African study outlines challenge to further wedge open the 'policy window' on sugar taxation

The “what-next” and the “how-to” are questions that need answering if findings from a multi-country African study on tax on sugar-sweetened beverages (SSBs) can be translated into policy to combat spikes in non-communicable diseases.

The three-and-a-half-year research project initiated by PRICELESS SA, a unit within Wits University’s School of Public Health, investigated the potential and viability of introducing a SSB tax in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. The research team was made up of more than 12 researchers from these countries as well as South Africa and Australia. Their findings were presented in a recent webinar.

Key similarities underpinning the findings can be leveraged into an opportunity to give shape to more coherent strategy for future action. From the webinar presentations it was clear there is a need, across the board, for better accurate data gathering and analysis and more interdisciplinary and holistic research where there are overlaps in health, economics, public policy and politics and governance.

Researchers called for improved public awareness of the role of SSB tax, along with improving nutrition literacy. Another echoed call was for strong leadership; more transparency from industry and government; and the need to build cohesion to take effective collaborative action.

Anne-Marie Thow, associate professor at the University of Sydney who was part of the research team, highlighted some key similarities from the country-specific findings.

Thow began her presentation by confirming growing evidence that diet-related choices and consumption of foods, including sugary drinks, are contributing to a rise of non-communicable disease in all the countries where research took place.

Thow said that, even with a mounting public health crisis, getting mechanisms like SSB taxation in place to put the brakes on the burden of obesity, diabetes and vascular disease is not straightforward. Pointing to the South African experience of getting to the Health Promotion Levy, she said one of the biggest obstacles to implementation of SBB taxation was aggressive push-back from industry.

She said in South Africa they had seen co-ordinated industry opposition mounted against moves to implement the tax. The tax that came into effect in April 2018 was a triumph, but at about 11% is below a WHO-recommended 20% increase.

Thow added that the food manufacturing industry’s multinational footprint and promise of economic prosperity exerts significant pressure on poor and middle income countries where governments welcome industry investment and expansion in their countries.

“Industry concerns regarding SSB tax has a high resonance with policy makers, but the livelihood versus health debate needs to be incorporated into decision making to assess the real cost of a rising obesity epidemic,” Thow said.

She also referred to a trend of governments imposing some form of duty or tax on sugar-sweetened drinks more as a way to generate revenue rather than as an effective mechanism to positively affect public health.

Different taxes linked to the sugar content of beverages should be adopted such as the ones adopted in countries like Mexico, the UK and South Africa. These resulted in increased prices of sugary drinks and encouraged producers to reformulate their products to reduce the sugar content.