CPCR’s Dr. Cosmas Zyambo unveils a ‘PIONEERING Study’ on the Public Health impacts of the Harmful Consumption of illicit Alcohol in Zambia

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…’Low-cost, high-ABV illicit spirits pose the highest risks to the health and safety of Zambian society’.

By Derrick Sinjela

On Wednesday, 29th November, 2023, the Centre for Primary Care Research (CPCR) released the results of the first study on the public health impact of the consumption of illicit alcohol in Zambia at a special event held on the sidelines of the Conference for Public Health in Africa (CPHIA).

Representing CPCR, Dr. Cosmas Zyambo, a senior lecturer at the School of Public Health and presenting said the groundbreaking study provides appropriate data that has long been missing from policy and programmatic conversations around illicit alcohol, allowing for the formation of practical, evidence-based recommendations for how different stakeholders in Zambia can come together to challenge the hold that illicit alcohol has on society.

Dr. Zyambo says harmful consumption of illicit alcohol is an international challenge – globally, one in four alcohol consumed is illicit, representing twenty-five point five percent (25.5%) of the total alcohol market.

“While no country is immune to the challenge of illicit alcohol, in Zambia the problem is particularly serious with seventy-one percent (71%) of all alcohol consumed being illicit. The research team at the CPCR collected data from over 1,000 consumers, producers, and retailers of illicit alcohol in Lusaka, Livingstone, and Ndola in the course of the study. To gain deeper insights, the researchers interviewed key stakeholders in the Ministry of Health, Zambia Revenue Authority, City Councils (Public health department),mental health clinics and alcohol rehabilitation centres. The data collected by the CPCR clearly demonstrates that most of the distillers of spirits were divorced / separated women with a primary school education,” explained Dr. Zyambo.

Dr. Zyambo laments that more than seventy percent (70%) of the women interviewed in the study produced between 20 to 100Litres/day of distilled spirits.

Dr. Zyambo says the data has shown serious negative health impacts that the high level of illicit alcohol consumption has had on the youths and young adults in Zambia.

“Of the consumers included in the survey, over two-thirds of those who consumed alcohol sixty-eight percent (68%) started drinking alcohol before the age of twenty (20-year-olds).

Dr. Zyambo explained that forty-six (46%) of the respondents started drinking alcohol between the ages of 15 and 19, while twenty-two (22%) started to drink even earlier below the age of fifteen (15), the youngest reported being six (6) years of age.

“This early initiation of alcohol consumption was seen as a predictor to consuming illicit alcohol later in life. With regard to the health consequences of illicit alcohol use, of the consumers included in the survey, nineteen percent (19%) had to go to the hospital due to an incident or accident while drinking.

“Over half reported that they failed to function normally because of the consumption of illicit alcohol, and nearly two-thirds said that they were unable to stop drinking once they had started. The statistics paint a devastating picture of the levels of alcohol dependency in the country, driven by the consumption of cheap, high-ABV (alcohol by volume) illicit spirits,” noted Dr. Zyambo.

Dr. Zyambo says a key challenge with illicit alcohol is that – because its production does not follow any health and safety standards – consumers can never be entirely sure that they are consuming a safe product.

“To this point, the CPCR took samples of eighty (80) different kinds of alcohol and assessed the contents in the Zambian Bureau of Standards laboratory to verify ingredients and ABV. What they found was that there were significant discrepancies between declared and measured ABV percentages across the illicit liquors and spirits in all three urban centers. This disparity, ranging from differences of twenty-three (23%) to seventy-six (76%), raises serious concerns about quality control, production consistency, labelling accuracy, and the presence of counterfeit alcohol that is presented as a name brand, but is in fact refilled with another alcohol entirely.

“Public health risk implications based on factors such as hygiene and sanitation in production and retail of illicit alcohol consumed were also considered in the study, wherein the use of dirty drums for distilling alcohol, lack of clean water supply, and lack of solid waste disposal were seen frequently, all posing serious health risks for consumers. While the results of this study are important in and of themselves, what is perhaps most important is what comes next – what will policymakers, regulators, and public health institutions do with this new information? How can Zambia take on the cheap, high-ABV spirits that we see all over our communities?,” noted Dr. Zyambo.

According to the CPCR’s report, read by Dr. Zyambo, what must be addressed are societal factors.

“The most hit are the lowly paid, they obviously gravitate toward cheaper sources, like Kachasu, boxer, you know, those which are produced in smaller sachets, or bottles, they are cheaper like I said. These drinks are cheaper than soft drinks, boxer is much cheaper,” (Ministry of Health (MoH) official); environmental factors, “The other driver is the price, illicit alcohol is very cheap and very affordable. It’s cheaper than soft drinks.” Health Official; and policy factors, “Some countries have designated places where to manufacture alcohol from and there are certain routes that they use to produce alcohol…We need to control the production aspect and the supply aspect.” (Policymaker). Additional recommendations surfaced in the CPCR’s report include the implementation of policies to close the gap in price between illicit and legal, regulated alcohol, additional support to female entrepreneurs to move into compliant industries, and targeted interventions to reduce illicit alcohol consumption among at-risk populations, especially youth,” noted Dr. Zyambo.