Budget 2025: Godongwana has shown complete contempt for ordinary people living in South Africa. 

Press Statement

12 March 2025

For Immediate Release

The Healthy Living Alliance (HEALA) is deeply disappointed with Finance Minister Enoch Godongwana’s decision to capitulate to industry’s demands. 

The decision to hike the value-added tax (VAT) instead of increasing the Health Promotion Levy (HPL) flies in the face of scientific evidence, which shows that the increase of the HPL is vital lifesaving intervention and an easy way to boost the fiscus. Godongwana has shown complete contempt for ordinary people living in South Africa. 

The proposed increase in VAT is a regressive measure. Indeed, leading voices on tax justice have indicated how its increase will bring thousands, if not close to millions, in our country closer to poverty and economic disaster. 

We have lost an opportunity to save the lives of thousands of South Africans.  We have lost the opportunity to protect the most vulnerable amongst us, the poor. Since its inception in 2018, the levy has contributed R10bn to the fiscus and has the potential to do more. This is money which could be spent on various health promotion interventions.

Treasury itself identified the levy as a tool reduce obesity and non-communicable diseases, an out-of-control epidemic in South Africa costing the state billions of Rands in health care and affecting low-income members of our society the most. 

This missed opportunity will cost millions of South Africans their lives, their welfare and their finances. It is the responsibility of the government to protect the lives and overall wellbeing of the people it serves, not coddling an industry which has been taking advantage of the government’s good will. 

The decision to implement a further moratorium after the Finance Minister’s decision in 2023 to place a two-year moratorium on an increase of the HPL points to the government’s leniency to the sugar industry and its continued decision to pander to minority interests. It is very clear that the sugar industry is being treated with kid gloves. This is despite evidence of mismanagement and graft which has caused more damage to the industry than the HPL ever could.  We demand Treasury to reevaluate its decision and follow the science. 

 “It is deeply disappointing that the minister missed an opportunity to increase  HPL to 20% to boost the fiscus and instead chose the option to rather increase VAT, which will hit hard in the pockets of the poorest of the poor, who are the most affected by non-communicable diseases (NCDs) and will put a strain on the health system. We all are experiencing non-communicable diseases in one way or the other. Either oneself, relative, family member, friend, colleague are who is living or have lost their lives due to diabetes, heart diseases or cancer. It has become clear to the Minister of Finance that the lives and livelihoods of South Africans are less important than the profits of the sugar industry. It is obvious that the sugar industry, like it’s counterparts in the alcohol and tobacco industry, will continue to disregard the effects their products  have on South Africans”, says Nzama Mbalati, HEALA CEO. 

South Africans are dying and will continue to do so unless urgent intervention takes place. HEALA will continue to fight for the realisation of Food Justice For ALL!

About HEALA: 

For media interviews contact

Zukiswa Zimela Communications Manager HEALA 

0745210652 | zukiswa[@]heala.org

Press Statement: The TRUE Cost of Diabetes

This World Diabetes Day, celebrated annually on 14 November, Healthy Living Alliance (HEALA) wishes to draw attention to diabetes care, as well as urge the government to continue reinforcing those policies that contribute towards lessening the plight of those living with this non-communicable disease. 

Diabetes affects 12% of the adult population in South Africa, and is the second leading cause of death after tuberculosis. Left untreated or detected late diabetes can wreak havoc on individuals’ health and livelihoods, as well as the national fiscus. Diabetes, for diagnosed patients alone, costs South Africa’s health system about R2.7 billion. Severe complications associated with diabetes range from loss of sight, strokes, and amputation of legs to heart conditions, nerve damage, and kidney problems – to name a few.

One of those affected by this life-changing disease is Alinah. In 2010, Alinah was diagnosed with diabetes. Following the diagnosis, the sixty-four-year-olds life changed forever when her leg was amputated. Alinah attributes her condition to a poor diet and the over-consumption of sugar-sweetened beverages. 

HEALA fully supports the 2024 World Diabetes Day theme: ‘Diabetes and Well-being’, and further casts a spotlight on the Health Promotion Levy (HPL) being a pivotal first step in ensuring that store and supermarket shelves lessen the temptation of sugar-sweetened beverages for consumers. 

“It is no coincidence that we are seeing the growing epidemic of diabetes in South Africa. In townships, villages and some urban areas, supermarkets are saturated with vigorously marketed, cheap sugary drinks – the likes of energy drinks, fruit juices, and fizzy drinks. In some areas, particularly where there is limited access to clean running water, people opt to quench their thirst with sugary drinks because some can be as cheap as below R10. Therefore, it is important that we enable consumers to move to healthier alternatives instead of resorting to sugary drinks as an easily-accessible option,” notes HEALA CEO Nzama Mbalati. 

The South African government introduced the HPL in 2018 to curb the consumption of sugary drinks – which are widely known to be associated with ill health. “On the one hand, consumers are exempted from HPL when they do not purchase sugary drinks. On the other hand, it is an opportunity for manufacturers to reduce the sugar content in their products, which then exempts them from paying the levy,” explains Mbalati, adding that HPL is a proven success, per research studies conducted in the townships of Langa and Soweto. “The studies found a two third reduction in the consumption of sugar-sweetened beverages, particularly among the youth and adults, since the inception of HPL six years ago.”

If the HPL is increased and expanded, the number of people like Babalo, who says his love of sugar-sweetened beverages is one of the things that led to his amputation could be reduced. The 50-year-old has diabetes and high blood pressure. These illnesses could be caused by drinking too many sugary drinks. He says he supports raising the tax. 

“I appreciate the government’s efforts to make fizzy drinks more expensive because they are trying to save people from diabetes,” he says.

HEALA is calling on the government to protect the HPL and increase this life-changing intervention to 20% and expand the levy to include 100% fruit juices to the lives of ordinary South Africans. 

Ends.

WATCH THE TRUE COST OF DIABETES

OP-ED: Sugar tax’ a huge success in curbing sugar consumption and promoting public wellness

The evidence is undeniable: the Health Promotion Levy, enacted in 2018 to combat South Africa’s soaring rates of diet-related diseases, delivered on its promise. Multiple studies have demonstrated that the tax has successfully reduced both sugary drink consumption and overall sugar intake. 

READ MORE: Media Statement: No evidence that the Health Promotion Levy has led to job losses

In the first year alone, the volume of sugary drinks purchased plummeted by half, leading to a nearly one-third drop in sugar consumption. At the same time, South Africans turned to healthier options, replacing fizzy drinks with non-taxed options like water or diet beveragesThese findings have been validated by peer-reviewed journals and industry alike. 

Cost-effective

Around the world, governments and international organisations have recognised that taxing sugary drinks is a simple, cost-effective way to promote public health. From the UK to the US to Mexico, these taxes have reduced sugary drink consumption without hurting the economy. In five US cities that implemented sugary drink taxes, sales of these drinks dropped and the trend continued over time. 

This op-ed was first published in the Daily Maverick on the 1st of November 2024. To read the entire article please click here.

This World Heart Day, the Healthy Living Alliance (HEALA) is calling on the government to take the health of South Africans to heart.

One in 3 South Africans suffer from some form of cardiovascular disease and heart disease and hypertension are in  listed in top ten causes of death in the country. A 2020 study  published in the European Heart Journal – Quality of Care and Clinical Outcomes journal highlighted poor diet as one of the leading contributors to heart disease deaths around the world.

The over consumption of an unhealthy diet is one of the leading causes of death for millions of people around the world.  Now more than ever, South Africa needs strong evidence based regulations to protect us from life threatening noncommunicable diseases such as cardiovascular disease.

Pre-packaged foods and beverages, high in salt, sugar and saturated fat have increasingly become readily available in virtually every community around the world, with South African shops inundated with these pre-packaged foods that are processed with high levels of added sugars, salt, and saturated fats. Research has found these nutrients are connected to increased obesity and chronic nutrition-related diseases.

“More than six million deaths [globally] could be avoided by reducing intake of processed foods, sugary beverages, trans and saturated fats, and added salt and sugar, “researchers found.

Front of pack warning labels are among the tools recommended by the World Health Organisation aimed at reducing the consumption of foods high in salt, sugar and saturated fat. Earlier this year the National Department of Health (NDoH) released for public comment draft regulations on the implementation of mandatory front of pack warning labels. According to the proposed regulations, all foods and beverages that have added salt, sugar or saturated fat and fall within “high in” thresholds or contain any non-sugar sweetener will have a black and white triangle warning on them to alert consumers.

The country cannot afford a delay in the implementation of the mandatory front of pack warning labels regulations. HEALA is calling on key decision makers to prioritise the health of South Africans.

“We calling on the National Department of Health to lead by its own mission “to improve health status through the prevention of illness, disease and the promotion of healthy lifestyles, and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability”,” says Nzama Mbalati, Programmes Manager at HEALA.

The consumption of sugar sweetened beverages has also been linked to an increased risk of heart diseases. In a bold move by the South African government, the country blazed a trail as the first African country to legalise a tax on sugary drinks, in order to reduce the consumption of these products. However, in a series of decisions which favour the sugar industry, including putting a moratorium on an increase of the tax until 2025, National Treasury has threatened the efficacy of the regulation and put people’s health at risk.

“Industry often uses its economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence government inaction in order to propagate the sale and distribution of its deadly products. We cannot allow the continuation of putting profits over people,” Mbalati says.

END

About HEALA’s advocacy work in South Africa:

HEALA is a coalition of civil society organisations advocating for equitable access to affordable, nutritious food in South Africa by building a more just food system. Because government policy forms a crucial part of the South Africa’s food system, HEALA believes that hunger, food insecurity and malnutrition are policy choices.

HEALA advances the right to food by advocating for more just food systems in South Africa. We do this by acting as a platform for organisations and communities to organise around the realisation of the right to affordable and nutritious food. Through our campaigns, we help amplify the voices of people on the ground to ensure that they are heard by those in power at a local, provincial and national level.

HEALA’s vision is a South Africa in which all people have equitable access to healthy food to unlock their full potential.

For more information about HEALA’s advocacy work, please visit: www.heala.org

Media Contact
Zukiswa Zimela, Communications Manager
zzimela@heala.org; 0745201652

South Africa can show BRICS leadership with a new sugar approach

South Africa blazed a trail as the first African country to legalise a tax on sugary drinks, making a bold stand on 1 April 2018. By implementing this pioneering move, we paved the way for a strategy that could reduce the consumption of sugar-sweetened beverages significantly.

Studies by the World Health Organization (WHO) show that a carefully designed tax, aimed at increasing the retail price by 20% or more, would result in proportional reductions in consumption, steering citizens towards healthier choices.

READ MORE: WE Can’t Rely On Food and Beverage Industry to Safeguard Our Health.  

Not long after South Africa’s groundbreaking action, other countries, including Botswana and Zambia, followed suit, implementing their own versions of the sugary drinks tax. However, the road to a healthier society has not been smooth. Many African nations have been slow to act, potentially because of resistance from the beverage industry, which has been fighting back vehemently against these new regulations.

South Africa’s courageous step may have set the stage for a broader transformation, sparking a debate on how to combat obesity and promote healthier living. But the struggle against industry pushback and the adaptation of these laws across the continent continues.

This opinion piece was published in the Daily Maverick on the 29th of August 2023

Click here to read the rest of the article.

#CoronavirusSA: Diabetes inaction will cost lives

Integrating diabetes testing and prevention strategies into the country’s Covid-19 response plans are key to reducing the mortalities the country may face, writes Karyn Maughan.

Diabetes – a life-long condition in which the body either cannot make enough insulin or cannot effectively use what it produces – is on the rise in South Africa, with the International Diabetes Federation (IDF) reporting that the country has highest proportion of adult diabetics on the continent. According to the 2019 report on mortality and causes of death by Statistics South Africa, diabetes is the second deadliest disease in the country. It has killed more people than HIV, hypertension and other forms of heart disease.  

Last year, the IDF released a study finding that the number of South Africans diagnosed with the disease had more than doubled from 2017, to a staggering 4.5million people. Frighteningly, the diabetes advocacy organisation also found that, in their Africa regional network, South Africa had registered the greatest number of deaths due to diabetes on the continent. 

Type Two diabetes, in particular, clearly constitutes a potentially devastating crisis for South Africa’s already fragile public health care system. The IDF’s 2019 Diabetes Atlas shows that 12.7% of adults in South Africa had diabetes in 2019, a 137% increase on the 2017 figure of 5.4%. The report also bolstered the findings of a forecasting study published in the Lancet in 2018, which predicted that diabetes would be the leading cause of death in South Africa in 2040.  

Covid-19 compounds diabetes issues 

That threat has now been exacerbated by the fact that diabetics are identified as a group of people most vulnerable to severe or deadly outcomes if infected with Covid-19. 

But, it would appear, government has done little to nothing to make information on the numbers of diabetics who have been infected with Covid-19 or how many diabetics have died as a consequence of the virus publicly available – although, it would appear that this information is accessible to the state.  

In early May, Health Minister Zweli Mkhize stated that an as-yet undisclosed analysis of hospitalised patients showed that “consistent with evidence emerging worldwide, hypertension, diabetes and cardiac disease are the three most common comorbidities associated with serious illness from Covid-19”. Weeks later, Western Cape premier, Alan Winde revealed that, of those people who had died in the province to date, 96% had an underlying health condition such as HIV, diabetes, hypertension and tuberculosis. 

Health-e News sent questions to the health department about whether government had done any research on the numbers of diabetics who had died from Covid-19 or its complications, and whether the state had any strategy to test people for diabetes during its Covid-19 testing process. The IDF estimates that two-million South Africans are ignorant of the fact that they have the disease. Arguably, improved screening for diabetes can significantly improve the prospects of such people surviving Covid-19 – particularly when uncontrolled diabetes constitutes such a significant threat for coronavirus patients. 

At the time of publication, the health department had not responded to these questions, despite promising to send them to a resident expert on diabetes. 

Diabetes not a priority 

Up until now, the only in-depth South African research available on the impact of Covid-19 on diabetics has been done by Discovery Health. In May, it released information about the 1733 coronavirus cases reported across its schemes.  

Discovery Health chief executive officer Ryan Noach, said that high risk members tend to be the elderly, and members living with chronic diseases, like diabetes. But the data contained in the report provides no real insight into the vast majority of South Africa’s diabetics: those who are unable to afford private health care and depend on state facilities for care and treatment. 

What’s also apparent is that the state has not, as it has done with smokers, made any attempt to mitigate the risks faced by diabetics with targeted interventions aimed at improving their blood sugar control – a step shown to profoundly reduce the risks of serious Covid-19 outcomes for diabetics.  

This may be because the number of diagnosed diabetics in South Africa is dwarfed by the eight million-strong population of smokers. But, while the debate about the risks of severe Covid-19 infection and death in smokers continues to rage, global research has clearly shown that poorly controlled diabetics are in significant danger of death from Covid-19.  

The Centre for Diabetes and Endocrinology note that, “the problem people with diabetes may face, is primarily a problem of worse outcomes, not a greater chance of contracting the virus. When people with diabetes do not manage their diabetes well and experience fluctuating blood glucose levels, they are generally at risk for a number of diabetes-related complications. And, in general, as a population, people with diabetes do face a higher chance of experiencing severe symptoms and serious complications when infected with any virus and with Covid-19.” 

This has clearly not escaped the attention of organisations fighting for the ban on smoking to be lifted. In papers filed at the Pretoria High Court, the Free-Trade and Independent Tobacco Association accused government of not being consistent or proportional in its decision to ban the sale of cigarettes and tobacco during South Africa’s Covid-19 shutdown but not to place any restrictions on the sale of junk food and sugary drinks – which constitute, they argue, a threat to diabetics. It was an accusation that Cooperative Governance and Traditional Affairs Minister Nkosazana Dlamini-Zuma did not respond to. 

What is apparent is that diabetes is not a priority for South African health authorities – certainly not in terms of awareness drives and, arguably, not in terms of campaigns to ensure that diagnosed diabetics are equipped with the material and information they need to manage the disease. This is despite the fact that, even without the risks attached to diabetes and Covid-19 infection, uncontrolled diabetes remains a significant health risk. It’s a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.  

As endocrinologist Dr Sundeep Ruder wrote in 2016, government’s focus on non-communicable diseases has centred on tuberculosis and HIV, which have individual budget allocations. “Diabetes is under the general non-communicable diseases budget. Non-governmental organisations receive little to no funding for diabetes education, prevention or supplies,” he stated. 

At this point, it is important to note that, globally, Type One diabetics (diagnosed as children as a consequence of genetics or autoimmune condition) make up 10% of the diabetic population. The vast majority of diabetics, 90%, develop the disease as a consequence of obesity and poor lifestyle decisions. Type Two diabetes is, largely, preventable through healthy dietary habits and regular exercise. 

That pathology is no different in South Africa. The exponential growth in diabetes in the country can be concretely linked to its well-documented levels of obesity – with more than half of all South Africans being defined as overweight or obese.  

Covid-19 arguably represents a perfect opportunity for government to not only run an effective diabetes testing campaign – aimed at reducing the risk of pandemic fatalities – but also to channel resources into ensuring that diabetics are educated about the proper management of the condition. 

Enabling diabetics to test themselves and assisting them with management of the disease may require additional budget allocation, but it will arguably also prevent the state from having to pay for amputations and kidney failure treatment further down the line. 

Current projections fluctuate but some suggest that Covid-19 will claim the lives of 45 000 – many of whom are expected to be diabetics. But, after that deadly tsunami eventually lifts, diabetes – which killed over 25 000 people in 2017 – will remain one of South Africa’s most pressing health emergencies.  

Unlike Covid-19, we know that the diabetes epidemic is among us. And we know how to stop it. – Health-e News 

#CoronavirusSA: Diabetes inaction will cost lives

Integrating diabetes testing and prevention strategies into the country’s Covid-19 response plans are key to reducing the mortalities the country may face, writes Karyn Maughan.

Diabetes – a life-long condition in which the body either cannot make enough insulin or cannot effectively use what it produces – is on the rise in South Africa, with the International Diabetes Federation (IDF) reporting that the country has highest proportion of adult diabetics on the continent. According to the 2019 report on mortality and causes of death by Statistics South Africa, diabetes is the second deadliest disease in the country. It has killed more people than HIV, hypertension and other forms of heart disease.  

Last year, the IDF released a study finding that the number of South Africans diagnosed with the disease had more than doubled from 2017, to a staggering 4.5million people. Frighteningly, the diabetes advocacy organisation also found that, in their Africa regional network, South Africa had registered the greatest number of deaths due to diabetes on the continent. 

Type Two diabetes, in particular, clearly constitutes a potentially devastating crisis for South Africa’s already fragile public health care system. The IDF’s 2019 Diabetes Atlas shows that 12.7% of adults in South Africa had diabetes in 2019, a 137% increase on the 2017 figure of 5.4%. The report also bolstered the findings of a forecasting study published in the Lancet in 2018, which predicted that diabetes would be the leading cause of death in South Africa in 2040.  

Covid-19 compounds diabetes issues 

That threat has now been exacerbated by the fact that diabetics are identified as a group of people most vulnerable to severe or deadly outcomes if infected with Covid-19. 

But, it would appear, government has done little to nothing to make information on the numbers of diabetics who have been infected with Covid-19 or how many diabetics have died as a consequence of the virus publicly available – although, it would appear that this information is accessible to the state.  

In early May, Health Minister Zweli Mkhize stated that an as-yet undisclosed analysis of hospitalised patients showed that “consistent with evidence emerging worldwide, hypertension, diabetes and cardiac disease are the three most common comorbidities associated with serious illness from Covid-19”. Weeks later, Western Cape premier, Alan Winde revealed that, of those people who had died in the province to date, 96% had an underlying health condition such as HIV, diabetes, hypertension and tuberculosis. 

Health-e News sent questions to the health department about whether government had done any research on the numbers of diabetics who had died from Covid-19 or its complications, and whether the state had any strategy to test people for diabetes during its Covid-19 testing process. The IDF estimates that two-million South Africans are ignorant of the fact that they have the disease. Arguably, improved screening for diabetes can significantly improve the prospects of such people surviving Covid-19 – particularly when uncontrolled diabetes constitutes such a significant threat for coronavirus patients. 

At the time of publication, the health department had not responded to these questions, despite promising to send them to a resident expert on diabetes. 

Diabetes not a priority 

Up until now, the only in-depth South African research available on the impact of Covid-19 on diabetics has been done by Discovery Health. In May, it released information about the 1733 coronavirus cases reported across its schemes.  

Discovery Health chief executive officer Ryan Noach, said that high risk members tend to be the elderly, and members living with chronic diseases, like diabetes. But the data contained in the report provides no real insight into the vast majority of South Africa’s diabetics: those who are unable to afford private health care and depend on state facilities for care and treatment. 

What’s also apparent is that the state has not, as it has done with smokers, made any attempt to mitigate the risks faced by diabetics with targeted interventions aimed at improving their blood sugar control – a step shown to profoundly reduce the risks of serious Covid-19 outcomes for diabetics.  

This may be because the number of diagnosed diabetics in South Africa is dwarfed by the eight million-strong population of smokers. But, while the debate about the risks of severe Covid-19 infection and death in smokers continues to rage, global research has clearly shown that poorly controlled diabetics are in significant danger of death from Covid-19.  

The Centre for Diabetes and Endocrinology note that, “the problem people with diabetes may face, is primarily a problem of worse outcomes, not a greater chance of contracting the virus. When people with diabetes do not manage their diabetes well and experience fluctuating blood glucose levels, they are generally at risk for a number of diabetes-related complications. And, in general, as a population, people with diabetes do face a higher chance of experiencing severe symptoms and serious complications when infected with any virus and with Covid-19.” 

This has clearly not escaped the attention of organisations fighting for the ban on smoking to be lifted. In papers filed at the Pretoria High Court, the Free-Trade and Independent Tobacco Association accused government of not being consistent or proportional in its decision to ban the sale of cigarettes and tobacco during South Africa’s Covid-19 shutdown but not to place any restrictions on the sale of junk food and sugary drinks – which constitute, they argue, a threat to diabetics. It was an accusation that Cooperative Governance and Traditional Affairs Minister Nkosazana Dlamini-Zuma did not respond to. 

What is apparent is that diabetes is not a priority for South African health authorities – certainly not in terms of awareness drives and, arguably, not in terms of campaigns to ensure that diagnosed diabetics are equipped with the material and information they need to manage the disease. This is despite the fact that, even without the risks attached to diabetes and Covid-19 infection, uncontrolled diabetes remains a significant health risk. It’s a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.  

As endocrinologist Dr Sundeep Ruder wrote in 2016, government’s focus on non-communicable diseases has centred on tuberculosis and HIV, which have individual budget allocations. “Diabetes is under the general non-communicable diseases budget. Non-governmental organisations receive little to no funding for diabetes education, prevention or supplies,” he stated. 

At this point, it is important to note that, globally, Type One diabetics (diagnosed as children as a consequence of genetics or autoimmune condition) make up 10% of the diabetic population. The vast majority of diabetics, 90%, develop the disease as a consequence of obesity and poor lifestyle decisions. Type Two diabetes is, largely, preventable through healthy dietary habits and regular exercise. 

That pathology is no different in South Africa. The exponential growth in diabetes in the country can be concretely linked to its well-documented levels of obesity – with more than half of all South Africans being defined as overweight or obese.  

Covid-19 arguably represents a perfect opportunity for government to not only run an effective diabetes testing campaign – aimed at reducing the risk of pandemic fatalities – but also to channel resources into ensuring that diabetics are educated about the proper management of the condition. 

Enabling diabetics to test themselves and assisting them with management of the disease may require additional budget allocation, but it will arguably also prevent the state from having to pay for amputations and kidney failure treatment further down the line. 

Current projections fluctuate but some suggest that Covid-19 will claim the lives of 45 000 – many of whom are expected to be diabetics. But, after that deadly tsunami eventually lifts, diabetes – which killed over 25 000 people in 2017 – will remain one of South Africa’s most pressing health emergencies.  

Unlike Covid-19, we know that the diabetes epidemic is among us. And we know how to stop it. – Health-e News