Here’s a startling fact: South Africa ranks among the countries with the highest rates of heavy drinking globally, with alcohol contributing to a staggering 7% of the nation’s disease burden. But here’s where it gets controversial—while many blame individual choices, the real drivers of harmful alcohol use might be deeply rooted in political, economic, and social systems. Now, a groundbreaking study led by the University of Cape Town (UCT) and the South African Medical Research Council (SAMRC) aims to uncover these hidden forces and pave the way for change.
The five-year project, titled Collaboration for Harm Reduction and Alcohol Safety in the Environment in Southern Africa (CHASE-SA), is no ordinary research initiative. It’s a multidisciplinary effort that brings together leading institutions like UCT, SAMRC, the University of Botswana, the London School of Hygiene & Tropical Medicine, and civil society organizations such as the Southern Africa Alcohol Policy Alliance (SAAPA). And this is the part most people miss—it’s not just about studying drinking habits; it’s about mapping the entire alcohol environment, from industry supply chains to community norms, and linking these to health and social outcomes.
Why does this matter? Because alcohol isn’t just a personal choice—it’s a public health crisis. In South Africa, alcohol intersects with pressing issues like gender-based violence, trauma-related injuries, and heightened risks of HIV and tuberculosis. The Western Cape, for instance, has one of the highest rates of fetal alcohol spectrum disorders globally. The project will dig into how political, commercial, environmental, and socio-cultural factors fuel harmful drinking, especially in historically disadvantaged communities.
“This is the first large-scale study in southern Africa to map the entire alcohol environment—from industry supply chains to community-level drinking norms—and connect these to health and social outcomes,” explains Richard Matzopoulos, project lead and honorary professor at UCT. “We’re not just asking who drinks and how much, but why harmful drinking is so entrenched and what can be done to change it.”
The research unfolds across four interconnected streams:
1. Political economy: Analyzing alcohol policies, regulations, and industry influence.
2. Acquisition and consumption environments: Mapping where and how alcohol is accessed and consumed across six sites in South Africa and three in Botswana.
3. Impacts on health and the alcohol economy: Linking drinking patterns to health, social, and economic outcomes through surveys, modeling, and data analysis.
4. From evidence to action: Co-creating policies and community interventions with policymakers, civil society, and affected communities.
Here’s the bold part: The study doesn’t shy away from controversy. As alcohol consumption declines in high-income countries, global alcohol companies are aggressively targeting low- and middle-income nations, where the burden of harm is already severe. South Africa’s COVID-19 alcohol sales bans, for example, revealed how quickly harm could be reduced—hospital admissions for trauma dropped significantly. But it also sparked an industry backlash, highlighting the tension between public health and corporate interests.
“The bans alerted the public to the extent of alcohol-associated risks and provided a rare opportunity to rethink alcohol policy,” Matzopoulos notes. “Our goal is to build the evidence base and coalitions needed to reduce harm and strengthen public health.”
But evidence alone isn’t enough. The project emphasizes collaboration with communities and policymakers, because meaningful change requires their buy-in. Here’s a thought-provoking question for you: If alcohol harm is driven by systemic factors, not just individual choices, should we hold industries and governments more accountable? Let us know your thoughts in the comments—this is a conversation we all need to have.
