FASD Awareness Month: True Cost of Alcohol by SAAPA SA calls of an excise tax review to help prevent FASD and support affected families.

Johannesburg, September 2026 - As Foetal Alcohol Spectrum Disorders (FASD) Awareness Month is recognised globally, the True Cost of Alcohol campaign by Southern African Alcohol Policy Alliance in South Africa (SAAPA SA) is calling for a stronger, coordinated national response that combines maternal and reproductive care with evidence-based alcohol policy. Central to this response should be alcohol excise tax reform that reduces harmful consumption while generating additional public health revenue that can support FASD prevention, early intervention, diagnosis, treatment and family support.

South Africa has the highest estimated prevalence of FASD globally, with researchers putting prevalence at 600 cases per 10 000  people. The same evidence base makes the case that raising excise taxes is a low cost, high impact public-health intervention: higher taxes increase prices, reduce demand and lower alcohol-related harm. A nationally representative 2025 survey of 1033 South African adults found that 72% would support government raising alcohol taxes to reduce alcohol-related harms. Support rises when people can see a clear social benefit from the revenue: 85% supported higher alcohol taxes when the money would be used for programmes supporting poor communities, while 82% supported increases when the funds would support public school education. Four in five respondents also regarded addressing alcohol-related harm as a government responsibility.

According to Nomcebo Dlamini, Campaign Director of the True Cost of Alcohol Campaign at SAAPA SA, these findings create a strong public mandate for government to link alcohol taxation more visibly to prevention and social investment.

“South Africans are telling government two things very clearly: alcohol harm is a serious public problem, and they are prepared to support alcohol taxes when those taxes are used to protect communities. During FASD Awareness Month, we are asking National Treasury and government to translate that support into action by ensuring that the review of the alcohol tax regime prioritises the protection of pregnant women and their unborn children," says Dlamini.

FASD is an umbrella term for a range of lifelong conditions associated with prenatal alcohol exposure. These can include difficulties with learning, behaviour, memory, attention and communication, as well as physical and developmental impairments. Importantly, FASD is preventable, but prevention cannot rest solely on telling women not to drink; prevention must address the wider environment in which alcohol is priced, marketed, sold and consumed. It must consider the broader environment in which women live; including alcohol affordability and availability, marketing, social pressures, poverty, mental health and  access to healthcare; as part of a comprehensive prevention package. FASD prevention should be integrated into the broader maternal and reproductive healthcare system, rather than being treated as a once-a-year campaign.

Healthcare workers are often among the first professionals who can identify alcohol use during pregnancy. They need the skills, time, referral networks and treatment options to respond effectively and compassionately. National Treasury can direct the additional alcohol excise-tax resources received to fund the capacitation of healthcare workers to support women better during pregnancy.

“Every antenatal visit should be an opportunity not only to monitor the physical health of a mother and her baby, but also to understand the social and behavioural factors that may affect pregnancy. Healthcare workers need the skills, confidence and resources to have these conversations in a compassionate and non-judgemental way,” says Dlamini.

The True Cost of Alcohol campaign emphasises that excise taxation must operate as part of a comprehensive package of alcohol harm reduction and control measures. This includes stronger controls on alcohol availability and marketing, effective monitoring of liquor licences, improved screening and treatment services, and pricing measures that make high-alcohol products less affordable. The organisation is therefore calling on National Treasury, the Department of Health and Social Development as well as all other relevant departments to use the Alcohol Taxation Review to strengthen the public health purpose of excise tax to develop a clear cross-government approach for investing in alcohol harm reduction, including FASD.

"FASD Awareness Month should lead to more than awareness. South Africa has the evidence, the public support and a live policy opportunity through the Alcohol Taxation Review. Increasing excise taxes can reduce alcohol consumption; directing additional public resources towards FASD prevention and support can help protect the next generation. These two objectives should be pursued together," Dlamini concludes.

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About the True Cost of Alcohol Campaign by SAAPA SA

The True Cost of Alcohol Campaign by SAAPA SA is a national civil-society campaign to save lives, reduce harm and restore dignity through targeted alcohol tax reform.

The Southern African Alcohol Policy Alliance South Africa (SAAPA SA) is a civil society coalition advocating for evidence-based alcohol policies that reduce harm, protect vulnerable populations and promote healthier communities across South Africa. For more information, visit www.truecostofa;cphol.africa