At Twincoz Bar, the clinking of beer bottles and the usual chorus of tusayukire wamu (cheers) has been deadened by a mournful mumble. Around the plastic tables of the roadside joint on the outskirts of Kampala, patrons talk of the scourge of sudden blindness followed by death.

In the past month, at least 40 Ugandans have died from drinking adulterated alcohol. In this unregulated east African country, believed to have the world's highest rate of alcohol consumption, the news is terrifying. The authorities appear helpless. Worst of all, no one seems safe.

"Since the death of DJ Ronnie, we know it can happen to anyone," said Twincoz owner Ruben Mugyeni. On 11 September, less than 24 hours after a night out with friends, popular radio presenter Ronnie Sempangi, 36, lost his sight, went into a coma and died from multiple organ failure. The late-night lonely-hearts presenter is thought to have unwittingly drunk lethal methanol. As one of the most-loved personalities in Uganda, thousands attended his funeral at Nanziga near Kampala.

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"DJ Ronnie used to drink here, in Nansana neighbourhood," said Mr Mugyeni. "We usually associate the dangerous artisanal waragi [spirit] with the rural areas. Ronnie drank Johnnie Walker, not that stuff. Or so everyone thought."

Kampala is one of the party capitals of Africa. Its streets are lined with a variety of unlicensed drinking joints – known as kafunda – where it is possible to drink virtually around the clock. Lax licensing enforcement means sachets of waragi – the word used for any alcohol spirit – are easier and cheaper to buy than mobile phone top-ups. Vendors patrol the bars selling nyama choma (grilled meat), and men and women gather good-naturedly beneath television screens blasting out Big Brother Africa or the British Premier League. There is no fighting or obvious binge drinking. There is also no debate about the impact of alcohol in a country where people profess to drink "from Monday to Monday".

"Consumption of alcohol is culturally and socially acceptable," said Nick Henderson, a Briton who is managing director of Nile Breweries. "Uganda's economy is agro-based, with a tradition of local brewing and distilling using sorghum, millet, maize, sugar, bananas and pineapples. The spate of deaths is attributed to high concentrations of methanol in local spirits, due to poor distilling or adulteration with industrial alcohol. There is a need for the government to address the very low prices of these spirits," he said.

In 2004 and 2005, two United Nations reports listed Uganda as having the highest per capita consumption of absolute alcohol in the world. Its score of 19.5 litres put it ahead of duty-free haven Luxembourg and of the Pilsener-swigging Czech Republic. But the World Food Organisation pointed out that 53 per cent of alcohol consumed by Ugandans was informally produced.

When asked whether alcohol leads to social and health problems, most Ugandans look utterly puzzled. Yet the country has among the highest rate of road fatalities in the world and the government is currently running an aggressive campaign to reduce domestic violence. But alcohol is not mentioned as a cause of problems. Brewing and distilling are deeply rooted in rural culture, where they are carried out by women and provide crucial income. The expression used for "cheers" in Kampala actually means "let us rejoice together". Ugandans are proud to tell the story of how the British empire's "war gin" for the troops was corrupted into the word waragi to mean any spirit, either branded or locally produced.

Access to alcohol is almost considered a basic freedom, as with guns in the US. Politicians tamper with it at their peril. In response to the poisonings, the health ministry asked parliament for an immediate ban on alcohol in sachets, but MPs voted against it.

The two large alcohol companies – Nile Breweries, which does not produce spirits, and Uganda Breweries, which does – find themselves in the unusual position of pressing government for more regulation.

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Sandor Walusimbi, head of corporate relations at Uganda Breweries, is critical of knee-jerk prohibitionist tendencies in Yoweri Museveni's government. "We manufacture Uganda Waringi which is an iconic gin, sold both in sachets and bottles," he said. "Before the poisonings, the government had announced a ban, effective from next year, on sachets. The decision was centred on environmental concerns and we were happy to comply, as they were giving us time to sell off our stocks. But he added: "The immediate ban attempted in parliament last week was no solution. Our products, which include whisky in sachets, are triple distilled and 100 per cent safe. To ban all sachets would only push low-income consumers into the informal sector."

Poverty is the key problem. Mr Henderson, whose company produces Nile Lager with water drawn from the source of the river, agrees. "While per capita consumption of alcohol is relatively high, Ugandans drink only 6 litres of beer per year, compared to the Czechs' 160 litres. Beer is too expensive for the majority of consumers."

At Twincoz bar, patrons will sit for hours around a single bottle of Bell or Tusker beer, for which they have paid up to 2,500 shillings (80p). A sachet of Uganda Waragi sells for 600 shillings (19p). Sachet waragi from the informal sector can be found for as little as 200 shillings.

Yet the government's only weapon so far has been taxation, creating a mood that Mr Henderson compares to 1920s American prohibitionism. Uganda and Nile Breweries are Uganda's top tax payers. Eight years ago the government briefly pushed excise duty on beer to 70 per cent. "The use of taxes, coupled with strict licensing laws, do not work. High taxation shifts consumers to higher-strength liquor," said Mr Henderson.

With no considered government policy in place, nor any enforced control of advertising or sales, it falls to the breweries to manage campaigns such as those against drink driving. These are inevitably less effective than a government scheme. But pure business sense has also enticed the breweries to appeal to the low-income market. Uganda Breweries has developed Senator, a lager brewed from locally grown barley and sold for 1,200 shillings (37p). Nile Breweries' answer, Eagle, is a runaway success made from local sorghum. The use of local ingredients allowed the breweries to argue for a 20 per cent excise duty.

But at Twincoz Bar drinkers say the situation has left them frightened and confused. "Last year, 200 people died in Kenya from drinking a poisonous waragi called Kill Me Quick," said Joseph Mugisha. "I think the same thing is going to happen here. We are receiving no information. We heard the sachets had been banned but you can buy them everywhere."

Everyone knows the story of DJ Ronnie's last night out. He is said to have been drinking Johnnie Walker whisky in one of Nansana's many bars. When the whisky ran out, he asked for "just anything – whatever there is". The next day, he was dead.

Mr Mugisha said that for the time being, he would stick to lager, adding: "But I don't see Ugandans giving up their waragi. It is part of life."