Every year, alcohol kills nearly three million people worldwide, causing more than 200 diseases and injuries. Yet despite that staggering toll, big alcohol in the Global South is not retreating. The world’s largest alcohol corporations are pushing forward, pouring billions into Africa, Asia, and Latin America, targeting regions where regulation is weak and populations are young.

In wealthier nations, the market is saturated and regulation is tightening. So Diageo, AB InBev, Heineken, Carlsberg, and San Miguel have turned south. These companies pour billions into regions with young populations, rising disposable incomes, and significantly weaker oversight. This expansion is not accidental. It is a calculated growth strategy, and communities are paying for it with their health, their safety, and in some cases their lives.

A Market Built on Vulnerability

The Global South holds 85% of the world’s population and has historically seen far lower rates of alcohol consumption. In many places, culture or religion limited drinking, and local communities brewed traditional beverages in small amounts.

That is changing rapidly.

Alcohol consumption has more than doubled in India and Vietnam over the past two decades. Alcohol deaths in Vietnam have quadrupled since 1990, placing the country among the world’s highest death rates from alcohol. Cambodia, Mozambique, and Myanmar have all recorded significant increases, with death rates in many Global South countries far above the global average.

The pattern is especially alarming when you look closer. Alcohol prevalence in parts of the region has actually dropped by 14% since the turn of the century, which sounds like progress. But total consumption has gone up. Fewer people are drinking, yet those who do are drinking far more heavily. That gap is causing immense harm.

How Big Alcohol in the Global South Targets the Young and Women

The expansion of alcohol multinationals in low and middle income countries follows a familiar playbook, one that mirrors the tactics the tobacco industry used when it penetrated these same markets decades ago.

Multinationals target young people and women with particular aggression. Companies deliberately price entry-level, sweetened products low and package them small to attract first-time consumers. Mini-bottles and sachets became enormously popular in India, despite evidence suggesting strong appeal to children. Uganda banned sachets in 2019 and Nigeria followed in 2024, though weak enforcement has allowed loopholes to remain open.

Gendered marketing is another powerful tool. Companies push empowerment messaging alongside sweetened, lower-alcohol products aimed at women, even as research shows women face greater health risks at lower levels of consumption. One striking example from southern Africa involved an advertisement for what appeared to be a perfume for young girls. It turned out to be promotion for an alcohol brand called Brutal Fruit, a product explicitly aimed at women.

Diageo has stated publicly that its strategy is to “speak to both sets of audiences, not just be male-centric.” Young professionals and women represent the clearest growth opportunities. Aspirational lifestyle marketing, celebrity endorsements, social media campaigns, and alcohol delivery apps give global brands unprecedented access to young people across the region.

Colonialism’s Long Shadow

The reach of big alcohol in the Global South did not begin recently. Its roots run deep into colonial history.

European powers once used alcohol as both a revenue stream and a mechanism of social control. They expanded production, eroded traditional restrictions, and embedded foreign firms in local economies. Heineken profits formed a significant share of colonial income in Nigeria. Authorities in Ghana deliberately promoted alcohol as a symbol of modernity and progress.

When independence came, many of those economic structures remained intact. Governments continued relying heavily on alcohol taxation. Foreign firms retained their political influence. Trade agreements kept local producers at a disadvantage.

A 2021 study described the situation as a “double burden of maldistribution.” Alcohol’s health and social harms fall hardest on disadvantaged groups and governments in poorer countries, while the wealth flows outward. Over 95% of the value of the five biggest alcohol firms sits in Europe and the United States, with virtually none retained in the Global South. The harms stay local. The money goes abroad.

The Health Toll Goes Far Beyond Liver Disease

In wealthier countries, most alcohol harm comes from noncommunicable diseases such as liver disease, cancer, and cardiovascular conditions. In low-income settings, the picture is far more complex and far more deadly.

Globally, nearly one in nine alcohol-related deaths involves tuberculosis, HIV, or respiratory infections. The link between alcohol and infectious disease is especially severe in Sub-Saharan Africa. Heavy drinkers account for more than half of new HIV infections in South Africa. Alcohol also fuels gender-based violence across the southern African region, with interpersonal violence among young men closely tied to drinking culture and availability.

The evidence is consistent: where alcohol is more available, consumption rises and harm follows.

Industry Interference in Policy

One of the most troubling dimensions of alcohol multinationals in low and middle income countries is their influence over the policies meant to protect people.

Only a handful of Sub-Saharan African countries, including South Africa, Malawi, and Kenya, have attempted multi-policy frameworks to reduce alcohol harm. SABMiller took leading roles in policy development in Lesotho, Malawi, Uganda, and Botswana, producing draft documents that prioritised economic arguments and pushed proven health measures aside. In at least one documented case, a soft copy of a draft policy simply disappeared from government systems.

San Miguel has long been tied to one of the Philippines’ most powerful political parties, giving the company direct leverage over legislation. Diageo spent six years paying bribes to officials in India to authorise the sale of its drinks, a pattern repeated in Thailand, South Korea, and elsewhere.

Political Donations and Legal Threats

Alcohol companies donated more money than any other industry sector during elections in Colombia, with AB InBev donating to six of the largest political parties. When stronger laws passed, the industry responded with legal challenges, misinformation campaigns, and investor-state disputes designed to delay or water down life-saving measures.

South Africa’s Draft Liquor Amendment Bill of 2016 aimed to restrict advertising and limit availability. Industry lobbyists dominated the process and even suggested that schools should be built around alcohol outlets rather than the other way around.

Labour Abuses Behind the CSR Gloss

Big alcohol in the Global South has also left a trail of documented human rights abuses, even as companies project an image of corporate responsibility.

Courts fined Ambev and Heineken in Brazil in 2021 for using Venezuelan migrants in conditions described as modern slavery. Two years later, authorities placed a Heineken subsidiary on Brazil’s slave labour list. Heineken is also a shareholder in China’s CR Beer, which sources hops from the Xinjiang region, where the forced labour of Uyghurs is widely documented.

Investigations across Africa revealed the industry’s reliance on “promotion girls,” women hired to push alcohol in bars. An internal 2007 report acknowledged that 15,000 such women were “vulnerable for misuse.” Heineken’s then-CEO dismissed responsibility entirely, arguing the company could not control how customers treated promoters.

Water Extraction and the CSR Myth

Meanwhile, companies present themselves as responsible actors through carefully managed corporate social responsibility programmes. Diageo partnered with WaterAid in Tanzania in 2024. Carlsberg funded water conservation in South India in 2023. Critics argue these campaigns primarily polish reputations and deflect pressure for stronger regulation.

Brewing and distilling consume vast amounts of water, often in drought-prone regions. Constellation Brands sought to build a brewery in the water-scarce Mexicali Valley in Mexico that would have consumed nearly seven billion litres of water per year from the Colorado River. After mass protests and a referendum where three-quarters voted against it, the project was cancelled.

Across a continent where hundreds of millions face malnutrition, companies divert land from food crops to supply alcohol brands. In Sri Lanka in 2024, the National Agrarian Unity organisation warned that rice shortages were worsening as more grain was channelled into alcohol production.

Community Resistance and the Path Forward

Despite the scale of the challenge, communities across the Global South are pushing back.

In the Philippines, the Sin Tax Coalition, a broad alliance of health professionals, advocacy groups, and concerned citizens, has secured meaningful policy victories over the years. South African community organisations mobilised the education sector and defeated a government proposal to allow schools to hold liquor licences for fundraising purposes.

These wins prove that collective action can hold industry power to account, even where regulation is weak and political will is thin.

Governments now face a clear choice. Alcohol will always rank low on development priority lists, and that vacuum allows multinationals to shape policy in their own image. Closing it requires political courage: raising taxes, restricting availability, banning targeted marketing, and removing the industry from policy development altogether.

Big alcohol in the Global South has found its new frontier. Whether governments and communities act before the cost grows even greater remains the defining question.

Source: dbrecoveryresources