Malawi’s alcohol sachets ban is blueprint for public health advances

New research led by the University of Stirling has laid bare the decade-long battle to ban alcohol sachets in Malawi – and offers lessons for other African countries.

The study shines a light on the political battle behind landmark 2017 regulation prohibiting the sale of the small plastic packets of high-strength liquor that was seen to pose major public health risks, particularly among young people.

Initially introduced for their affordability and portability, sachets quickly became a social and health crisis. Reports of underage drinking, and various social disorders from alcohol harm prompted widespread concern.

In response, advocates began a sustained campaign to argue the case for regulation, drawing on local research and global health data.

The new study was led by Dr Isabelle Uny, of the Institute for Social Marketing and Health (ISMH) in the Faculty of Health Sciences and Sport at the University of Stirling, in partnership with Dr Benjamin Kaneka at the University of Malawi.

Public health problem

Dr Uny said: “These sachets were seen as a public health problem because they were extremely affordable, and widely available, making alcohol accessible to young people and vulnerable populations.”

The research sets out how a struggle between competing coalitions ultimately led to the successful implementation of the ban, despite significant resistance from alcohol and plastic manufacturers.

Led by a coalition of government agencies, civil society organizations, NGOs, traditional and religious leaders, public health advocates in Malawi managed to overcome sustained legal opposition from powerful industry players.

Powerful commercial interests

Dr Uny said: “This is the first detailed analysis of how an African country successfully implemented a sachet ban policy. It demonstrates that public health advocates can counter powerful commercial interests through strategic coalition-building and evidence-based advocacy.

“The findings are particularly significant because alcohol consumption is rising across Africa, especially among young people, and other countries have recently implemented, or are considering, similar sachets bans.”

Dr Isabelle Uny

The study details how industry actors and plastics manufacturers used strategic litigation to delay the policy’s adoption.

However, a strong and enduring pro-ban coalition remained steadfast, leveraging both legal avenues and public opinion to maintain pressure.

A decisive high court ruling in 2017 paved the way for the final ban, which was inscribed in the new National Alcohol Policy, marking a significant victory for public health in Malawi and setting an example for other countries grappling with similar challenges.

The research concludes that Malawi’s experience offers lessons for other African nations, including:

•    Building broad-based coalitions that unite various stakeholders around a common goal.
•    Using local and international evidence to frame public health issues in a compelling and morally urgent way.
•    Developing robust media strategies to shape public opinion and sustain political will.
•    Preparing for industry pushback, including legal and political manoeuvres designed to delay action.

Blueprint for countries

The impact of this work has already extended beyond Malawi – findings from the study were included in a 2025 World Health Organization (WHO) policy brief aimed at supporting similar alcohol control efforts across Africa.

Dr Uny said: “The research provides a blueprint for other African countries facing similar challenges with alcohol sachets and harmful drinking.

“The lessons learned – about coalition-building, using local evidence, media engagement, and weathering industry opposition – can be applied across Sub-Saharan Africa, and have resonance for other areas of alcohol control policy.”

The paper Competing coalitions in alcohol policymaking in Malawi: a retrospective case study analysis of the alcohol sachet ban was published in the International Journal of Drug Policy.

The Institute for Social Marketing and Health is designated as a World Health Organization Collaborating Centre on Alcohol Policy and Public Health Research. Find out more here.