1. bringing the Global Alcohol Strategy to those who need it most Dr Joanne Corrigall Richard Matzopoulos Dr Joanne Corrigall Richard Matzopoulos

2. Injury prevention workgroup: current activities Vision: To reduce injuries in the Western Cape All injuries Interpersonal violence & Road Traffic injuries Alcohol-related Interpersonal violence and road injuries Largest contributors to injury BoD Largest contributing risk factor to injury BoD Groundwork for broader interventions

3. Who is dying from homicide? Men aged 20-39 >50% are alcohol positive

4. Alcohol & Violence  Hundreds of studies show an association between alcohol use and violence  Meta-analyses, cohort studies, case cross-over studies, time series analyses  Individual & population-level studies  Hundreds of studies show an association between alcohol use and violence  Meta-analyses, cohort studies, case cross-over studies, time series analyses  Individual & population-level studies

5. Inconsistency? More than 95% of studies show a positive association between alcohol and violence The only real inconsistency is the SIZE of the effect i.e. how big an influence does alcohol have on aggressive behaviour? Largest effects in populations with -high binge-drinking -high public drinking -violent societies -easy access to alcohol SOUTH AFRICA Foran & O’Leary 2008 Clinical Psychological Review 28(7) 1222-1234

6. Health burden from Alcohol (South Africa) Violence Road Violence Neuropsyche Road Injuries HIV, TB

7. South Africans are big drinkers  South Africa 2nd highest rate of substance abuse & dependence in the world  Alcohol consumed per drinker per year +/- 18 litres : comparable to UK, Ukraine & Russia : top 4 heaviest drinkers in the world  Western Cape province- more drinkers, more binge drinkers  Trends: increase in alcohol consumption amongst youth  South Africa 2nd highest rate of substance abuse & dependence in the world  Alcohol consumed per drinker per year +/- 18 litres : comparable to UK, Ukraine & Russia : top 4 heaviest drinkers in the world  Western Cape province- more drinkers, more binge drinkers  Trends: increase in alcohol consumption amongst youth

8. Alcohol related violence  10 times the global average of violence (men)  Western Cape: Highest homicide per capita in SA  Within Western Cape: 50% of alcohol-related injury deaths occur in 5 suburbs!!  10 times the global average of violence (men)  Western Cape: Highest homicide per capita in SA  Within Western Cape: 50% of alcohol-related injury deaths occur in 5 suburbs!!

9. SuburbsZeroPositiveUnknownTotal Khayelitsha313 (15%)527 (21%)303 (8%)1143 (13%) Gugulethu97 (5%)169 (7%)143 (4%)409 (5%) Nyanga121 (6%)161 (7%)149 (4%)431 (5%) Kraaifontein73 (3%)124 (5)92 (2%)289 (3%) Philippi110 (5%)125 (5%)143 (4%)378 (4%)..... Total2135 (100%) 2460 (100%)3902 (100%)8497 (100%) Source: PIMMS (DoP analysis) The “High 5” approach Violence is CONCENTRATED Approx. 50% of alcohol-related violence occurs in 5 areas

10. The High 5 project High 5 A focus on 5 high risk areas to deliver intersectoral alcohol-related violence reduction interventions

11. DECREASE DEMAND FOR ALCOHOL HIGH 5 AREA I/V’S HIGH 5 AREA I/V’S REDUCE SUPPLY OF ALCOHOL CREATE SAFER DRINKING ENVIRONMENTS EXAMPLES Targeted implementation of Liquor Act Community Mobilisation around liquor act and licensing EXAMPLES Social mobilisation for Safer drinking environments Traffic calming Infrastructural improvements Urban upgrading M&E FOR OUTCOMES AND TARGETING OF INTERVENTIONS EXAMPLE Detailed trauma surveillance EXAMPLES Brief Interventions Counter-messaging Education Recreation Skills development ECD Mental Health Social Cohesion Urban upgrading

12. VPUU with Alcohol included Examples: ECD Conflict management Social cohesion Business development Examples: ECD Conflict management Social cohesion Business development Examples: Street lights Creating local trading places Use of Public Buildings/Spaces Examples: Financial Models, Action Plans Governance, Capacity Building M&E Policy Alcohol: Brief Interventions Counter-messaging Education Recreation Skills development ECD Mental Health Social Cohesion Urban upgrading Alcohol: Implementation of Liquor Act Safer drinking environments Traffic calming Infrastructural improvements Urban upgrading Alcohol: Expand include alcohol Alcohol abuse prevention model a good fit with VPUU model

13. MEETS bringing the Global Alcohol Strategy to those who need it most

14. Need for campaign GENERAL PUBLIC, DRINKERS & INTERVENTION AGENTS  Scewed normative views of drinking  Bombardment of alcohol advertising & misinformation campaign  Poor knowledge of risks & how to avoid them  Poor knowledge of what the problem is & how to fix it  Need to gain support for policies/legislation/interventions : need community involvement PUBLIC MESSENGERS: Wrong messages being spread! GENERAL PUBLIC, DRINKERS & INTERVENTION AGENTS  Scewed normative views of drinking  Bombardment of alcohol advertising & misinformation campaign  Poor knowledge of risks & how to avoid them  Poor knowledge of what the problem is & how to fix it  Need to gain support for policies/legislation/interventions : need community involvement PUBLIC MESSENGERS: Wrong messages being spread!

15. BOOZA MYTHS  Drugs cause more violence than alcohol  Advertising has no effect on drinking  Alcoholics are the main problem  Educating people about the harms of alcohol is the answer  Restricting access to alcohol will make no difference  Drugs cause more violence than alcohol  Advertising has no effect on drinking  Alcoholics are the main problem  Educating people about the harms of alcohol is the answer  Restricting access to alcohol will make no difference BUSTED to the rescue!!

16. Booza TV  EPISODE 1: THE CULTURE OF DRINKING  EPISODE 2: WHY WE DRINK ALCOHOL AND WHY WE ABUSE IT  EPISODE 3: ALCOHOL, THE MEDIA & ROAD INJURIES  EPISODE 4: ALCOHOL AND VIOLENCE  EPISODE 5: THE LIQUOR ACT  EPISODE 6: SOLUTIONS  EPISODE 1: THE CULTURE OF DRINKING  EPISODE 2: WHY WE DRINK ALCOHOL AND WHY WE ABUSE IT  EPISODE 3: ALCOHOL, THE MEDIA & ROAD INJURIES  EPISODE 4: ALCOHOL AND VIOLENCE  EPISODE 5: THE LIQUOR ACT  EPISODE 6: SOLUTIONS

17. PLAY 15 MINUTE CLIP OF BOOZA TV

18. Elsies River Pilot Project  Pilots Booza TV as a tool for social mobilisation for actions to reduce alcohol-related violence  2 groups: Stakeholders & Binge Drinking Youth  Pilots Booza TV as a tool for social mobilisation for actions to reduce alcohol-related violence  2 groups: Stakeholders & Binge Drinking Youth

19. Pilot study results: Booza TV is effective in challenging normative views about drinking; and Establishing links between violence & drinking successfully mobilised support for evidence-based interventions including the Liquor Act MOST notable effects amongst DRINKING YOUTH (opinion changes, fact uptake, possibility of changing current culture)

20. Thank You The Boozalution will be televised!