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Sugar poison — The case for a higher tax on sugar-sweetened beverages

Sugar poison — The case for a higher tax on sugar-sweetened beverages
Lillian Roberts
By Lillian Roberts
23 Mar 2025
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At a recent Daily Maverick webinar experts unpacked the Health Promotion Levy, how much added sugar people should consume daily, the fiscal and health benefits of increasing the tax, and whether there should be a department of food in the South African government. 

“Free sugar” in sugary beverages such as sodas and fruit juices are dangerous because people don’t realise how much sugar they are drinking, attendees heard at a recent Daily Maverick webinar on the Health Promotion Levy.

https://www.youtube.com/watch?v=tYrAb0RDaws

“The quickly absorbed sugar triggers bodily processes which can cause fat to build up around the organs, make the body resistant to insulin and lead to weight gain,” said moderator Zukiswa Pikoli, managing editor of Maverick Citizen, as she introduced the two panellists: Mikateko Mafuyeka, legal adviser for Africa at the Global Health Advocacy Incubator, and Angelika Grimbeek, policy and research manager at the Healthy Living Alliance. 

Pikoli added that diabetes is the second-biggest killer in the country, and the cost of treating diabetes in the public healthcare sector is about R2.7-billion a year. 

“The Health Promotion Levy [HPL] was introduced in 2018 taxing the amount of extra sugar added to sugar-sweetened beverages at 10%. The World Health Organisation [WHO] has recommended that a tax of at least 20% on all sugary drinks be placed as an effective tool to help reduce consumption and curb related health risks. If tax is 20% as per WHO recommendation, it could generate R5.4-billion a year and fund our struggle in the healthcare system,” Pikoli said. 

In the 2025 Budget presentation on 12 March, the government proposed cancelling any increase to the Health Promotion Levy to allow the sugar industry more time to restructure in response to regional competition.

“These are life-changing conditions. So we really need interventions in place from a national government level that can actually help curb these diseases and start controlling them better,” Grimbeek said.

Given that the HPL has not been increased, despite original proposals to gradually increase it over the years, Mafuyeka said: “We’ve gotten to a point where we don’t know who drives the policy objectives in South Africa anymore.” She wondered if the cancellation of the increase is government-based, a Treasury decision or influence from industry.

What is the HPL actually for? 


Grimbeek highlighted that the HPL does not tax the table sugar South Africans buy for cooking or adding to their tea and coffee. The HPL, or the sugar-sweetened beverages (SSB) tax, is a tax on the sugar content within sugar-sweetened beverages. 

All fizzy drinks, energy drinks and concentrates are taxed under this levy, as well as some milk-based sugar-sweetened beverages. 

“We are waiting for Treasury to release a statement about this and to actually expand the Health Promotion Levy to include fruit juices. I think a lot of people don’t really see fruit juices as unhealthy. There is this misconception that they are a healthy alternative to other drinks,” Grimbeek said. 

“The truth of the matter is that fruit juices are just as bad for us because of the sugar content.”  

She explained that sugar-sweetened drinks are also ultra-processed products, which significant evidence has shown to be problematic for human and planetary health. 

“Ultra-processed products, in a nutshell, are products that are made in a factory where […] by the time that it’s processed so much, we don’t even really know what the actual food ingredient was that created it. So although it might be in the label or something, it’s not a food anymore. It’s actually just a product.” 

Grimbeek added that packaged foods contaiN stabilisers and chemicals, along with ingredients high in sugar, salt, and fat, a combination that makes these foods quite addictive.

She said that over the last 20 years there’s been a nutrition transition from healthier foods to the consumption of sugar-sweetened beverages and food products that are bad for our health. She put this down to two reasons  – food and beverage manufacturers are really good at making sure their products are sold, so they are marketed heavily; and the products are extremely accessible – from spaza shops in rural areas to every retail outlet in urban areas. They’re even sold on transportation. 

How is sugar taxed? 


Pikoli asked Grimbeek to sketch what happens to a person’s body when consuming excess sugar and how this ends up being a public health crisis.

Manufacturers want to sell products, so they are going to make them as tasty as possible, and one way to make something tasty is to add sugar, Grimbeek explained. 

“Especially for younger children, to get them hooked on sugary drinks from a young age is a very clever marketing tactic, to get to consumers for life. So we really do need to also remember that the risk is not just for the adults that are often the people that develop the diseases, even though younger adolescents are starting to develop non communicable diseases.” 

Free sugars refer to the added sugars that have been put into drinks, she said, and the WHO has recommended that only 5–10% of our daily energy intake should come from free sugars. 

“Just to put that in a bit of perspective, that means about 12 teaspoons for an adult of sugar, and then nine teaspoons for a child. And again, this is now the maximum level. We shouldn’t actually have any free sugars. But if we look at a can of fizzy drink, […] usually, even with all of these reductions that we’ve seen in the amount of sugar that’s in them, there’s still about 40g in a can, which is about 10 teaspoons. So even just one can of these drinks already reaches our daily maximum limit,” Grimbeek said. 

She explained that SSBs such as fizzy drinks represent empty calories: there is no nutritional benefit to them. 

“A lot of people will not compensate for the amount of sugar that they’ve received by drinking a sugary drink with them changing something in their diet for the day to reduce the amount of other sugar.

“Here prevention is better than cure, and we need a preventative measure like the Health Promotion Levy in place and implemented at the best level to be able to see the results we want to see.”

How should the government intervene? 


“I think the government has to push for policies that improve the health and the lives of all South Africans. Policies, regulations and laws that create a healthy food environment, because South Africans make choices based on what’s accessible to them and they live in the realities of the food environment in which they exist,” Mafuyeka said. 

She said that there are still parts of the country where people can’t access water, but if you walk into a shop there are SSBs. 

“We also need to move away from looking at the issue as an individual choice, and one of we need an enabling environment. That starts with policies such as HPL, and other policies that promote health and a healthy environment, like Front of Package Warning Labels,” Mafuyeka said, referring to draft regulation R3337. 

She said policy objectives like the HPL need to be driven by the government and not industry. 

“At the end of the day, it’s going to be everyday South Africans and poor South Africans that have to bear the brunt of it. We have these multinational companies or these big corporations who then take the profits and leave the public sector, the health sector, which is already struggling with having to manage non-communicable diseases,” Mafuyeka said. 

The Department of Health’s mandate is to strengthen, sustain and protect health regulations and policies that ensure a healthy food environment, Mafuyeka noted. 

Pikoli asked Mafuyeka if an increase to HPL is appropriate, considering citizens are already financially overburdened. “Wouldn’t adding an additional tax or increasing a tax further burden people?” 

Mafuyeka said the HPL’s purpose is to promote health, but it also generates revenue. 

In the first two years the levy generated R5.8-billion, and since then it has generated more than R10-billion, she said, adding that the revenue can be used, whether it’s for the National School Nutrition Programme, or for social grants. If the HPL had been gradually increased annually, billions generated could have gone towards social assistance. 

“I would like for South Africans to look at it as two things; it’s best for health, it’s best for government because it generates revenue, and it’s also put in place not to punish you as an individual, but to force industry to reduce the sugar content in the SSBs, and also to generate revenue that can be for Health Promotion measures by the Department of Health,” Mafuyeka said. 

Industry issues 


The industry has repeatedly denied allegations of interference and consistently blames the HPL for its troubles.

Mafuyeka said the sugar industry’s struggles have less to do with the HPL, and more to do with corruption within the industry leading to job losses, as well as their failure to diversify crops and pivot away from fossil fuels, “something that they stated in their own sugar masterplan that they will be doing”. 

“So it becomes a situation whereby it’s almost as if industry needs and wants prevail over the health benefits of having the Health Promotion Levy right, the revenue generation benefit of increasing the HPL gradually throughout the years.” 

Mafuyeka asked if industry is in the policymaking seat, rather than the Treasury or Health Department. 

“This also links into what happened when we were first introducing the Health Promotion Levy in South Africa. It was delayed for years because there were instances of backdoor meetings, industry trying to have the rate at a lower amount, which is what we ended up getting in the first place when it was introduced. We had asked for 20%, but we got 10% then it went to 11% and it has been stuck there.” 

Mafuyeka said the HPL IS at risk of being rendered ineffective, with inflation rising, but the levy not increasing over the years.

“We’ve also seen that there’s heavy lobbying by industry,” she said. 

Industries, like the tobacco industry, are also using the threat of  litigation, in South Africa and outside, to stall, delay or overturn policies that protect people’s health, Mafuyeka said. In some cases, courts have stepped up to say the right to health or a healthy environment outweighs the rights of a producer, industry or businesses. 

“So we need to apply pressure on the government to say you are moving away from your mandate. Industry’s mandate is to maximise profits for the shareholders. That will always be an objective. Therefore, we cannot have their voices be the loudest. We cannot help them having this level of access and say or control when it comes to health policies and policies that are meant to better the lives of all South Africans.”

“Do we need a Department of Food?" asked Pikoli. 

Grimbeek said she did not want to say a loud yes. 

“But I think you are picking up on something very important, how nutrition does need to be part of the agenda when it comes to policies. And I think for so many years in South Africa, it’s sort of always alluded to, and it’s mentioned, but it’s never taken that seriously,” Grimbeek said. 

She said there’s been a shift recently questioning how hunger can still be an issue in a middle-income country, why children are dying of malnutrition and why stunting is still an issue. Grimbeek thinks the Presidency needs to come together with a plan to counter hunger. 

She said in the buildup to the budget speech there was a lot of opposition against the HPL, stating that it hasn’t reaped the rewards South Africa wanted to see. She said the HPL was implemented only in 2018, and the long-term health effects will take a long time to see, with commitment from the government and numerous types of interventions. 

“There’s lots of evidence that’s shown that it has actually changed consumer behaviour. So there’s been a reduction in specific areas, in specific socio-economic classes, especially in the poorer classes, where there’s been a decrease in the amount of sugary beverages consumed,” Grimbeek said. 

There’s also been a reformulation of products which have less sugar or zero sugar options, she said, while noting that there’s still a debate about whether zero-sugar SSBs are healthy. 

“In the context of South Africa […] whenever there’s a mention of a commission or another department, South Africans say it’s just another way for money to be misused by government,” Mafuyeka said.  

She highlighted the alarming combination of obesity and non-communicable diseases alongside hunger, malnutrition and stunting, as well as food deserts. She said the issue warrants a conversation within the Presidency, and that civil society and organisations should have the support of citizens. 

“The issue of food is very political … and it’s something that needs to be front and centre on an agenda of a government department.” DM

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