In response to the shortage, governments across the world adopted temporary policies. These allowed for the production of hand sanitiser by entities that weren’t registered manufacturers and for alcohol distillers to shift their production to hand sanitisers.
Concern has been growing about safety issues related to hand sanitisers – in South Africa as well as other countries. But South Africa has been behind the curve in putting in place measures to ensure products are safe.
The purpose of a hand sanitiser is to disrupt the enveloping lipid membrane of SARS-CoV-2. This kills the virus. The World Health Organisation (WHO) has recommended that consumers use an alcohol-based sanitiser with an alcohol content of at least 70%, based on effective and fast anti-microbial activity.
The WHO further recommends that hand sanitisers comprise ethyl alcohol (ethanol) or isopropyl alcohol (2-propanol) as the active ingredient, in addition to inactive ingredients listed as follows:
But the policing of these conditions has been weak in countries like South Africa.
Methanol is a cheaper alcohol, but repeated use of methanol-based hand sanitiser can cause it to be absorbed through the skin. This can cause chronic toxicity, hallucinations or even death in extreme cases. As for 1-propanol, not to be confused with 2-propanol, the substance can be toxic and life-threatening when ingested and is therefore not an acceptable ingredient for hand sanitisers.
Countries across the globe have detected other toxic substances in hand sanitisers that can also pose acute or chronic toxicity. These include glutaraldehyde, polyhexamethylene biguanide and ethyl acetate.
Sub-potent levels of alcohol have been recorded in the Netherlands, the UAE, Australia, Guyana, Kenya, Nigeria and Rwanda. Zambia recalled products from a number of producers, including South Africa.
In May 2020, a laboratory found that two out of the 11 hand sanitisers bought from retailers in the city of Pietermaritzburg contained 1-propanol. Four contained only between 46% and 67% alcohol while claiming to contain 70%.
Yet no hand sanitiser products in South Africa have been recalled. The country also has no regulatory system in place to assess hand sanitisers intended for household use. Companies have been required to voluntarily comply with the national standard on disinfectant alcohol-based hand-rubs, but this is woefully inadequate.
Part of the Consumer Protection Act seeks to ensure that consumers are provided with adequate evidence-based information. This is critical, especially since consumers are inundated with all sorts of brands and types of sanitisers that are intended for frequent use.
Firstly, labelling requirements should be standardised and enforced. The following information should be indicated on every bottle of hand sanitiser:
Thirdly, products that don’t comply with specifications or are not properly labelled should not be sold or provided in public spaces.
Fourth, a national task team should be established to investigate the regulatory framework and current levels of compliance.
Fifth, imports of raw material used in manufacturing of hand sanitisers and ready-to-use formulated products should be regulated more effectively. Likewise, products that are exported from South Africa to neighbouring countries should be monitored better.
Finally, environmental health inspectors or the National Regulator for Compulsory Specifications should mercilessly track down fake products and have them confiscated and destroyed.
Dr Tracy Muwanga, a trans-disciplinary postdoctoral fellow in the faculties of Law and Natural and Agricultural Sciences at the University of Pretoria, contributed to this article.
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