The year of the pandemic has been a godsend for SA’s prohibitionists. It brought together in an unholy alliance an eclectic hotchpotch of players from across the political spectrum: Nkosazana Dlamini-Zuma, the Medical Research Council/Dr Charles Parry, the Southern African Alcohol Policy Alliance and Bheki Cele, united only in their common objective to impose more rigorous controls over the sale and distribution of liquor.
The game-changer for them was the ANC government’s decision to use the Disaster Management Act to direct SA’s response to Covid-19. Intended as legislation to deal with regional catastrophes such as floods and wildfires, the act is not subject to the same statutory review mechanisms mandated in the country’s emergency regulations. The choice of the Disaster Management Act enabled the government to suspend parliamentary oversight and freed the prohibitionist wing within the ANC to drive a number of policies that had been mooted in draft legislation but failed to make it into the statute books.
In the early days of the Covid-19 lockdown alcohol and tobacco sales were banned outright, though there was no evidence at the time that either product would contribute to the spread of the disease. Accordingly, it became vitally important for the anti-alcohol brigade to obtain data to support their agenda. By May 20 2020 (less than two months after the imposition of the hard lockdown and long before proper statistical tools could be brought to bear on the issue) Richard Matzopoulos, funded by the Medical Research Council, published “SA’s Covid-19 alcohol sales ban: the potential for better policy-making” in the International Journal of Health Policy Management.
He and his associates argued that “the dramatic decrease in violence and injuries after an alcohol sales ban in SA has implications for its alcohol policy postlockdown ... The decline in alcohol-related trauma, alongside alcohol’s perceived role in crime and undermining public safety, has won political and popular support for maintenance of these restrictions.” He concluded that “we have here an opportunity for stakeholders to work together to develop better alcohol policy and safeguard the post-Covid-19 future of all South Africans”.
In effect it would be like taking the traffic movement figures from the intersection of Sandton Drive and William Nicol and extrapolating from them the vehicle-per-hour numbers for the whole of SA
This theme — that hospital trauma admissions are alcohol-related and that controlling the supply of alcohol would free hospital capacity to deal with Covid-19 emergencies — swiftly became a pillar of government policy. It was a perfect smokescreen for those driving a long-term prohibitionist agenda. By the second half of 2020 it was widely assumed that their arguments were factually correct.
This was followed up in early 2021 with what appeared to be a more extensively researched study reviewing the pattern of trauma admissions at a hospital in Worcester, Western Cape, over the whole of 2020. The choice of Worcester, where the community had been grievously affected by Covid-19-induced unemployment, was hardly a neutral decision: it would be certain to show serious trauma spikes in the periods when the lockdown was lifted. In effect it would be like taking the traffic movement figures from the intersection of Sandton Drive and William Nicol and extrapolating from them the vehicle-per-hour numbers for the whole of SA.
This study showed (somewhat unsurprisingly) that when restrictions were lifted trauma admissions increased. However, it concluded — without any evidence to show causality — that this was due to the availability of alcohol. This claim was tenuous at best given the ready supply of bootlegged beverages. The authors went on to suggest that “temporary complete bans on alcohol sales can be used to decrease health facility traffic”.
The study provoked an immediate peer-reviewed critique of the authors’ assumptions. It was drafted by, among others, Graham Barr, emeritus professor in statistical science at the University of Cape Town. It cast doubt on their statistical methodology (most notably Poisson regression) and challenged the validity of using alcohol restrictions as the only variable to explain trauma admissions.
“[T]here are clearly many other factors ... which have not been included in the model ... For example, the levels of trauma admissions could be affected by altered levels of gang violence, availability of hard drugs on the street, altered levels of traffic on the roads, reduced presence of pedestrians on streets, and so on ... all of which are conceivably related to the various Covid-19 restrictions put in place during 2020.”
Squeaky clean
In fact, earlier peer-reviewed research revealed that there was no direct causal relationship between the alcohol ban and the reduction in the number of trauma admissions. It used statistics gathered in many other countries that had experienced hard lockdowns but that had not been subjected to a prohibition on alcohol sales.
This study showed that similar drops in trauma were experienced across these countries, irrespective of whether there were bans on the sale of alcoholic beverages. It argued that the more likely explanation for the reduced trauma cases was the limitations on the movement of citizens. Fewer cars on the road, fewer people about after dark, fewer accidents.
Since this peer-reviewed research had been funded by the liquor industry, Parry immediately retaliated, arguing (while not addressing the substantive issues) that the study was flawed on account of who had paid for it. Essentially its authors were hired guns, he suggested. This position naturally implies that Parry and his associates’ research is squeaky clean, due to the apparent neutrality of their funding sources.
However, it should come as no surprise to discover that there is nothing agnostic about how the SA prohibitionists obtain their data. Parry is the director of the Alcohol, Tobacco & Other Drug Research Unit at the government-funded Medical Research Council. He is also on the board of the Global Alcohol Policy Alliance, of which the Southern African Alcohol Policy Alliance is an affiliate. The alliance doesn’t state on its website where its funding comes from, but it was established at a conference supported by, among others, the Medical Research Council and the WHO regional office for Africa.
WHO data
Parry is also a member of the WHO Expert Panel on Drug Dependence and Alcohol Problems. The WHO, in turn, is the origin of much of the ANC government’s thinking on health policy.
Parry is the source of much of the WHO data on alcohol consumption in SA — much of it obtained not through an actual review of the numbers, but by what Parry has admitted is extrapolation obtained by “modelling”. And Parry’s modelling is not without its flaws. His published claim that alcohol accounts for 62,000 deaths annually in SA is remarkable for having produced an alcohol mortality burden that exceeds the total number of non-natural deaths in SA.
In short, there’s something of a closed loop: the Medical Research Council and the WHO supported the founding of the Southern African Alcohol Policy Alliance (and possibly continue to fund it), the alliance is a member of Global Alcohol Policy Alliance, Parry is on its board, he advises the WHO and the WHO advises our government, which funds the Medical Research Council.
The Global Alcohol Policy Alliance has set itself the goal of building momentum towards a “framework convention on alcohol control”, which aims to bind signatories to certain policies such as restrictions on advertising and pack sizes. The global alliance, and so also the Southern African alliance, expressly oppose allowing the alcohol industry to be consulted on alcohol policy.
It is simply extraordinary that this Faustian pact, in which science has willingly become the handmaid to the most corrupt government in this country’s history, has proceeded for so long without comment or criticism.
• Fridjhon is an international wine judge and writer.
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