Levy on sugary drinks having an impact

THREE years ago, South Africa introduced Africa’s first major tax on sugar-sweetened beverages based on grams of sugar. The tax stands at about 11% of the price per litre.

We assessed the impact in recently published research. We found that the health-promotion levy coincided with large reductions in purchases of taxable beverages, in terms of volume and sugar quantities. We didn’t find significant changes for non-taxable beverages.

This isn’t the first research to show positive outcomes from the levy. A national study one year after it was introduced found households in urban areas halved the volume of sugary beverages they bought, cutting their sugar intake by nearly a third.

Research shows that excess sugar, particularly in liquid form, is a major cause of obesity and is a risk factor for diseases like type 2 diabetes, hypertension, heart disease, many common cancers and tooth decay. Recognising this danger, the World Health Organization (WHO) has recommended that individuals should consume no more than 10% of total calories from added sugar, and preferably less than 5%.

Carbonated sugary drinks play a major role in making these numbers hard to attain. A 250ml cooldrink contains upwards of 26g of sugar – more than half the daily recommended limit.

Sub-Saharan Africa faces a tidal wave of diet-related noncommunicable diseases, with rapidly rising intake of sugar-sweetened beverages and other ultra-processed foods. South Africa, in particular, has a heavy burden of these noncommunicable diseases.

While other countries in sub-Saharan Africa have levied sugar-sweetened beverage taxes, South Africa is the first country in the region to evaluate such a policy. Our results clearly show positive changes that could offer useful public health gains across the region. The reductions in sugar from taxable beverage purchases suggest a potential role for sugar-based taxes more broadly.

South Africa’s levy showed that in 2018 the country was prepared to put the health of the public first.

But the government has failed to capitalise on the early gains, despite the evidence that’s been presented to it about the impact of the levy on consumption patterns. An example of this is that it has not raised the rate at which the tax is imposed.

Health experts had been lobbying for an increase to 20% – the levy recommended by the WHO. No country in the world has reached this benchmark. Nations are getting only part of the benefits in terms of preventing obesity. This matters to the future health of children.

Some forecasts suggest South Africa will have the 10th highest level of childhood obesity by 2030, affecting more than 4 million children.

The campaign to get the levy increased is based on the growing body of research showing that sugar is addictive, that it is harmful to people’s health and that it is overwhelming the country’s health system.

The government can save lives and reduce the numbers of people who develop diseases by taking three very simple steps. First, it needs clear regulations. Second, it needs preventative strategies. Third, it needs watertight policies for reducing consumption of unhealthy foods. Increasing the health promotion levy, introducing mandatory front-of-package labelling and banning the marketing of unhealthy products to children should be at the top of the priority list.