SA is being asked to believe that increasing excise taxes on alcohol will destroy jobs, fuel illicit trade and weaken the economy. It is a message repeated often and loudly.
But the real crisis facing this country is not taxation. It is the devastating human and economic toll of alcohol harm that South Africans are already paying every day.
That’s according to Southern African Alcohol Policy Alliance-South Africa (SAAPA-SA), whose latest civil society campaign, The True Cost of Alcohol, aims to save lives, reduce harm, and restore dignity through targeted alcohol tax reform.
President Cyril Ramaphosa’s 2026 State of the Nation Address signalled a stronger national focus on alcohol harm, recognising its links to violence, road fatalities and economic pressure — watch the video below.
Government’s consultation on regulation, excise duties, availability and advertising reflects a shift towards evidence-based policy. The proposed illicit economy disruption programme underscores the need for stronger enforcement and coordinated state capability to address illegal trade without weakening public health measures.
SAAPA-SA points to global and local data to illustrate the scale of the issue. The World Health Organization reports that 100 South Africans die each day from alcohol-related causes. That is roughly 37,000 preventable deaths every year.
These are not abstract statistics. They are families losing parents, children and breadwinners. They are communities mourning losses that evidence shows could be reduced through stronger policy action.
The alcohol industry argues that increased excise taxes will expand illicit trade and threaten employment. Illicit alcohol is indeed a serious concern.
But even researchers acknowledge that taxation is not the primary driver of illicit markets. Weak enforcement, organised crime and regulatory gaps play a major role.
University of Cape Town economists and global institutions like the World Bank have emphasised that excise taxes remain one of the most effective tools available to reduce alcohol harm while still increasing government revenue.
The question is not whether illicit trade exists. The question is whether SA should abandon proven public health measures because criminal networks operate outside the law.
Alcohol is deeply linked to violence and trauma in SA. Evidence shows it is a major contributor to physical and sexual assault, including domestic violence and rape. According to the Human Sciences Research Council, around 36% of South African women experience physical or sexual violence in their lifetime.
These realities rarely appear in industry messaging about economic growth, says SAAPA-SA. Yet they represent enormous costs to healthcare systems, policing, social services and the broader economy. The true cost is carried by victims, families and taxpayers, not by corporate balance sheets.
Perhaps nowhere is the price of alcohol harm clearer than on SA’s roads. Approximately 58% of road fatalities are linked to alcohol consumption. Drinking and driving kills around 14 people every day and contributes to crashes that cost the country more than R200bn annually.
When alcohol remains cheap and easily accessible, harmful consumption patterns increase. Large-volume products and aggressive marketing shift the financial burden onto victims of alcohol harm, consumers and public systems.
The industry may measure success in sales volumes, but communities measure the impact in funerals and hospital admissions.
Economists estimated that alcohol-related harm cost SA as much as R800bn* in 2025. That represents a societal burden of roughly R13,000 for every person in the country.
Industry narratives often highlight employment and tax contributions while ignoring this far larger economic drain. Lost productivity, trauma care, law enforcement and long-term health impacts weaken the economy far more than public health interest taxation ever could, says SAAPA-SA.
UCT researchers have made it clear that SA’s current alcohol tax structure does not go far enough, especially when it comes to beer, which dominates the market and is central to heavy episodic drinking. They recommend predictable above-inflation excise increases and more targeted tax tiers to reduce consumption while still raising revenue.
The evidence shows that higher prices reduce harmful drinking. This is not ideology. It is established public health policy used around the world.
Excise tax is often framed as punishment. It is protection. It protects families from preventable loss. It protects healthcare systems already under strain. It protects the economy from the escalating costs of violence, road crashes and chronic illness.
Increasing excise tax is not about attacking business. It is about recognising that the current balance between private profit and public harm is unsustainable, says SAAPA-SA.
Excise tax is often framed as punishment. It is protection — for families, the healthcare system and the economy
— SAAPA-SA
SA has reached a point where inaction carries a higher price than reform. The national debate must move beyond fear-based narratives. The real question is simple: who should carry the cost of alcohol harm — communities or corporations?
On February 18, SAAPA-SA and its coalition partners will lead South Africans from across the country on a march to Parliament. The call is clear: increase excise tax on alcohol.
This march is not only about policy. It is about recognising the value of human life and the responsibility of government to act on evidence.
SA cannot afford another year of preventable deaths, rising violence and economic loss disguised as normal business. The facts are clear. The research is clear. The voices of affected communities are clear.
The time to act is now.
This article was sponsored by SAAPA-SA.
*Drawn from ‘The cost of harmful alcohol use in SA’ by RG Matzopoulos, S Truen, B Bowman and J Corrigall, published in the South African Medical Journal.
