Institutions: School of Public Health, University of the Western Cape, the South African Medical Research Council and Stellenbosch University

alcohol

What We Learned from the COVID-19 Alcohol Ban

During the COVID-19 lockdown, South Africa implemented temporary alcohol bans, resulting in a substantial reduction in alcohol consumption and related harms. Studies from this period indicated positive changes, including statistically significant reductions in unnatural deaths, fewer pediatric injury admissions, and improved public health outcomes. This “natural experiment” highlighted the potential of alcohol regulation in mitigating harm within communities and protecting child health.

The CAP-2030 Research Initiative

To further explore the structural drivers of alcohol misuse and harm, the CAP-2030 network, including researchers from the University of the Western Cape, the South African Medical Research Council, and Stellenbosch University, engaged in a comprehensive study. Our goal was to empower communities to actively participate in a multisectoral approach to reducing alcohol-related harm, particularly among marginalized groups.

Resources

First page of article
2024

Whole-of-community and intersectoral interventions that address alcohol-related harms: A scoping review

Research Activities and Approach

The CAP-2030 network focused on three primary activities to advance understanding and effect change in alcohol harm reduction:

1. Scoping Review of Alcohol Harm Reduction Interventions

Conducted a systematic review of community-based and intersectoral approaches to alcohol harm reduction, focusing on interventions in low- and middle-income countries. This review identified a critical research gap in interventions relevant to these contexts.

2. Policy Engagement on Liquor Licensing

Submitted formal objections to liquor license applications at petrol station convenience stores, emphasizing the increased risks these licenses pose to women, children, and vulnerable community members.

What are the key lessons from these experiences?


There is no silver bullet


You need to be willing to work at it for a decade

There are inherent and potentially lethal conflicts of interest between stakeholders

You must have the active support of outlet associations, local gov, and liquor authority

Key group is young binge drinkers but they are HARD to reach


Keep the manufacturing industry at arm’s length

Limited data that all parties trust and will use as the basis for discussion and planning

‘WHO 10 best buys to reduce harm’ needs to be implemented in SA but seemingly no political commitment

Initiatives are rarely sustained for long periods of time, due to funding and shifting priorities.

A lack of understanding about the principles of harm reduction, and people do not follow the evidence

3. Advisory Group Formation and Stakeholder Engagement

Established a collaborative advisory group that brought together representatives from the Western Cape government, child advocacy organizations, and academic institutions.

This group worked to build trust among stakeholders and produced a report mapping current alcohol-related challenges, enablers, and actionable priorities. These findings were shared with key national and international policymakers, including the Children’s Commissioner for the Western Cape, the Southern African Alcohol Policy Alliance (SAAPA), the United Nations, WHO, and UNICEF.

A Vision for Collaborative Action

This research demonstrates that addressing alcohol-related harms to protect children in South Africa requires sustained political commitment, robust local partnerships, and comprehensive, evidence-based approaches. By applying these insights, policymakers and communities can work together to create a safer and healthier future for South Africa’s children.
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CAP-2030 works in countries around the world, bringing together policymakers, scientists, and advocates and children themselves to solve the most pressing challenges facing children and future generations. Our consortium is always welcoming new members - click on a country to learn more - or reach out to join our global movement for children!
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