South Africa faces the highest rates of Foetal Alcohol Spectrum Disorder (FASD) in the world, with some regions like the Western and Northern Cape reporting that up to one in three children are affected. FASD is entirely preventable, yet it remains a silent crisis, caused by alcohol consumption during pregnancy and made worse by systemic issues such as poverty, gender-based violence, and the legacy of the apartheid-era “dop system.” The impact is devastating: children with FASD often struggle with learning, memory, and behaviour, placing lifelong strain on families, schools, and communities.

This International FASD Awareness Day on 9 September is an urgent call to break the silence. South Africa still has no national plan to prevent or respond to FASD, despite the billions of rand lost annually in healthcare, education, and lost opportunities. Preventing FASD is not only about protecting children, it is about safeguarding the future of the nation. The Rethink Your Drink campaign, a reimagined alcohol harms reduction initiative by DGMT, highlights that when a pregnant woman drinks, it is not just her health at stake but the child’s entire future. Their work focuses on changing the norms, policies, and industry practices that promote and normalise heavy drinking, especially among young people and in under-resourced communities.

The solutions are within reach. Rethink Your Drink promotes the World Health Organisation’s five ‘best buy’ strategies: banning alcohol advertising, increasing alcohol prices through tax reform and minimum unit pricing, lowering the legal blood alcohol limit for driving, restricting availability by reducing outlet density and limiting trading hours, and expanding access to treatment and counselling. Alongside these, community-led initiatives to create safe, alcohol-free environments and provide practical support for women are vital. Each of us also has a role to play: by raising awareness, challenging harmful norms, and supporting pregnant women with understanding rather than judgment. On 9 September, wearing red or posting a photo of red shoes is one simple way to show solidarity and push for the change that children and families in South Africa so urgently need.

Find more from Rethink Your Drink (South Africa, September 2025)