Health minister supports the reduction of sugar in sweetened beverages

Currently, the health promotion levy — implemented in April 2018 — is almost half of the World Health Organisation’s recommendation which research has shown could be more effective.

Health minister Dr Zweli Mkhize “supports the principle” of the Health Promotion Levy, commonly known as the sugary drinks tax, his spokesperson Dr Lwazi Manzi told Health-e. 

“The minister cannot proclaim on the actual number as that is the business of Treasury [but] he supports the principle of the sugar tax,” she said.

This comes after Health-e asked Mkhize whether or not he in favour of the World Health Organization’s recommended 20% levy on sugar-added beverages.

“We support that there should be a reduction in the content of sugar in drinks and in consumable foods. All that has to be about the overall culture of getting people to take less sugar and take less starch, try and keep a balanced diet which is healthy and recommended so that we can avoid diabetes,” Mkhize told Health-e.

Mkhize and other health officials were commemorating World Diabetes month, the Minister of Health Dr Zweli Mkhize took to Alexandra township and raised awareness about the impact of diabetes on individuals, families, the health system and society at large. This was in line with this year’s global theme for World Diabetes Day “Family and Diabetes”.

“Every South African has been affected by diabetes — whether directly or indirectly. For those who have experienced or witnessed the complications of this deadly disease, it can be devastating and disruptive for families and communities,” Mkhize wrote in Health-e last week.

In April 2018, government introduced an 11% Health Promotion Levy on all sugar-added beverages. The tax was introduced as a way to discourage people from drinking sugary drinks in an attempt to stem non-communicable diseases (NCDs), particularly diabetes, heart disease and strokes.

But over a year since the levy was implemented, activists and researchers say this is not enough. Mathematical modelling done by the Wits School of Public Health’s research tank PRICELESS SA, published in Plos, indicates that a 20% tax on sugary drinks would result in 220 000 fewer obese South Africans and contribute up to R7-billion in revenue that could be used to fund health initiatives.

Living with Diabetes

Pitso Molemane has been living with diabetes for about 35 years and said people must eat healthily and exercise in order to fight diabetes.  “I have gone under so many complications with diabetes, from minor stroke to your heart attack and all that,” he added. “At that age, I was not even aware of what diabetes is.”

According to Molemane, NCDs such as diabetes are scared of physical activity and healthy eating. But living a healthy lifestyle is a challenge because unhealthy food is easily accessible — especially in low-income black communities such as Alexandra. According to 2018 research published in the South African Health Review, the distribution of healthy food outlets is unfairly skewed towards suburban areas in Gauteng. These areas — mostly populated by affluent residents — have the highest number of stores with healthier food options. The inner city of Johannesburg and in black communities also had a high concentration of fast food outlets.

There are two things that can deal with diabetes, healthy eating as per what the dietician is telling you to do, also exercising a lot, but very important is that you need to take your medication as per the orders of the doctors.

Diabetes is deadly

About 10  000 new cases of diabetes are reported each month. Research shows that non-communicable diseases currently account for more than 40% of deaths in the country. Studies have also shown that the excessive consumption of sugar-sweetened beverages has been linked to obesity, which leads to an increased risk of non-communicable diseases.

Gauteng Health MEC, Dr Bandile Masuku said, diabetes is one of the diseases that continuously burden the province’s health facilities. However, he added, diabetes can be prevented more especially type 2 diabetes because it can be prevented and can be controlled.

Masuku said diabetes awareness is also part of the National Health Insurance (NHI) discussions that are currently underway. “NHI cannot be sustainable if we don’t control some of these diseases like diabetes,” he said.

Mkhize urged all South Africans and their families to adopt and maintain healthy lifestyles by eating healthy meals, exercising frequently and by regular health screening and testing to avoid preventable and manageable diseases such as diabetes.

“Diabetes is now amongst us, what is important is how do we deal with it, we must also learn to be specialists on diabetes, it’s very important to know the symptoms.”

According to Mkhize, if implemented, the NHI will play an integral role in ensuring patients living with diabetes have an uninterrupted supply of medication. “The NHI will create funds for the country to be able to organise the best [chronic] treatment,” he added. Mkhize did not elaborate on how he or the health department envisions the procurement of chronic medicine to operate under the NHI Fund.

The national health department has also launched a new campaign focusing on cancers and diabetes, the aim of the campaign is to encourage South Africans to go to for early screening.

Mkhize said: “There is a new epidemic growing out there. All our [health facilities] are going to be ready with early screening, early information and early interventions in those kinds of diseases.” – Health-e News

Calls for South Africa’s sugary drinks tax to increase intensify

Activists say Treasury and national health department must abide by international health standards for the levy on sugary drinks to be effective in curbing the rise of non-communicable diseases in the country.

Ahead of the midterm budget speech civil society organisations demanded  National Treasury commit to increasing the Health Promotion Levy (HPL), commonly known as the sugary drinks tax, to 20%.

In 2018, the government implemented the 11% HPL on all sugar-sweetened beverages, but activists say this is not enough and the levy needs to be increased to 20% as per the World Health Organization’s recommendation.

Speaking to Health-e, MaryJane Matsolo of the Healthy Living Alliance says the 11% was inadequate to make a difference. “This is not enough to significantly decrease the consumption of sugary drinks in South Africa. Ordinary people need to be protected from the poison which is sugary drinks, ” she says. Currently, Matsolo says, sugary drinks are easily accessible to ordinary South Africans — specifically poor people — who are already susceptible to various non-communicable diseases (NCDs) such as diabetes, stroke and heart disease.

“The issue of NCDs needs political will that’s why we want the minister of finance Tito Mboweni to tell the nation what are the plans to increase the HPL to 20%. We are hoping that the minister and Treasury will take our call into during the midterm budget speech,” she explains. “We will be waiting with expectation next year in February when he ultimately announces what is going to happen to HPL in the budget speech.”

Mboweni made no mention of the levy in his mid-term budget speech. Treasury says that the midterm budget does not make any tax adjustments as that would create uncertainty. But the department says that taxes, such as this one, tax may be increased in the budget speech in February.

Between September and October over 11 000 people countrywide, have signed the petition calling Mboweni to announce increased the levy to 20% from 1st April 2020 which will be its second anniversary.

Higher levy means lower NCDs

The Treatment Action Campaign says increasing the sugary drinks tax is important for the health of South Africans and are supporting the call. “There is no way we can not support this, our people are dying of NCDs just because they don’t know the dangers of the food and drinks they are consuming,” says Simo Sithandabantu, TAC’s provincial manager in Western Cape.

He says he only hopes that government will listen and come back to the people with the expected response “This is a start, there is still a lot to come if the government doesn’t listen we will mobilise all nine provinces and bring everything to stand still,” Sithandabantu told Health-e.

Activists are hoping that their continued call for a WHO-standard levy will not fall on deaf ears.

“In the past three years, we have sent Treasury many submissions and petitions asking for a stronger Health Promotion Levy of 20%. We’re calling on our government to stand up to companies like Coca-Cola who watered down the sugary drinks tax to 11%,” says Lawrence Mbalati, Heala’s progammes manager.

According to National Treasury, the initial proposal was to introduce the levy at 20%, however, Treasury decided to take a phased-in approach of starting at a lower rate and a tax-free threshold. “This was based on the concerns of potential jobs losses which were raised during the consultation process,” Treasury in response to questions sent by Health-e.

The department says when Mexico introduced a tax on soft drinks in 2014, it started at a rate of 1 peso per litre (equivalent to a 10% increase) and this resulted in decreases in consumption of sugary beverages.

Responding to whether are there any plans to increase the tax to 20%, Treasury says it normally reviews their tax policy interventions after few years of implementation and make adjustments where it is necessary.  Similarly, the HPL will be subjected to a review process in the future. – Health-e News