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The latest World Health Organisation (WHO) report has ranked Uganda first in alcohol consumption on the African continent. 

According to the 2023 report released by the global health body, on average, a Ugandan consumes 12.21 litres of pure alcohol annually.

Men consume more than women, with an average of 19.93 litres of pure alcohol annually compared to 4.88 litres for women.

Seychelles follows in second place with an annual alcohol consumption of 11.99 litres of pure liquor for men and 4.72 for women. 

The 130-page report is structured under the theme 'Monitoring health for the SDGs, sustainable development goal' and it documents successes and challenges in public health, with a focus on SDG indicators and trends. 

Tanzania is ranked third in Africa, with an average of 10.36 litres of alcohol consumed by a Tanzanian annually. 

Health time bomb

UN's health agency says harmful use of alcohol is the underlying factor in more than 200 diseases and injuries. 

WHO projections indicate that about three million deaths worldwide result from the harmful use of alcohol, which translates into 5.3% of all global deaths annually.

The report also highlights that there are gender differences in alcohol-related mortality and morbidity. 

The percentage of alcohol-attributable deaths among men amounts to 7.7% of all global deaths, compared to 2.6% of all deaths among women. The report attributes 5.1% of the global disease and injury burden to alcohol. 

What experts say

Dr David Kalema, a WHO consultant on alcohol issues in Uganda, says many people’s lives have been destabilised by alcohol through the aggression and violence associated with it.

“We have had many situations of domestic violence, family breakups, and children not going to school, on top of alcohol being the second leading cause of road accident fatalities and injuries. In fact, alcohol has far-reaching consequences than we can mention,” he says. 

The rehabilitation of alcohol addicts, Kalema says, has huge cost implications for the economy, requiring the government or a family to spend at least sh7m to rehabilitate an individual to recovery. 

According to the WHO report, a significant proportion of the disease burden attributable to alcohol consumption arises from unintentional and intentional injuries, including those due to road traffic crashes, violence, and suicide. 

It adds that fatal alcohol-related injuries tend to occur in relatively younger age groups. 

Prof. Nazarius Mbona Tumwesigye from Makerere University School of Public Health attributes the overconsumption of alcohol in Uganda to harsh economic conditions compounded by the COVID-19 pandemic. 

“When people get these economic hardships, some resort to taking alcohol, thinking that they will get some good moments and even catch sleep and in the process, some end up getting addicted,” he says. 

Amudat RDC Nsubuga Bewayo communicating on phone as suspected alcoholics, arrested during an operation to fight idleness and crime, lie on the ground at the Amudat Central Police Station

Peer pressure, Tumwesigye adds, is another cause, with many young people wanting to follow what others are doing. 

He says the problem affects the rich and the poor. 

“It is a problem among the rich in upscale suburbs and the poor living in slums. If a child grows up in a slum where almost everybody is taking alcohol, they will pick up the habit early in life."

Alcohol consumption, Tumwesigye says, has huge economic implications not only for an individual but also for the broader economy. 

“People lose jobs because they are drunk. So you wreck your own life and that of your family." 

The don urges the Government to place a high tax on alcohol to make it more expensive to afford. 

The WHO report notes that the adverse health impacts and social harm from drinking alcohol are greater for poorer societies. The poor, according to the report, experience greater health and social harm from alcohol consumption than more affluent individuals.

In the East African Community (EAC) region, Rwanda ranks lowest in liquor consumption, with an average of 1.88 litres per person annually. 

In the Democratic Republic of Congo, the average alcohol consumption is 2.12 litres. Kenya’s average alcohol consumption is 2.87 litres per person annually. 

Linked to early death

The WHO report discloses that alcohol consumption causes death and disability early in life, adding that among people aged 20–39 years, approximately 13.5% of total deaths are attributable to alcohol. 

It says there is a fundamental relationship between harmful use of alcohol and a range of mental and behavioural disorders, other non-communicable conditions and injuries. 

What health ministry says

Uganda's health ministry concurs with the WHO on the rise of substance and alcohol abuse-related mental breakdowns. 

Dr Kenneth Kalani, the deputy head of mental health and psychosocial division at the ministry, says 9.8% of mental patients suffer from alcohol use disorder. 

“And we still think that this is an underestimation given the fact that many patients sit at home and don’t know that they actually suffer from mental illnesses."

Kalani admits that Uganda suffers the mental treatment gap of about 85% since this percentage does not show up for mental care. “They are at home, they are at workplaces, they are walking in the streets like any other normal people."

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Regulating alcohol consumption

Currently, the Parliament of Uganda is in the process of reinforcing the legal framework on alcohol sale and management. 

Sarah Opendi, the Tororo Woman Member of Parliament and brains behind the private member’s Alcoholic Drinks Control Bill, seeks to regulate the manufacture, importation, sale and consumption of alcoholic drinks and also provide for the licensing of persons trading in alcoholic drinks and premises. 

The Bill also seeks to prohibit the sale of alcohol to specified persons and regulate the promotion and advertisement of alcoholic drinks. 

Also critical is the time for alcohol sale. The proposed legislation suggests that the sale of alcohol starts from midday (noon) to 6pm. 

According to Opendi, although the Bill does not stop the consumption of alcohol, it aims to provide a comprehensive legal framework to address the challenges associated with alcohol that have persisted for quite some time. 

MP Sarah Opendi introduced a Bill that seeks to regulate the manufacture, importation, sale and consumption of alcoholic drinks

In order to achieve a reduction in the harmful use of alcohol in line with the targets included in the SDG 2030 agenda and the WHO global monitoring framework for noncommunicable diseases, the report emphasises concerted action by countries, effective global governance and appropriate engagement of all relevant stakeholders. 

It stresses that countries have a responsibility to formulate, implement, monitor and evaluate public policies to reduce the harmful use of alcohol through; regulating the marketing of alcoholic beverages, regulating and restricting the availability of alcohol, enacting appropriate drink-driving policies, reducing demand through taxation and pricing mechanisms, among others. 

The report also calls for awareness of the health and social problems for individuals and society at large caused by the harmful use of alcohol. 

The SDG target 3.5 seeks to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol. 

A bodaboda cyclist ferries a local alcoholic drink from Nalufutu trading centre in Sironko district

Out of all African countries ranked by the WHO in the alcohol consumption index, only Mauritania scores zero for alcohol consumption. 

It is followed by Niger, Comoros, Sierra Leone, Senegal, Guinea, Algeria, Madagascar and Gambia, all scoring below two litres on average. 

Global ranking

At the continental level, Africa is ranked fourth in terms of alcohol consumption after Europe, America and the Western Pacific. 

Europe scores well above the recommended 5.5 global value at 9.2 litres. America is at 7.5, the West Pacific is at 6.1, Africa is at 4.5, South East Asia is at 3.8 and the Eastern Mediterranean is at 0.3. 

In 2010, WHO member states agreed on a global strategy to reduce the harmful use of alcohol, which represents international consensus that reducing the harmful use of alcohol and its associated health and social burden is a public health priority. 

The strategy also provides guidance for action at all levels, including 10 recommended target areas for policy options and interventions for national action to reduce the harmful use of alcohol and the main components for global action to support and complement activities at the country level.

Previous reports

Uganda was ranked the number one African country in alcohol consumption in 2013, in a report published by US broadcaster CNN. 

The report titled 'World’s 10 best-drinking nations' placed Uganda in the eighth position globally, ahead of Germany and Australia, which were in the ninth and 10th positions, respectively. 

In 2014, the global status report on alcohol ranked Uganda above all the other partner states in the EAC, stating that on average, a Ugandan drinks at least 23.7 litres of alcohol annually. 

It went on to indicate that about 80% of alcohol in Uganda was unregulated, brewed and sold at home.