Maverick Citizen

Maverick Citizen Op-ed

Substance abuse: Another wasted conference or a new beginning?

Hillbrow has a needle exchange programme for injecting drug users. But many residents are angry that drugs are openly used on the streets of the central Johannesburg suburb. Photo: Anova Health Institute’s Jab Smart outreach project.

Lindiwe Zulu has only been Minister of Social Development for around five months, but she appears to have a great passion for the job. At the launch of the National Conference on Substance Abuse and Family-related Interventions on 30 October, she injected a sense of urgency into the proceedings, making it clear that the subject of the conference, and the work of her department, is people.

While those in attendance at the launch of the National Conference on Substance Abuse and Family-related Interventions on 30 October were there to talk about policies and programmes, it was the lives of people, especially those affected by substance abuse, that should be the main concern, Minister of Social Development Lindiwe Zulu said.

She went on to say that everyone in society must take responsibility for dealing with the challenges associated with substance abuse. Those working in government must arrive at work every day seized with a sense of purpose underpinned by a commitment to serve. Government systems must be able to respond quickly, effectively and appropriately. The police service must do what they are supposed to do to protect those who turn to them for help; schools must be observant and supportive of the children in their care; social workers must have a proper understanding of their jobs and of the communities within which they work, in order to be able to provide the appropriate assistance.

The important thing, she said, is that citizens must have the “comfort of institutional recourse” when they need it. At the same time, citizens in their homes, in their streets and in their communities must take responsibility for addressing the many challenges confronting our society daily.

The minister also questioned the significance of conferences if there was no commitment to honouring their outcomes. “How much is this conference costing?” she asked her director-general. Would the impact of the conference justify the money spent? What would be done differently in order to address the issues raised in the conference? To the extent that the harm caused by substance abuse is continuing and, in some respects, increasing, what is not being done right by the department and other stakeholders? She stressed that she was asking these questions mindful that a great deal of valuable work was being done, that she did not wish to sound negative or demoralising.

In the context of her “call to effective action”, the minister noted that the last conference on substance abuse was held in 2011 and she wondered how many of the resolutions taken at that conference had actually been implemented. The Southern African Alcohol Policy Alliance of South Africa (SAAPA SA) was at the conference when the minister spoke and did a quick audit of the 35 resolutions taken in 2011. Fifteen of them are of particular interest to those doing alcohol advocacy work and SAAPA SA is able to report to the minister that steps have indeed been taken to implement many of them.

For example, resolutions 21 and 22 proposed a partial or complete ban on alcohol advertising and an end to sponsorships of sport, arts and culture. The Department of Health answered the call and drafted the Control of Marketing of Alcoholic Beverages Bill in 2013 – the Bill was endorsed by the Inter-Ministerial Committee (IMC) To Combat Alcohol and Substance Abuse and approved by Cabinet for publication in the Government Gazette to invite public comment. The Bill pulls no punches, calling for a complete ban on all marketing (advertising and sponsorships) by the alcohol industry.

The Road Traffic Amendment Bill of 2015 responds directly to resolution 32 by calling for a reduction of the legal blood alcohol content (BAC) from 0.05g/100ml to zero. In other words, anyone driving a vehicle would not be allowed to have any alcohol in their blood.

The National Norms and Standards of the Liquor Act 59 of 2003 sets operating times for liquor outlets across the country – the Norms and Standards were signed off by the accountable MECs of all nine provinces in 2015.

The national Liquor Amendment Bill drafted by the Department of Trade and Industry in 2017 talks to a number of the Resolutions: 3 – changing the legal drinking age from 18 to 21; 5 – controlling the location of liquor outlets; 9 – labelling of alcohol products; 10 – holding sellers of alcohol responsible for the behaviour of their customers; 21 – introducing some restrictions on alcohol advertising, though falling short of the complete ban envisaged by the Department of Health.

But, as Guinean revolutionary Amilcar Cabral once said: Tell no lies, claim no easy victories!

It is disappointing that nothing has been done to create an independent fund with contributions from the liquor industry (resolution 11) that would be used to combat alcohol harm. We are not able to say whether resolution 35 has been actioned – that of making all public service functions alcohol-free.

Of much greater concern is that, though responsible MECs of the nine provinces signed on to the National Norms and Standards in 2015, provinces do not seem to be adhering to the specified operating times for liquor outlets. Furthermore, the three groundbreaking Bills – which, if enacted, would give effect to more than half of the 2011 resolutions – appear to be on hold with no apparent work being done on them since 2017. And so, what this means is that the real answer to her question, at least with respect to alcohol, is no, none of the Resolutions has been implemented.

It is true that there is an increase in excise tax on alcohol every year (resolution 7) – that is not new. That has been happening in most countries in the world since alcohol was first regulated. However, one of the main reasons for imposing such taxes today, according to the World Health Organisation (WHO), is to make alcohol less affordable, thereby reducing consumption and limiting alcohol harm. In February 2019, the average nominal excise tax on alcohol was increased by 7.4%. The problem is that, in real terms, it only went up by 2.2%, less than half the current inflation rate. In other words, the tax increase has done nothing to make alcohol less affordable.

It could, at a stretch, be argued that something has been done in relation to resolutions 12 and 31 – educating and raising awareness around the risks and problems of alcohol harm. However, there are three smallanyana problems with these campaigns. First, they are no match for the aggressive pro-alcohol propaganda (also known as advertising) of the industry; second, many of them are carried out in collaboration with the liquor industry’s “responsible drinking” arm,, in defiance of a Cabinet decision in November 2010 that government departments should not work with or accept support from the liquor industry; and third, the WHO has warned that education programmes on their own have no impact. They must be underpinned by effective legislation that addresses the WHO’s three “Best Buys”: reducing availability of alcohol, curbing or banning advertising, and increasing taxes.

SAAPA SA encourages the minister to act firmly and quickly to rescue the conference of 2011 (and its resolutions) and to ensure that the conference of 2019 has the desired impact and represents money well spent. The Department of Social Development (DSD) is seen as the department that is responsible for ensuring that government deals seriously with these issues – this is why, when the Inter-Ministerial Committee to Combat Alcohol and Drug Abuse was established in 2011, comprising 12 departments, it was convened under the leadership of the DSD.

We therefore urge the minister to reconvene the IMC and to put pressure on her colleagues in Cabinet to fast-track the outstanding legislation referenced above. Failing that, the DSD can draft legislation of its own to give effect to the resolutions. Otherwise, eight years hence, the Minister of Social Development of 2027 will be looking back and asking: “Have the resolutions of 2011 and 2019 been implemented?” and “Are these conferences worth the money being spent on them?” DM

Maurice Smithers is a lifelong activist and tilter against windmills. A 1970s university dropout, he has just completed a Masters in Development Planning. He is currently national coordinator of the Southern African Alcohol Policy Alliance in South Africa (SAAPA SA) whose aim is to give civil society a ‘loud’ voice in the formulation and implementation of alcohol policy to counter the influence of the liquor industry and its cohorts.