By MONICA Mayuni/Zambia, Lusaka,
ZAMBIA’s battle against illicit alcohol and counterfeit cigarettes is no longer merely a law enforcement or revenue collection issue. It is increasingly becoming a public health emergency that threatens to overwhelm an already stretched healthcare system at a time when the country is adjusting to reduced external support for the health sector.
This concern took centre stage on Wednesday when the Public Private Dialogue Forum (PPDF), working with the Ministry of Commerce, Trade and Industry, convened government agencies, regulators, law enforcement institutions and the private sector to develop a coordinated response against the growing illicit trade in alcohol and cigarettes.
In a statement issued on Wednesday by PPDF Director in charge of strategic communications and partnerships Francesca Phiri, the meeting warned that illicit alcohol has been linked to increasing hospital admissions and deaths, while counterfeit and smuggled cigarettes continue to undermine legitimate businesses and deprive Government of vital tax revenue needed to finance public services.
Health experts say the problem of illicit use and in some cases abuse of both alcohol and cigarettes extend far beyond lost taxes.
According to the World Health Organization (WHO), tobacco use remains one of the leading causes of preventable deaths worldwide, contributing to cancers, heart disease, stroke, chronic respiratory diseases and many other illnesses. Alcohol misuse similarly increases the risk of liver disease, cardiovascular disease, mental health disorders, injuries, road traffic crashes and several forms of cancer.
The danger becomes even greater when the products consumed are illicit.
Unlike regulated products, illicit alcohol is often manufactured in unsafe environments with little or no quality control. Scientific studies have shown that some illicit alcoholic beverages contain dangerously high levels of methanol and other toxic chemicals capable of causing blindness, irreversible organ damage or death. Counterfeit cigarettes may also contain unusually high concentrations of harmful chemicals and contaminants, exposing smokers to even greater health risks.
Every patient admitted with alcohol poisoning, liver failure, cancer, stroke or chronic lung disease adds pressure on hospitals already struggling with limited resources, medicines and healthcare personnel.
The timing is particularly significant.
Zambia, like many developing countries, is working to strengthen the resilience of its health sector following the reduction and withdrawal of some health programmes previously supported by the United States (US) Government. As Government mobilises domestic resources to sustain essential health services, preventable illnesses linked to tobacco and harmful alcohol consumption threaten to consume resources that could otherwise be directed towards maternal health, child health, infectious diseases and other national priorities.
Medical experts note that treatment for chronic diseases associated with tobacco and alcohol use is expensive and often lifelong.
Cancer treatment, dialysis for kidney failure, cardiac care, intensive care admissions and long-term management of chronic respiratory diseases (CRDs) require specialised equipment, medicines and highly trained health professionals.
When these cases increase, hospitals experience congestion, healthcare workers become overstretched and waiting times for other patients inevitably rise.
The PPDF meeting identified several drivers behind the illicit trade, including illegal manufacturing of alcohol outside regulated facilities, counterfeit products, organised smuggling across porous borders, under-declaration of goods, undervaluation and diversion of transit cargo.
Stakeholders welcomed ongoing enforcement measures, including specialised anti-smuggling units, surveillance drones, artificial intelligence (AI)-assisted detection of suspicious trade patterns, enhanced customs inspections and increased intelligence sharing with international partners.
Beyond enforcement, public health researchers say understanding why people consume illicit alcohol and cigarettes is equally important.
Scientific evidence points to several contributing factors.
Poverty and low incomes often push consumers towards cheaper illicit products. High unemployment, particularly among young people, increases vulnerability to substance abuse. Limited public awareness of the dangers associated with counterfeit products also contributes to demand. Easy availability, weak enforcement in some communities, addiction to nicotine and alcohol, mental health challenges, peer pressure and aggressive illegal distribution networks further fuel consumption.
Unless these root causes are addressed alongside stronger law enforcement, experts warn that the illicit market will continue to thrive.
The consequences could be severe.
An increase in preventable diseases would place additional pressure on hospitals, raise healthcare expenditure, reduce workforce productivity and increase premature deaths among economically active citizens. Government would simultaneously lose tax revenue through smuggling while spending more to treat illnesses resulting from the same illicit products—a cycle that weakens both public health and economic growth.
Recognising the urgency, stakeholders resolved to strengthen inter-agency coordination, intensify action against illegal production and smuggling networks, expand public awareness campaigns and deepen intelligence sharing between Government and the private sector.
For Zambia, the fight against illicit alcohol and cigarettes is therefore about far more than protecting legitimate businesses. It is about safeguarding lives, preserving scarce healthcare resources and ensuring that a health system already facing significant financial pressures is not overwhelmed by preventable illness and avoidable deaths.
Francesca Phiri
