In the past decade, a sense of urgency has started to pervade alcohol regulation in South Africa. The burden of alcohol-related mortality and morbidity is among the highest in the world, and its effects are made worse by persistent socio-economic and structural inequalities. Moreover, alcohol is also a principle risk factor for infectious and chronic diseases, as well as a tenacious barrier to the achievement of the Millennium Development Goals. Its consumption and negative externalities have therefore become a public health and development crisis.