Alcohol kills 62,000 people in SA every year: Time to hike taxes, drive down demand?

South Africa’s long-running battle over alcohol regulation is heating up again, with the Treasury considering increases to excise duties to reduce excessive drinking.

The proposal, revealed in a Sunday Times Business report, is sparking resistance from alcohol producers, who argue that raising taxes above inflation will simply push consumers towards the illicit alcohol market.

But health economists say the evidence tells a different story.

A deadly national problem

Professor Susan Goldstein of the SA Medical Research Council’s Centre for Health Economics and Decision Science says the scale of alcohol-related harm in South Africa cannot be ignored.

She estimates that alcohol is linked to about 62,000 deaths a year in the country, with 2.6 million deaths globally.

“This is not something taken lightly,” Goldstein says. “Alcohol is a harmful substance, and it needs to be controlled.”

Does higher tax really work?

Goldstein argues that international research is clear: increasing the price of alcohol is one of the most effective ways to reduce consumption.

“The way you make people drink less is to make it more expensive,” she explains. “And the way to do that is through excise duties.”

However, she cautions that taxation alone is not enough in South Africa, where enforcement is weak, and governance failures allow illicit markets to flourish.

The illicit trade argument

The alcohol industry insists that higher taxes will mirror what happened with tobacco, where illegal cigarettes now dominate large parts of the market.

Goldstein disputes this comparison, saying global evidence shows illicit trade does not automatically rise with higher taxes.

“What decides whether tax works or not is administration, enforcement and political governance,” she ays. “And unfortunately, those are areas where South Africa struggles.”

Who does Treasury listen to?

Goldstein also questions the Treasury’s engagement process, noting that officials held meetings with alcohol producers but not with public health advocates or the Department of Health.

“These industries are powerful and wealthy,” she says. “But profits should not come before people’s health.”

Not prohibition – control

Goldstein is clear that she is not calling for prohibition.

“We’re not abolitionists,” she says. “People will drink. I drink occasionally. But people need to understand alcohol is harmful.”

She also criticises alcohol advertising, which she says glamorises drinking while ignoring its links to violence, domestic abuse and cancer.

Beyond messaging

While public awareness campaigns matter, Goldstein believes structural interventions are more effective – including pricing, availability and regulation.

“Communication on its own won’t fix this,” she says. “We need to change the environment people are drinking in.”

She points to tobacco control as proof that social norms can shift rapidly with the right mix of policy and enforcement.

“Things change,” she says. “But only if we’re serious about it.”

For more information, listen to Goldstein using the audio player below: