Global experts unite for sugary drinks tax in SA

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Scholars and academics from leading universities around the world have added their voices to the call for the implementation of a tax on sugary drinks in South Africa.

Signatories to an open letter in support of the tax from the Harvard Chan School of Public Health, Johns Hopkins Medical Institution, New York University, University of London, Wits University, University of Cape Town, Stellenbosch University, Oxford University, Mexico’s Instituto Nacional de Salud Pública, and public Health Associations from South Africa, Australia and Quebec among others, have stated that the science on the role of SSBs is clear – excess sugar consumption is a major cause of obesity and its related diseases.

They have expressed strong support for taxation of sugary drinks in South Africa as a critical highly effective measure and part of a broader programme to address these issues. They maintain that excess sugar consumption is a major cause of obesity and its related diseases, as excessive sugar intake causes increased risk of diabetes, liver and kidney damage, heart disease, and some cancers.

Between 2001 and 2015, sales of sugary drinks in South Africa grew by over 65%, reaching 262ml per capita per day. Simultaneously, between 1998 and 2012, obesity grew from 30.0% to 39.2% among women, and from 7.5% to 10.6% among men.

The World Health Organization (WHO) and the World Cancer Research Fund recommend that people should consume no more than 10% of total calories from added sugar, and preferably less than 5%.

In a situation where the country’s health system is unable to cope with demand and health resources are focused more on cure than prevention, sugary drink taxes are a winning solution for governments as they reduce consumption while increasing revenue. Studies have demonstrated a 20% tax on sugary drinks in South Africa could reduce obesity prevalence by 3.8% among men and 2.4% among women, and raise annual revenues of R6.4 billion which could be used to address obesity and related diseases. The tax also increases consumption of healthier beverages, such as water and milk.

Sugary drink taxes are particularly effective among lower income consumers, who are more responsive to price increases and who often suffer disproportionately from the ill effects of obesity.

Globally, taxes have clearly worked. Mexico had the world’s highest intake of sugary drinks. After a modest tax of 10%, the country experienced a meaningful price increase and a significant reduction in sugary drink purchases. Its tax most significantly reduced consumption among lower-income and high-volume consumers, thus achieving health benefits among the two groups with the greatest health risk.1 After the tax was in effect for one year, sugary drink purchases among the poorest third of the population were reduced by 9%.2 In the second year of the tax, contrary to industry pronouncements, per capita sales and purchases of sugary drinks declined further above the yearlong decline. After the tax, Mexican research showed that consumers were replacing sugary drinks with healthier beverages like water.2

Even in high income, lower sugary drink-consuming Berkeley California, USA, the tax had positive impacts on reducing frequency of sugary drink consumption and increasing water consumption frequency.3

The WHO and other global experts recommend that sugary drink taxes should be 20% or greater in order to be most impactful.4-7 Governments in the UK and many other locations are now promoting 20% or higher sugary drink taxes as an essential strategy for achieving major health benefits.5,8-10

It is critical to note that any tax of sugary beverages should include all forms-sodas, energy drinks, fruit juices, waters, sports drinks, powders and concentrates.

Signed by:

  1. Barry M. Popkin
  2. R. Kenan, Jr. Distinguished Professor of Nutrition
    University of North Carolina
  3. Carlos A. Monteiro, MD, PhD
    Professor of Nutrition and Public Health
    Department of Nutrition, School of Public Health
    University of São Paulo
  4. Ricardo Uauy, MD, PhD
    Professor and former Director INTA
    University of Chile
  5. Juan Rivera Dommarco, PhD
    Director, Centro de Investigacion en Nutricion y salud
    Instituto Nacional de Salud Pública
    Mexico
  6. Carlos A. Aguilar Salinas
    Investigador en Ciencias Médicas F
    Instituto Nacional de Ciencias Medicas y Nutrición
  7. Walter Willett, MD, DrPH
    Professor of Nutrition and Epidemiology
    Harvard Chan School of Public Health
  8. Frank Hu, MD, PhD
    Professor of Nutrition and Epidemiology
    Harvard Chan School of Public Health
  9. Carlos A. Camargo, MD DrPH
    Professor of Emergency Medicine & Medicine
    Harvard Medical School
    Professor of Epidemiology
    Harvard School of Public Health
  10. Lawrence J. Appel, MD, MPH
  11. David Molina, M.D., M.P.H. Professor of Medicine
    Professor of Medicine, Epidemiology and International Health
    Johns Hopkins Medical Institutions
    Chair, AHA Lifestyle and Cardiometabolic Health Council
  12. Barbara J. Moore, PhD, FTOS
    President Emeritus, Shape Up America!
  13. Marion Nestle
    Professor of Nutrition, Food Studies, and Public Health
    New York University
  14. John D Potter MD PhD
    Professor Emeritus of Epidemiology
    University of Washington
    Seattle, WA, USA
  15. Michael I Goran, PhD
    Director, Childhood Obesity Research Center
    Co-Director USC Diabetes and Obesity Research Institute
    Professor of Preventive Medicine; Physiology & Biophysics; and Pediatrics
    The Dr. Robert C & Veronica Atkins Chair in Childhood Obesity & Diabetes
    USC Keck School of Medicine
  16. David L. Katz, MD, MPH
    President, American College of Lifestyle Medicine
    Founder, True Health Initiative
  17. Tim Lobstein
    Director of Policy
    World Obesity Federation
  18. Professor Corinna Hawkes
    Centre for Food Policy,
    City University of London
  19. Professor Tim Lang
    Centre for Food Policy,
    City University of London
  20. Mike Rayner BA, DPhil
    Professor of Population Health,
    Director, British Heart Foundation Centre
    Nuffield Department of Population Health,
    University of Oxford,
  21. Michael Moore
    CEO: Public Health Association of Australia
    President: World Federation of Public Health Associations
  22. Lucie Granger
    Executive Director Québec Public Health Association

From South Africa

  1. Public Health Association of South Africa
  2. World Federation of Public Health Associations
  3. South African Paediatric Association
  4. Rural Health Advocacy Project
  5. SECTION27
  6. The National Council Against Smoking
  7. Professor Laetitia Rispel
    HOD, School of Public Health, University of the Witwatersrand
  8. Sundeep Ruder
    Endocrinologist
    Associate Lecturer, University of the Witwatersrand
    Honorary Consultant, Charlotte Maxeke Academic Hospital
  9. Professor Stephen Tollman
    Director, MRC/Wits Rural Public Health and health Transition Unit (Agincourt)
    School of public Health, University of the Witwatersrand
  10. Professor Kathleen Kahn
    MRC/Wits Rural Public Health and health Transition Unit (Agincourt),
    School of public Health,
    University of the Witwatersrand
  11. Karen Hofman
    Professor and Director
    PRICELESS SA
    School of public Health, University of the Witwatersrand
  12. Aviva Tugendhaft
    Deputy Director,
    PRICELESS SA
    School of public Health, University of the Witwatersrand
  13. Nicholas Stacey
    Health Economist
    PRICELESS SA
    School of public Health, University of the Witwatersrand
  14. Mpho Molete
    Chair of PHASA
    Dental Public Health Group University of Witwatersrand
  15. Nadia Mohamed
    Department of Paediatric Dentistry,
    University of the Western Cape
  16. Professor Mohamed Jeebhay
    HOD and Director,
    School of Public Health and Family Medicine,
    University of Cape Town
  17. Professor Julia Goedecke
    Non-communicable Disease Research Unit, SA Medical Research Council
  18. Yussuf Saloojee
    Executive Director, National Council Against Smoking
  19. Veerasamy Yengopal
    HOD, Community Dentistry, University of the Witwatersrand
  20. Professor Sudeshni Naidoo
    Chair, Alliance for a Caries Free Future (ACFF), South African Chapter
  21. Professor Usuf Chikte,
    Executive Head, Department of Interdisciplinary Health Sciences, University of Stellenbosch
  22. Centre for Diabetes and Endocrinology (Pty) Ltd (CDE – Your Partner in Diabetes

References

  1. Ng SW, Rivera J, Popkin B, Colchero M. Did high purchasers respond differently to the excise tax to sugar sweetened beverages in Mexico. Cuernevaca and Chapel Hill: INSP-UNC; 2016.
  2. Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study.BMJ.2016;352.
  3. Falbe J, Thompson HR, Becker CM, Rojas N, McCulloch CE, Madsen KA. Impact of the Berkeley excise tax on sugar-sweetened beverage consumption.Am J Public Health.2016;106(10):e1-e7.
  4. WHO Regional Office for Europe (Nutrition Physical Activity and Obesity Programme ). Using price policies to promote healthier diets. In: Lifecourse DoNDat, ed. Brussels: WHO European Regional Office; 2015:41.
  5. Briggs ADM, Mytton OT, Kehlbacher A, Tiffin R, Rayner M, Scarborough P. Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study.BMJ.2013;347.
  6. Long MW, Gortmaker SL, Ward ZJ, et al. Cost effectiveness of a sugar-sweetened beverage excise tax in the U.S.Am J Prev Med.2015;49(1):112-123.
  7. Veerman JL, Sacks G, Antonopoulos N, Martin J. The impact of a tax on sugar-sweetened beverages on health and health care costs: A modelling study.PLoS ONE.2016;11(4):e0151460.
  8. Encarnação R, Lloyd-Williams F, Bromley H, Capewell S. Obesity prevention strategies: could food or soda taxes improve health?J R Coll Physicians Edinb.2016;46(1):32-38.
  9. Boseley S. Doctors demand a 20% tax on sugary drinks to fight UK obesity epidemicThe Guardian2015.
  10. Donnelly L. Gordhan announces sugar tax.Mail & Guardian2016.

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Every South African has a right to access clean drinking water and healthy food. HEALA is an alliance of organisations with this mission in mind.

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