Department of Psychology, University of Johannesburg, Johannesburg, South Africa.
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.
Drug Alcohol Rev. 2021 Mar;40(3):402-419. doi: 10.1111/dar.13247. Epub 2021 Feb 25.
Sub-Saharan Africa (SSA) has long been characterised as a region with weak alcohol policies, high proportions of abstainers and heavy episodic drinkers (among drinkers), and as a target for market expansion by global alcohol producers. However, inter-regional analyses of these issues are seldom conducted.
Focusing mainly on the period 2000-2016, we compare alcohol consumption and harms, alcohol policy developments and alcohol industry activities over time and across the four sub-regions of SSA.
Per-capita consumption of alcohol and alcohol-related disease burden have increased in Central Africa but stabilised or reduced in other regions, although they are still high. Most countries have implemented tax policies, but they have seldom adopted other World Health Organization 'best buys' for cost-effective alcohol control policies. Countries range from having minimal alcohol controls to having total bans (e.g. some Muslim-majority countries); and some, such as Botswana, have attempted stringent tax policies to address alcohol harm. Alcohol producers have continued their aggressive marketing and policy interference activities, some of which have been highlighted and, in a few instances, resisted by civil society and public health advocates, particularly in southern Africa.
Increased government support and commitment are needed to be able to adopt and implement effective alcohol policies and respond to pressures from alcohol companies to which SSA remains a target market.
SSA needs effective alcohol control measures in order to reverse the trajectory of worsening alcohol harms observed in some countries and reinforce improvements in alcohol harms observed in others.
撒哈拉以南非洲（SSA）长期以来一直被认为是一个酒精政策薄弱、大量戒酒者和重度间歇性饮酒者（在饮酒者中）比例高的地区，也是全球酒精生产商市场扩张的目标。然而，很少对这些问题进行区域间分析。
主要关注 2000 年至 2016 年期间，我们比较了 SSA 四个次区域在不同时间和不同时期的酒精消费和危害、酒精政策发展以及酒精行业活动。
中部非洲的人均酒精消费和与酒精相关的疾病负担增加了，但其他地区的消费和负担稳定或减少，尽管它们仍然很高。大多数国家都实施了税收政策，但很少采用世界卫生组织（WHO）的其他“最佳购买”措施来实施具有成本效益的酒精控制政策。各国的酒精控制政策从最小控制到完全禁止（如一些穆斯林占多数的国家）；而博茨瓦纳等一些国家则试图实施严格的税收政策来解决酒精危害问题。酒精生产商继续积极开展营销和政策干预活动，其中一些活动已被曝光，在少数情况下，受到民间社会和公共卫生倡导者的抵制，特别是在南部非洲。
需要增加政府的支持和承诺，以便能够采用和实施有效的酒精政策，并应对来自于 SSA 仍然是目标市场的酒精公司的压力。
SSA 需要采取有效的酒精控制措施，以扭转一些国家观察到的酒精危害恶化的趋势，并加强其他国家观察到的酒精危害改善的趋势。
