Minimum unit pricing is not a silver bullet, but it is a policy proven to reduce alcohol harm at a population level
In a recent article Nigel Fairbrass warned SA against minimum unit pricing (MUP) by pointing to Scotland as a failed “ideological” experiment.
Readers should know that Fairbrass is not a neutral commentator: he is the former senior vice-president of communications at SABMiller, one of the world’s largest alcohol multinationals, and now cofounder of Eterna Partners, a consultancy advising corporations on reputational challenges.
His article relies on selective storytelling, highlighting findings that fit his case while ignoring the full body of evidence. Our responsibility is to consider the complete picture. When we do, Scotland’s experience tells a clear story: MUP reduces deaths, lowers hospital admissions and curbs consumption of the cheapest, strongest alcohol.
Lives saved and hospitalisations reduced
MUP, a pricing mechanism that increases the price of cheap alcohol favoured by the heaviest drinkers, was introduced in Scotland in 2018. Thereafter, alcohol-specific deaths fell by 13.4% in just two-and-a-half years, according to Public Health Scotland’s 2023 evaluation. Alcohol-specific hospital admissions dropped 4.1% in the same period. That equates to about 156 lives saved and 411 hospital admissions prevented every year, as confirmed by the Administrative Data Research UK study.
In a country where alcohol deaths had been rising before 2018, this reversal is significant and measurable.
Consumption fell — especially cheap, strong alcohol
Fairbrass states that the “responsible majority” of moderate drinkers are most affected by MUP. Not true. Most moderate drinkers tend to purchase drinks that are sold above the minimum price. In fact, Scotland experienced a 3% net reduction in total alcohol sales per adult that was almost entirely driven by lower rates of “hazardous drinking”, even if some of the most hard-core drinkers did not change their ways.
Public Health Scotland found that males, households in the most deprived areas and households that bought the most alcohol before MUP saw the largest reductions. Far from being “regressive,” MUP narrowed health inequalities by reducing harm where it was most severe.
MUP is good for public health
Fairbrass says one study found no change in accident and emergency visits after the policy was introduced in Scotland. However, a systematic review of 22 studies conducted in countries that had implemented MUP, found that acute alcohol-related hospital admissions reduced by 2%-9% immediately after MUP was introduced, while admissions for chronic alcohol-related conditions saw a 4%-9% annual drop, after a lag of about two to three years. This is because many of alcohol’s most serious harms such as liver disease, cancer and long-term dependence are chronic conditions that take years to develop and years to reduce.
We must rely on the whole evidence. Taken in full, it shows reductions in consumption, hospital admissions and deaths, not only for Scotland but for other countries such as Russia and Australia. Those are the outcomes most directly linked to affordability and availability of alcohol. On those terms, the evidence is clear: MUP has worked.
Critics such as Fairbrass emphasise what MUP cannot fix on its own — crime, short-term injury or illicit markets — while ignoring what it demonstrably achieves. This is a familiar pattern. We’ve seen it with big tobacco, big sugar and car manufacturers. Each time the tactic was the same: exaggerate limitations, highlight uncertainty and underplay evidence to stall regulation. And each time society benefited and industry adapted.
Lessons for SA
SA loses nearly 62,000 lives a year to alcohol, alongside billions of rand in economic costs. Big liquor has its eyes set on low-income communities, where alcohol is fuelling violence, road crashes and the world’s highest rates of foetal alcohol spectrum disorder (FASD). In SA, where the alcohol-related death rate in poorer communities is four-and-a-half times higher than in wealthier ones, MUP is hardly the punishment big liquor claims it to be. It is a life-saving measure.
MUP is not a silver bullet, but it is a policy proven to reduce alcohol harm at a population level. Selective storytelling, highlighting what MUP does not fix while ignoring what it clearly achieves, is not neutral analysis.
Business Live originally published this op-ed on 27 September 2025.
