UCT leads landmark study to curb alcohol harm in SA

The University of Cape Town (UCT) and the South African Medical Research Council (SAMRC) have launched a landmark multidisciplinary research initiative to investigate the political, economic and social drivers of harmful alcohol use in South Africa and Botswana; and assess its far-reaching impacts. The five-year project aims to generate evidence that supports the co-creation of effective policies and community interventions with stakeholders to reduce alcohol-related harm.

The initiative, titled “Collaboration for Harm Reduction and Alcohol Safety in the Environment in Southern Africa” (CHASE-SA), brings together leading institutions and partners. Co-led by UCT’s Division of Public Health Medicine in the School of Public Health, and the SAMRC. The project also involves the University of Botswana (UB), the London School of Hygiene & Tropical Medicine (LSHTM), the Centre for the Aids Programme of Research in South Africa (CAPRISA) and civil society organisations such as the Southern Africa Alcohol Policy Alliance (SAAPA).

Understanding the full alcohol environment

South Africa ranks among the countries with the highest rates of heavy episodic drinking globally, with alcohol contributing to approximately 7% of the national disease burden. The harmful effects of alcohol use intersect with pressing public health and social issues, including gender-based violence, trauma-related injuries, and heightened HIV and tuberculosis infection risks. In addition, the Western Cape has one of the highest reported rates of foetal alcohol spectrum disorders worldwide.

The project will investigate how political, commercial, environmental and socio-cultural factors shape harmful drinking patterns, particularly in historically disadvantaged and vulnerable 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.”

“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 link these to health and social outcomes,” said project lead, Richard Matzopoulos, who is an honorary professor at UCT and the head of the SAMRC’s Burden of Disease Research Unit.

“We want to understand not just who drinks and how much, but why harmful drinking is so entrenched, and what levers exist for change.”

A collaborative and multidisciplinary approach

The CHASE-SA research will unfold across four interconnected work streams:

• political economy: analysing alcohol policies, regulation, and industry influence
• acquisition and consumption environments: mapping where and how alcohol is accessed and consumed across six sites in South Africa and three in Botswana
• impacts on health and the alcohol economy: linking drinking patterns to health, social and economic outcomes through surveys, modelling and secondary data analysis
• from evidence to action: co-creating policies and community interventions with policymakers, civil society and affected communities.

Building evidence for stronger policy

Harms associated with alcohol use are influenced not only by individual choice but also by the environments in which people live, industry marketing strategies, and the regulatory frameworks that shape access. As alcohol consumption declines in many high-income countries, global alcohol companies are increasingly targeting new markets in low- and middle-income countries, where the burden of alcohol-related harm is especially severe.

South Africa’s COVID-19 alcohol sales bans revealed how quickly harm could be reduced, with significant declines in trauma-related hospital admissions.

“It prompted an industry backlash but alerted the public to the extent of alcohol-associated risks. This has provided rare impetus for considering better alcohol policy,” added Matzopoulos.
 

“Our goal is to build the evidence base and the coalitions needed to reduce alcohol-related harm and strengthen public health.”

For meaningful change, the project emphasises collaboration with both communities and policy makers.

“Evidence alone does not change policy, but evidence co-created with communities and decision-makers can. Our goal is to build the evidence base and the coalitions needed to reduce alcohol-related harm and strengthen public health,” Matzopoulos concluded.