Almost half of South Africans who consume alcohol drink too much. It’s a fact based on the number of drinkers who say they consume more than 15 drinks a week. This contributes to accidents, homicides and a range of medical conditions that place a heavy burden on our healthcare systems.
The use of alcohol by teenagers is also worrying – with some studies showing that about 30% of teenage boys and 20% of teenage girls are binge drinkers.
The number of people dying from alcohol-related violence should set off national alarm bells. But it doesn’t. Alcohol is a factor in 60% of femicides, half of all homicides, two-fifths of rapes and a quarter of traffic fatalities caused by driver error.
Heavy drinking is so normalised in South African society that it has become part of our social fabric. We refuse to acknowledge the red flags, even as our communities and health systems come under immense strain.
To change things, we need to build strong coalitions across communities, media, academia and government demanding policy reform and drive critical conversations about alcohol harms.
A recent example of this is a new partnership between the Africa Centre for Inclusive Health Management (ACIHM) and DG Murray Trust (DGMT) to tackle heavy drinking. This collaboration aims to challenge the norms, policies and industry practices that promote and normalise heavy drinking.
“South Africa is one of the heaviest drinking countries in the world, with those who drink tending to do so heavily, more than five drinks in one sitting. The health, social and economic costs and the burden on the country’s health system are severe,” says the centre’s director, Munya Saruchera.
He says people don’t fully understand the health risks associated with drinking, such as Cancer and Foetal Alcohol Spectrum Disorder (FASD). But even when children escape the direct effects of FASD, heavy drinking by parents, or other adults in the household, also affects children in the home. They may experience physical and emotional neglect, abuse, stress, trauma, conflict and insecurity.
During adolescence, heavy and binge drinking can disrupt brain development in ways that extend far beyond the teenage years, leading to long-term cognitive deficits, difficulties with emotional regulation, and structural changes to the brain.
Research underscores the urgent need for policy change, and policymakers can no longer turn a blind eye to the red flags. They must stop treating alcohol reform as optional. It is a public health emergency — one we can no longer afford to ignore.
A Cape Town study led by researcher Samantha Filby, examined the effect of liquor trading hours in the Western Cape and found a strong correlation between late closing hours and spikes in hospital admissions, road accidents and interpersonal violence. The period between 2am and 4am was identified as especially dangerous.
Measures such as raising alcohol prices are proven to curb excessive consumption. The ultimate goal is to drive policy reform at national, provincial and municipal levels, focusing on trading hours, licensing and restricting alcohol advertising.
But legislative changes alone are not enough. South Africa needs a cultural shift, driven by public health messaging, in order to actively reduce consumption.
We must normalise critical conversations about alcohol use from family dinner tables to parliamentary debates, much like the public health mobilisation that made talking about safe sex and young people’s agency a big part of the strategy to tackle HIV and Aids.
Globally, the Sober Curious movement is reshaping drinking culture, but South Africa risks being left behind. In many rural and low-income areas, taverns and shebeens remain the only spaces for social connection. Without safe, community-driven alternatives, alcohol becomes the default form of recreation — particularly for unemployed youth.
Civil society cannot wait for the government to act.
Zimasa Mpemnyama is the Rethink Your Drink project lead at the DG Murray Trust.
It will take more than policy to change South Africans’ excessive use of alcohol; we all need to take part in the Sober Curious movement