Public Health Leaders Say Harm Reduction Can Help South Africans Make Healthier Choices

Midrand – Public health leaders have highlighted the importance of harm reduction in improving health outcomes, saying it should be seen as a practical way of helping people make healthier choices instead of expecting immediate behavioral change.

The discussion took place during The Wellness Collective, hosted by WomenCan at Pere House in Midrand on Tuesday. The event brought together healthcare leaders, policymakers and industry representatives to discuss how harm reduction is already being used in public health and where it could play a bigger role in the future.

Former chairperson of Parliament's Portfolio Committee on Health, Sibongiseni Dhlomo, said harm reduction is not a new concept and has already been applied in several government health programmes. He pointed to the use of condoms, antiretroviral treatment and needle-exchange programmes as examples of interventions that help reduce health risks while supporting people to make safer choices.

"The government doesn't simply tell people not to have sex. It provides condoms, antiretroviral treatment and education. That's harm reduction," Dhlomo said. He said the same thinking should also be considered when discussing tobacco use, especially as Parliament prepares to begin the next stage of deliberations on the Tobacco Products and Electronic Delivery Systems Control Bill.

According to Dhlomo, public participation also played an important role in shaping the proposed legislation. He said lawmakers travelled to 27 municipalities, received more than 40,000 written submissions and heard from dozens of organisations before refining the Bill.

"The policy we ended up with was different from where we started because we listened to the evidence and to the public," he said.

Dhlomo added that discussions with scientists and public health experts helped policymakers better understand that not all nicotine products carry the same level of risk. Delivering the keynote address, Gauteng Health MEC Faith Mazibuko said harm reduction recognizes that changing unhealthy habits is often a gradual process.

"Harm reduction is about reducing preventable harm while helping people move towards healthier choices. It recognizes that change does not always happen overnight, but every positive step towards better health matters," she said.

Mazibuko said the government already uses this approach in different public health campaigns, including promoting healthier eating, encouraging responsible alcohol use, supporting safer sexual practices and preventing disease. She said the healthiest decision anyone can make is not to start smoking, while quitting completely remains the best option for those who already smoke.

However, she acknowledged that nicotine addiction can be difficult to overcome and that many smokers need support during the quitting process. Former Gauteng Health MEC and specialist gynaecologist Dr Bandile Masuku said harm reduction is something many people already understand through everyday examples. "When you get into your car, you put on your seatbelt. Wearing a seat-belt doesn't eliminate the risk of being in an accident, but it significantly reduces the risk of serious injury or death. That's harm reduction," he said.

Masuku said the government also has an important role to play by creating policies that encourage healthier lifestyles. Also speaking at the event was Buhle Binta, Head of Scientific Engagement for Sub-Saharan Africa at Philip Morris International. She said while quitting smoking completely remains the best choice, there should also be conversations about less harmful alternatives for adults who are unable or unwilling to quit smoking.

Binta said more than one billion people worldwide still smoke, while South Africa has an estimated 11 million smokers. She added that science should continue to guide discussions around tobacco regulation and public health.

"Ultimately, science should guide these conversations. The evidence must continue to be evaluated, openly debated and communicated through appropriate regulatory frameworks and public education so that adult consumers can make informed decisions," she said.

The event focused on how harm reduction is already part of many public health interventions and explored how the same approach could help South Africans make healthier choices across different areas of their lives.