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Cutting off access to legal products will only add to the burden, as the heaviest drinkers are least likely to reduce their drinking and will seek whatever alternatives are available, writes Marjana Martinic.
The price of pineapples has sky-rocketed and yeast has been flying off supermarket shelves.
The increased popularity of these two items - key ingredients in a traditional African recipe for homemade beer - is an indication of how some are choosing to cope with the lockdown ban on the production, transportation and sale of alcohol.
South Africans are proud of their reputation for improvisation and the ability to "make a plan", but the unregulated production of alcohol can be lethal.
The authorities are already investigating a tragedy in the Northern Cape, where a couple died after they apparently drank homemade beer.
Meanwhile Police Minister Bheki Cele has expressed concern that some of these concoctions have included battery acid in their ingredient list.
However well-intentioned, the South African government’s decision to impose the world’s strictest rules on alcohol during its coronavirus lockdown poses a particular risk to health, stokes organised crime and deprives the fiscus of significant revenue at a time when it is needed most.
South Africa has long had a thriving informal market for often dangerous bootleg alcohol. This informal sector includes many small producers of cheap home brews selling to the poor.
But prohibition also entices more organised, criminal elements who profit as illicit alcohol becomes the only option for consumers.
Already we have seen a significant spike in smuggling from neighbouring countries, as well as evidence of more sophisticated operations of refilling of branded alcohol bottles with concoctions derived from neutral spirits.
The World Health Organisation (WHO) conservatively estimates that, even before the pandemic, roughly one in four drinks consumed around the world was home-brewed, illicitly manufactured, or smuggled illegally across borders.
Illicit alcohol accounts for up to 60% of consumption in some parts of Africa and the WHO estimates it to be 24% of the South African market.
Similar figures are reported for most neighbouring countries, except for Mozambique, where the illicit market is estimated at 46%.
Unlike legally produced beer, wine and spirits, illicit products obviously do not need to comply with standards for quality, integrity and strength.
In some places, the use of embalming fluid to increase potency has been reported.
Dangerously high alcohol content, contamination during production, and toxic ingredients like methanol and methylated spirits make mass poisonings an all-too-common occurrence.
Banning alcohol also leads to significant issues by depriving public services of crucial tax revenues.
SARS commissioner Ed Kieswetter said last week that the lockdown ban had already cost the Treasury more than R1.3 billion in alcohol excise duties alone.
Supporters of the alcohol ban are keen to stress that trauma-related admissions to South Africa’s hospitals have fallen during lockdown.
But increased police activity, the presence of thousands of troops on the street and a now-formalised curfew have been significant factors in the marked drop in casualties of violence and shootings.
There has also been a very welcome decrease in road fatalities as the restrictions on travel have kept almost all motorists off the road, not just the drink-drivers.
South Africa is not an outlier here however.
Non-Covid related admissions have dropped remarkably in hospitals across the world, even in those countries who have not implemented a total ban on alcohol sales.
According to the British Medical Journal, emergency room visits dropped by 25% in the first week of the lockdown in the UK, even though the UK adopted a much softer approach to the issue of alcohol - closing bars, nightclubs and restaurants but allowing restricted sales in supermarkets and liquor stores.
It is also worth noting that, according to the global standard database maintained by the Institute for Health Metrics and Evaluation at the University of Washington, at least 85% of road accidents in South Africa are in no way attributable to alcohol-related risk factors.
There are reasonable concerns that the Covid-19 pandemic could worsen alcohol abuse due to stress and anxiety.
But cutting off access to legal products will only add to the burden, as the heaviest drinkers are least likely to reduce their drinking and will seek whatever alternatives are available.
The impact will be greatest on many who are already in poor health.
- Marjana Martinic is an international expert on alcohol policy who has worked at alcohol policy think tanks and served as an independent scientific adviser to the European Commission, on the OECD Task Force on Illicit Trade, and on the International Council on Alcohol & Addictions
