Health Minister Aaron Motsoaledi recalls an incident that happened while he was still a practising doctor, that has driven him in his determination to ban alcohol advertising.
“A lady brought a three-day-old baby who was being fed with Nestum. We all know that no newborn can ever take Nestum. It should start at about six months. There is no way that the intestine of a three-day-old can take this. This tummy started getting smaller. We admitted the child, but it was too late, the baby died.
“I was really upset and I attacked the mother, asking why she did this. She told me that I could not blame her. She said: ‘Doctor, I respect you, but you can’t be wiser than the government.’
“She said: ‘The reason I fed the baby is because this thing is praised by the radio every day.’
“I asked what this had to do with the government and she said that if it was wrong, the government would not have allowed it.
“That was her simple logic. If this thing is as dangerous as you say, the state would not allow it.”
The tragedy underlined for Motsoaledi just how important it was for the state to intervene in public health issues.
“And yet… they say you are a nanny state. People need protection (from harm) by the government at all times.
“The protection can’t just be through education. It must be through many other means. Reduce the availability of drugs and reduce the easy sale.”
He points out that he is not alone in this view.
“The issue of non-communicable diseases is so serious that the UN called a high-level meeting in September 2011 to talk about them, and the instruction was that countries must do everything in their power to bring the risk factors (smoking, alcohol, poor diet and lack of exercise) under check.
“We must do everything in our power in terms of planning, rules and regulations to bring this under control.”
As to whether this should mean greater regulation or a more vigorous education campaign, Motsoaledi argues that there is no “silver bullet” and that educating people about the health problems associated with substance abuse while the alcohol industry carries on with business as usual is not the answer.
“You can’t say with a social ill like that that you have only one way to correct them: educating the public… There is ample research that there are many other methods.
“For instance, in Botswana, they mercilessly use overtaxing. They (industry bosses) will also not accept that. They say it will kill the economy.
“The only thing is educating people and they know it won’t work. It is cheating the public to say we will keep on advertising, you must educate. In other words, we have the right in terms of freedom of trade and freedom of expression, to destroy.
“It is the duty of the government to clean up behind. That’s basically what they are telling me, and I am not accepting it.
“I am not saying that education will not help. I’m saying it must not be the only thing. In our school health programme, there are five programmes. One of them is this education about drugs and alcohol. But when the child is being taught at school, she must not go home to be inundated with these messages of using alcohol.”
Motsoaledi said the ban on cigarette advertising had led to a 23 to 25 percent reduction in smoking.
Asked if his aim was still to ban alcohol advertising or to restrict it, Motsoaledi said the aim was to cut back on such advertising… whether by a complete or partial ban. “It is going for public hearings.”
He did not believe the industry’s argument that a ban on
advertising could lead to job losses.
“A similar thing was said with smoking. Nobody has actually shown me how many jobs were lost, but you remember that that was the main thing.
“The control of alcohol did not start now. The World Health Organisation (WHO) commissioned 15 PhDs to go into history as far back as possible, and to find out every single bit of evidence about this issue of alcohol and alcohol control measures. They went back centuries, to periods before Christ, and they found that already there were steps to try to curtail the effects of alcohol on the population.
“You are talking about something that is more than 2 000 years old. It is not new.
“There are two groups here.
“There are those, like me, who look at the effects of alcohol from the public health and public benefit perspective, and there are those who look at it from a commercial point of view. They don’t care how many people die and how many suffer.
“These are people who are driven by short-sighted greed. They want to make a fast buck in the name of the economy. They don’t really care how many people will be alive.
“Russia successfully introduced alcohol control measures in 1985 and life expectancy jumped, meaning that those in favour of public health won.
“At the moment, everything is being reversed and the industry gives that as an example that these measures don’t work. It is not true.
“What has happened is that those with commercial interests became too strong and reversed the gains of those who came with other interests.
“Dr Nkosazana Dlamini Zuma won on the issue of cigarettes 15 years ago, but are you aware that cigarette companies are still trying to reverse that today? If they succeed by virtue of their financial power, it will not be because the anti-smoking measures are not working. It will be because commercial interests have won over public health interests.
“Just last month, there was a squabble here, where the cigarette companies wanted to sponsor members of Parliament to visit England to see new measures. Meaning when they come back, they must reverse the new laws. They are still trying.”
Motsoaledi said he was confident that he had the support of his colleagues in the economic ministries in his battle against the alcohol industry.
He added: “Commercial interests and public health interests cannot converge. It will always be a war. One must win over the other. There is no convergence. If you check, part of the reason why the WHO has got strict rules on sponsorship is because they don’t want the influence of commercial interests.”
It is all about future generations, according to Motsoaledi. “
On issues such as drugs, alcohol and smoking, the best remedy is never to start, and if you want children never to start, you stop those who are encouraging them to start.
“All adverts, especially for liquor, are targeting young children who don’t drink. They are targeting those who want to start drinking later and telling them to please start now. They are targeting those who drink every day, and asking them to please use this product every day.
“Many people will argue that alcohol is not like the drugs that need to be banned, and you are aware that that argument is manifestly false. Alcohol has two identities. One is an ordinary commodity, the other is a drug, just like cocaine, only it is legal. It can addict people, it can make them change their lives.
“In every country, people know that this thing is a drug, but when the commercial interests speak, they want to bring the commodity part of it out, not the drug part.
“This double sense of alcohol is causing confusion among the population and yet we know, in terms of our statistics, the commonest drug now that causes addiction is alcohol. The others are very dangerous, but they are not as available as alcohol.
“They are not as prevalent as alcohol. It is the commonest consumed drug in the market. You cannot control drug consumption in Eldorado Park and Mitchells Plain if you don’t start with alcohol, because everything starts with alcohol.”
And then there is the question of unhealthy foods. The minister said he had taken the issue of healthy lifestyles and eating to Parliament.
“We need to start setting an example. I am appealing to everybody, whether they be the premier or the president. I have made it very clear and the president himself has said it many times.”
Asked whether he had been able to influence the food in Parliament’s canteen, Motsoaledi said he had given notice that he intended to do so.
“On the diet issue, we are still concentrating on salt intake and fatty acids.
“In August 2010, I already passed regulations to reduce the amount of fatty acids in food.
“The only weakness is that we have no capacity to monitor when industries start cheating. We have chosen targets of reducing salt intake because it clearly is associated with hypertension and strokes.”