Policymaking is, at its core, a process of solution modelling to problems. To correctly model an effective and efficient solution, the problems have to be thoroughly understood by closely analysing the facts, empirical data and the context in which the problem(s) and stakeholders are located.
The solution modelling to the problem(s) is a careful balancing act of trade-offs. Simply put, solve the problem within the resources available to you while mitigating the unintended consequences.
You might find this conceptualisation of policymaking relatively intuitive, but our government, Cabinet and particularly our National Coronavirus Command Council (NCCC) are either oblivious to this intuition or are just bad at policymaking, particularly in a time of an unmitigated crisis and disaster such as the one in which we find ourselves.
The government demonstrated its deficiency in policymaking through holding on to counterintuitive policies during our perpetual coronavirus lockdown – and nothing is more indicative of this than the third episode and ongoing ban on the domestic sale of alcohol.
It is important that we dig into how the president and his Cabinet got this wrong as it serves as a useful case study.
So how did they get it wrong?
At the start of the outbreak of Covid-19 in South Africa in March 2020, we all had very little idea about what we were dealing with. So it was important to shut down as much of society as we could to adequately prepare ourselves. As the President stated at the time, the initial 21-day lockdown was to suppress the spread of Covid-19 so that hospitals could ramp up their resources (PPE, bed capacity and staff complement). Businesses and other organisations also used this time to figure out how to adapt to a world in which a deadly, highly contagious virus has become part of everyday life.
In doing so, government put a ban on the sale of alcohol. This was necessary at the time because we had very little information with which to model any sort of solution that would work for our context. But as time went by, we learnt very crucial things about Covid-19 that we should have made centre points in our attempts to model our short- and medium-term future.
Crucially, we learnt that Covid-19 mutates. We saw this happening in other countries; we should have modelled scenario planning around this and invited all sectors of society to participate in this national scenario planning – but we didn’t. In fact, this is what the national Disaster Management Act legally mandates its custodians to do.
We also learnt early on that we might experience multiple waves of the spread of Covid-19. The experts warned that this could be the case and the minister of health and the president expected this to be the case – yet the president and his NCCC did not use this downtime (lockdown Level 2 and Level 1) as an opportunity to truly form the social compact necessary for the short-term and medium-term future around Covid-19. Neither was this time used as an opportunity to invest in ramping up our critical healthcare resources such as rapidly building more ICU and trauma units. This should have been done given that we expected a second wave (and now a third wave and fourth wave, as warned by Professor Tivani Mashamba, who specialises in diagnostics research at the University of Pretoria).
And so when the second wave hit, the president once again put a ban on the domestic sale of alcohol, again citing the pressure that alcohol-related violence places on the strained and limited ICU and trauma resources within our hospitals.
At face value, it is very easy to understand that alcohol-related violence and trauma place a strain on ICU and trauma resources. But not only has this statement been exaggerated by the government, it has also been something that the government poorly prepared for, to the detriment of the hundreds of thousands of South Africans whose livelihoods are inextricably tied to the alcohol industry value chain one way or the other.
It is important to closely analyse the empirical data to determine to what extent alcohol-related violence places a strain on ICU and trauma resources within our hospitals. This is a crucial step in the process of policymaking because once you establish the scale of the problem, you can adequately model, at scale, a solution to the problem. This our government has not attempted to do.
In their court papers challenging the alcohol ban, South African Breweries (SAB) calculates that alcohol-related trauma accounts for 2,000 general ward beds per week nationally, which averages out at five beds per hospital and a further 1,600 ICU beds per week nationally, which averages out at four beds per hospital.
If this calculation is true, it is unfathomable why the government has not capacitated each hospital with five to 10 additional ICU beds since the start of the lockdown.
More than that, government argues that the ban on the sale of alcohol prevents people from unnecessarily moving around to places that accommodate on-site consumption. This is true. But the solution to this is not a blanket ban on the sale of alcohol, the logical conclusion should be to prohibit on-site consumption to encourage at-home consumption. Not only will this prevent unnecessary movement that could potentially spread the virus but it also significantly reduces the chances of alcohol-related motor vehicle accidents. It should also be worth noting that people move around less because of the strict curfew.
Importantly though, we have to realistically calculate how much longer we expect to be living under a state of disaster and lockdown. To this question, the answer is, scarily long.
There is a naive belief that with multiple-approved Covid-19 vaccines, we will soon be out of the woods, but that is not remotely close to the truth.
The UK, for instance, has already started their vaccine roll-out programme and is currently inoculating 300,000 people per week. At its current rate, it is estimated that the UK will take seven years to vaccinate the whole country – during this period, experts in the UK are fearing a third wave.
South Africa, which battles with a similar but more transmissible variant of Covid-19 as the UK and has a similar population size to the UK – but has far fewer resources – needs to look at this as an example of how long we should anticipate to battle with Covid-19.
It does not seem that South Africa will be out of the woods anytime within the next three to five years, assuming we have enough money to buy enough vaccine doses to cover two-thirds of the country to achieve herd immunity. While this is happening, experts are fearing a third and fourth wave.
Moreover, we should not lose sight of the fact that many medical experts are worried that the current approved vaccines may be ineffective against the 501.v2 Covid-19 variant that we are battling with in South Africa and there is the fear that the world could possibly have to deal with new mutations and variants as time goes by.
This all indicates that we have to plan for the worst-case scenario and build policies around that.
It is inconceivable that the industry could survive further intermittent bans on the sale of alcohol over the next three to five years – which would most likely be the case if government holds on to the belief that an alcohol ban is necessary every time we experience a rise in the number of Covid-19 cases.
So how, then, do we get out of this ban and prevent the next one?
President Cyril Ramaphosa continuously speaks of building social compacts to battle our challenges, but has kept the alcohol industry out of participating in any of these social compacts. This is an industry with vast resources, ideas and expertise that could be of great value to the ongoing social compact.
Many of these resources could relate to enterprise development and assistance of small businesses within the alcohol value chain which have suffered and are suffering as a result of the pandemic and are on the brink of shutting down. Some of these resources could be dedicated towards assisting government in managing hospital resources and further capacitating hospitals within hotspots. The already-lost R5-billion to tax collection from SAB alone as a result of the ban could have gone a very long way to building additional field hospitals and ICU beds across the country.
The wine industry is on the brink of writing off R1.5-billion in inventory as a result of the ban. The lost tax revenue of that could have assisted a great deal.
At stake are 165,000 jobs, and in South Africa, 165,000 jobs means more than 600,000 people who depend on those 165,000 people will be impacted adversely.
The government has not used the relevant data to configure policies to achieve the balancing act of saving lives and saving livelihoods. The government has not sought to mitigate the unintended consequences of the ban policy and the government has not been appreciative of and sincere about the context within which these problems are located.
This has been a policymaking blunder that needs to be corrected.
- Oliver Dickson is a political commentator and broadcaster, formerly hosting Late Night Talk on Radio 702.
OPINION: Oliver Dickson