New research initiative launched to tackle alcohol harm in Southern Africa

The University of Cape Town (UCT) and the South African Medical Research Council (SAMRC) have embarked on a groundbreaking multidisciplinary research project to combat harmful alcohol use in South Africa and Botswana. This major undertaking, named the Collaboration for Harm Reduction and Alcohol Safety in the Environment in Southern Africa (CHASE-SA), aims to delve into the political, economic, and social factors that drive alcohol abuse, as well as evaluate its extensive consequences on communities and health outcomes across these regions. 

Spanning five years, the CHASE-SA initiative represents a significant partnership between UCT's Division of Public Health Medicine in the School of Public Health, the SAMRC, 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 key civil society organisations including the Southern Africa Alcohol Policy Alliance (SAAPA).

Understanding the alcohol landscape

Alcohol misuse remains a pressing public health crisis in South Africa, with the nation among the highest in the world for rates of heavy episodic drinking. This consumption pattern has dire implications, including a staggering 7% contribution to the national disease burden, and exacerbates social issues such as gender-based violence and increases susceptibility to HIV and tuberculosis infections. Notably, provinces like the Western Cape report alarmingly high incidences of foetal alcohol spectrum disorders.

According to Richard Matzopoulos, the project lead and honorary professor at UCT, “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." He emphasises the need to grasp the nuances behind harmful drinking behaviours, asking not just who drinks and how much, but more critically, the reasons behind the entrenched patterns of misuse.

A collaborative framework for change

The CHASE-SA project will unfold through four interconnected work streams, each designed to provide a comprehensive understanding of the issues at play:

• Political economy: Analysing alcohol policies, regulation, and industry influence.
• Acquisition and consumption environments: Mapping how and where 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.

Evidence as a catalyst for policy reform

The project is timely, as alcohol-related harm has been starkly illustrated during the COVID-19 pandemic, when South Africa's temporary bans on alcohol sales led to dramatic reductions in trauma-related hospital admissions. “This prompted an industry backlash but also raised public awareness about alcohol-associated risks, fostering an unprecedented momentum for enhanced alcohol policy,” Matzopoulos noted.

Asking for meaningful change, the CHASE-SA initiative prioritises collaboration, particularly with communities and policymakers. Matzopoulos stresses, “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.”

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