Academic journal article Applied Health Economics and Health Policy

Alcohol Policy and Taxation in South Africa

Academic journal article Applied Health Economics and Health Policy

Alcohol Policy and Taxation in South Africa

Article excerpt

Key points for decision makers

* Alcohol taxes in South Africa appear to be regressive - i.e. the poor pay more as a proportion of their income in taxes than the rich

* There is a need in South Africa to understand why the poor drink and bear a greater burden of alcohol tax

* Alcohol policy formulation in South Africa needs to take into account peculiar context-specific issues relating to alcohol consumption and taxation and align alcohol policy with the values of the community

Introduction

Globally, alcohol consumption accounts for over 4% of the burden of disease, more so in developing countries. It is also implicated in over 3% of deaths worldwide.[(1)] Alcohol policy has been used as a tool to try to curb the negative impact of alcohol misuse.[(2)] The effectiveness of these policies has been investigated and a consensus has emerged that it is best to target, specifically, a reduction in the total amount of alcohol consumption in the population, but particularly abusive drinking, together with the high-risk contexts and drinking behaviours often associated with alcohol-related problems.[(2)] Such policies have long histories in developed countries such as Australia, the UK and many eastern European countries.[(2,3)] However, they are less well developed in Africa. Even when they are extolled in government policy documents, they are often not enforced.[(4)] South Africa is the only African country to have witnessed a rapid development of alcohol policy. That, however, has been a piecemeal product of competing interests, values and ideology.[(5)] For instance, apartheid created informal and unlicensed sales outlets (called shebeens)[(6)] which outweigh, in numbers, the formal and licensed outlets. In 1997, for instance, only 10% of sales outlets were licensed.[(7)] In terms of consumption, currently approximately half of men and one-fifth of women in South Africa consume alcohol.[(6)]

Generally in Africa, both home-brewed (called umqombothi in South Africa) and commercially produced alcohol are consumed.[(8)] In 2008, in response to the increasing burden of alcohol consumption and misuse in Africa, the annual meeting of health ministers from 46 countries, in Cameroon, drew up a ten-point plan to curb harmful drinking of alcohol. The points include regulating availability, restricting sale, regulating marketing, increasing taxes and prices, enacting, strengthening or enforcing drinking and driving laws, establishing and strengthening alcohol information and surveillance systems, increasing community action, strengthening health sector response, raising political commitment and building partnerships.[(8)] However, the extent to which these have been implemented is limited and then only in a few countries in the region. In South Africa, though consideration has been given to implementing such policies, there is a lack of an integrated and comprehensive strategy that draws on the social, economic and psychological aspects of alcohol consumption and misuse. This lack is at least in part because alcohol drinking practices differ considerably both between and within countries. There is therefore a need to develop alcohol policies that are specific to individual countries and to drinkers within countries.[(4)] One size does not fit all.

Currently in South Africa, four policy areas relating to alcohol are operational. These, based on the list agreed upon by African health ministers in 2008, are organised through different government departments. They include placing restrictions on alcohol advertising (including counter advertising), regulating retail sales of alcohol, imposition of alcohol taxes and controlling the packaging of alcohol.[(5)] A summary of these is contained in (table I). However, alcohol abuse and its effects (individual and social) have not been reduced significantly[(9,10)] and per capita alcohol consumption has remained much the same over the last 2 decades. …

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