President Cyril Ramaphosa recently indicated that the legal limit for alcohol in the blood of drivers will be lowered from the current blood alcohol concentration (BAC) level of 0.05g of pure alcohol per 100ml of blood. This was stated in the context of addressing the current crisis SA faces where approximately 14,000 persons are killed on our roads annually. This costs us R140-billion each year, roughly R2,500 for every man, woman and child in South Africa.

This reflects a positive move to enact one of several pieces of alcohol control legislation currently stalled in South Africa. Such legislation includes the Control of Marketing of Alcoholic Beverages Bill of 2013, the Liquor Amendment Bill of 2017, the National Road Traffic Amendment Bill of 2015 and the Western Cape Alcohol Harms Reduction White Paper of 2017. In most cases, the legislation has, for various reasons, not been presented to the legislature for discussion or a vote even though it has been approved by Cabinet.

Why do we need to reduce the drinking limit of drivers? Research reported by the UK National Institute for Health Care and Effectiveness (2010) has shown that alcohol affects drivers’ vision, balance and reaction time. Drivers with a BAC of 0.02-0.05 have a more than three times greater risk of dying in a vehicle crash than drivers with alcohol levels below that. The risk increases more than six times with a BAC 0.05-0.08, and 11 times for a BAC 0.08-0.10. Younger drivers are particularly at risk of crashing whatever their BAC level because they are less experienced and have a lower tolerance to alcohol. According to the Department of Transport, one in five drivers on SA roads at night is over the 0.05 BAC limit, and this is worse in the early hours of the morning.

Serious consideration should be given to enacting the 2015 legislation reducing permissible BAC levels to zero. Possibly sanctions should only be incurred for drivers testing over 0.02 to allow persons to test positive for the alcohol in some medications. These should possibly be administrative fines for levels of BAC 0.02-0.05 and criminal sanctions for levels over 0.05g/100ml.

This will help to separate out two events: drinking and driving. This move is supported by the Automobile Association. According to the World Health Organization (2018) 15 countries have zero as the maximum permissible level for drivers at the national level. In Brazil, a change in traffic legislation in 2008, which reduced allowable BACs in drivers to 0.02, led to a reduction in traffic injury and fatalities in the state and capital of Sao Paulo by 7% and 16% respectively. The difference was largely due to enforcement. Implementation of a 0.02 BAC law in Sweden in 1990 reduced fatal crashes by 6%.

However, our recent umbrella review of systematic reviews of alcohol control interventions (Parry & Siegfried, 2019), suggests that reducing BAC limits alone is unlikely to be successful if not combined with other interventions such as increasing police patrols and mandating ignition locks be installed in the vehicles of persons convicted of alcohol-impaired driving, requiring them to blow into a device which checks the driver’s alcohol level before the vehicle will start.

Not permitting any drinking and driving is a logical step to take the guesswork out of having to calculate if we are over or under the legal limit. Yes, it would cramp our drinking lifestyles a little, but so it should. We would experience fewer fatalities on our roads, lower insurance premiums, and a reduced drain on the fiscus. Drivers need to be aware of and understand the law. They also need to believe that they are likely to be detected and punished for breaking the law. DM

Professor Charles Parry is the director of the Alcohol, Tobacco and Other Drug Research Unit of the South African Medical Research Council.