OP ED: Our Children Are Telling Us Something Is Wrong 

We live in a country where children can eat every day and still go hungry. This is the shocking reality facing many South African households today. Cheap, ultra-processed foods have become the most affordable and accessible option for struggling families.  

This contradiction should alarm all of us. 

According to UNICEF, around 23% of South African children live in severe food poverty. This means they consume food from only one or two food groups a day and are at significantly higher risk of malnutrition and developmental delays. At the same time, communities are seeing rising levels of childhood obesity, stunting and diet-related illness existing side by side. Furthermore, the percentage of overweight and obesity in children under 5 years rose from 13% in 2016 to 23% in 2024.  

Availability of ultra-processed food

The proliferation of cheap, unhealthy ultra-processed food means that a small packet of crisps from a spaza shop or street vendor costs as little as R3–R5, while a single piece of fruit (a banana or apple) can cost the same or more at a formal retailer. A nutritious home-cooked meal for a child costs considerably more. For many families, the math is stark: ultra-processed snacks are cheaper, closer, and more readily available than fresh food. 

 In one neighbourhood I drive through regularly, children stop after school to buy brightly colored sweets, sugary drinks and cheap snacks from informal traders. Among them is a mother whose two young boys spend most days beside her, eating the same food she sells.  

Across South Africa, millions of households are under immense economic pressure. Social grants remain a critical lifeline for many families, yet rising food prices, unemployment and inequality continue to push nutritious food further out of reach. For many households, the priority is no longer healthy eating; it is about survival.

This piece was published on the 19th of June by Health-e. Click HERE to read the full article.

Budget 2026 a chance to boost ‘sugary drinks tax’, cut costs and save lives

As South Africa prepares for its 2026 budget speech, the under-discussed Health Promotion Levy stands out as a proven tool to curb sugar consumption, reduce costly non-communicable diseases and ease pressure on the healthcare system. Allowing the sugary drinks tax to stagnate under industry pressure risks deepening inequality, shifting the burden of preventable illness onto poor communities instead of strengthening prevention and public health.

As South Africa approaches this year’s budget speech (25 February 2026) , much attention is being paid to unemployment, national debt and inequality.

Yet one tax, which has the potential to improve the lives of South Africans, particularly the poorest, receives little attention.

The Health Promotion Levy, commonly called the sugary drinks tax, was introduced in 2018 with a clear objective: reduce excessive sugar consumption with a view to reducing obesity and associated non-communicable diseases (NCDs) like diabetes and hypertension. When the levy was adopted, it worked. A United Nations University World Institute for Development Economics Research study released in 2025 noted that the levy led to an increase of 15% in the consumption of non-taxable sugary drinks.

Click here to read the rest of the article.

This article was published in The Daily Maverick on the 24th of February 2026.

The Health Promotion Levy Is a Food Justice and Human Rights Imperative, Not a Tax on the Poor

Johannesburg, South Africa, 23 January. With Minister of Finance Enoch Godongwana set to deliver his Budget Vote on 25 February, civil society organisations — the Healthy Living Alliance (HEALA), Grow Great (GG), Treatment Action Campaign (TAC), and other members of the Food Justice Coalition (FJC) reiterate strong support for South Africa’s Health Promotion Levy (HPL), emphasising that the levy is a proven human rights-based policy tool that protects lives, reduces inequality, and advances the constitutional right of access to health care services.

As pressure mounts from industry groups to weaken or repeal the HPL, we warn that rolling back the levy would undermine progress in addressing hunger, diet-related disease and the growing burden of non-communicable diseases (NCDs), which disproportionately affect low-income communities.

Non-communicable diseases account for approximately 51% of all deaths in South Africa, with diabetes now the second leading natural cause of death nationally (Stats SA). Oral diseases continue to contribute to significant global and national morbidity and disability, with over 3.7 billion people impacted globally. Nationally, 1 in 4 (27.9%), people aged 5 years and above experienced untreated dental decay and 24.5% of persons over the age of 15 experienced severe gum diseases (leading to preventable and premature tooth loss) both of these disease having a significant, but often overlooked impact on health and quality of life.  Excess body weight affects around 68% of women and 31% of men in South Africa, while childhood overweight and obesity rates are among the highest in sub-Saharan Africa.

The HPL Is Not Harmful to Poor Households

“Framing the Health Promotion Levy as harmful to poor households is not only misleading, but deeply cynical,” said Nzama Mbalati, CEO at HEALA. “Low-income communities already pay the highest price for unhealthy food environments through preventable illness, lost income and avoidable deaths.”

Since its introduction in 2018 at a rate of 11% (2.1 cents per gram of sugar above 4g/100ml), peer-reviewed research has shown that the HPL led to a 29% reduction in sugar purchased from taxable beverages among lower-income households, alongside significant product reformulation by manufacturers.

From a revenue perspective, the HPL has generated approximately R2 billion per year in its early years of implementation. If increased to 20% in line with World Health Organization (WHO) recommendations, revenue could increase substantially while maximising public health impact. WHO recommends that sugary drink taxes raise retail prices by at least 20% to meaningfully reduce consumption.

Moreover, the potential to earmark HPL revenue for health promotion, nutrition programmes and food security interventions offers a direct opportunity to support vulnerable communities” says Mbalati.

A Rights-Based Response to an Unjust Food System

South Africa faces a dual crisis of hunger and obesity, driven by a food system that makes ultra-processed, sugary products cheap and widely available while healthier options remain unaffordable for many households.

 Recent national data indicates that one in four South African children under five experiences stunting, while at the same time sugary beverage consumption remains high, particularly among adolescents. Excessive sugar intake is a major contributor to diabetes, dental decay,  heart disease and stroke, conditions that place immense strain on families and the public health system. The International Diabetes Federation estimates that over 4.2 million adults in South Africa are living with diabetes, with many more undiagnosed. Diabetes-related complications significantly increase public healthcare expenditure and reduce household income due to disability and premature mortality.

Public health evidence, including local studies evaluating the HPL, shows that the levy has shifted consumer purchasing behaviour toward beverages with less sugar and incentivised industry reformulation without the large-scale job losses predicted by industry opponents.

Supporting Farmers Through Just Transition

We note with concern that local farmers are affected by uncertainty in the global sugar industry. The supply chain faces high production costs, shrinking markets and changing consumer behaviour.

For long-term sustainability, government and farmers must work collaboratively to pivot away from sugar dependency through a just transition framework.

One promising approach involves creating opportunities for farmers to supply affordable, nutritious produce to Early Childhood Development (ECD) centres nationwide. Government-facilitated farmer-ECD partnerships would support farmer livelihoods while improving child nutrition outcomes.

Debunking the “Tax on the Poor” Narrative

HEALA and Union Against Hunger stress that the claim that the HPL unfairly targets poor households ignores the lived reality of diet-related disease.

Lower-income communities experience disproportionately high rates of obesity and diabetes, yet face reduced access to preventative healthcare and early screening services. Evidence shows that lower-income households also benefit most from reductions in sugary beverage consumption following price increases.

“The real injustice is allowing an aggressive sugary drinks market to continue targeting children and low-income communities with impunity,” added Tendai Mafuma, Senior Legal Researcher at SECTION27. “Weakening the HPL would be a direct betrayal of the government’s constitutional obligations.”

A Call to Protect and Strengthen the HPL

We call on National Treasury and policymakers to:

  • Reject industry-driven attempts to weaken or repeal the Health Promotion Levy.
  • Increase the levy in line with global best practice to maximise health impact (minimum 20% price increase as recommended by WHO).
  • Commit to investing HPL revenue in health promotion, nutrition and food security programmes.
  • Place food justice and human rights at the centre of fiscal and health policy decision-making.

“At a time of rising hunger, inequality and preventable disease, South Africa cannot afford policy capture by vested interests,” says Dr. Edzani Mphaphuli, Executive Director at Grow Great .“The Health Promotion Levy is not the problem , it is part of the solution.”

ENDS

For media enquiries and Interviews, please contact:

Mr. Neo Merafi

Maverick Brand Communications 

neo@maverickbrand.co.za

WhatsApp: 071 359 9738

OR

Ms. Zukiswa Zimela 

Communications Manager- HEALA 

zukiswa@heala.org

WhatsApp: 074 521 0652  

Notes to Editors (Updated)

  • The Health Promotion Levy was introduced in April 2018.
  • The levy taxes sugary beverages containing more than 4g of sugar per 100ml.
  • Non-communicable diseases account for approximately 51% of deaths in South Africa.
  • Diabetes is the second leading natural cause of death nationally.
  • Peer-reviewed research shows a 29% reduction in sugar purchased from taxable beverages among lower-income households after implementation.
  • WHO recommends sugary drink taxes increase prices by at least 20% to achieve optimal public health impact.
  • The HPL allocation to the NDoH has remained largely unspent for the past 10 years. For the 2025/2026 fiscal year, only R15 million of the allocated R52 million has been earmarked, and this for a limited number of organisations — namely Park Run, the National Organ Donation Foundation, the National Cancer Registry, and the Knowledge Translation Unit (KTU) at UCT.

HEALA embarks on roadshows to highlight the importance Front-of-Packaging Labelling on packaged foods

FOR IMMEDIATE RELEASE

31 July 2025

The Healthy Living Alliance (HEALA) is calling on the South African government to ratify regulations that make it mandatory for foods high in salt, sugar and saturated fat to carry a clear warning label on the front of packages. This, so that consumers can be empowered to make informed, and healthier decisions when buying food – especially when trying to identify healthier options.

Shockingly, low-income South African adults consume, on average, 40% of their calories from ultra-processed products, according to a study published in Public Health NutritionExperts are clear on the dangers of eating ultra-processed foods. Two large European studies published in The BMJ Journal found direct links between lengthened exposure to ultra-processed foods and heart disease deaths, poor mental health, obesity and diabetes. 

The National Department of Health (NdoH) has had almost two years to ratify the R3337 (formally referred to as the Draft Regulation Relating to Labelling and Advertising of Foodstuffs published by the South African National Department of Health on April 21, 2023). This set of regulations is aimed at introducing significant changes to how food products are labelled and advertised – particularly focusing on front-of-pack warning labels, marketing restrictions aimed at protecting children, and stricter guidelines for health-related claims.

South Africans have been waiting since the conclusion of the public consultation process on September 21, 2023. Time is up, our health is on a steady decline, and we are vulnerable to predatory food manufacturers that prioritise profit over the wellness of the masses.

HEALA will be embarking on roadshows in Gauteng, Limpopo and KwaZulu-Natal to raise awareness on the importance of font-of-package warning labels. We are inviting all South Africans to add their voice to the call for the National Department of Health (NdoH) to protect our health. Each day without these regulations is a denial of vulnerable consumers’ rights to know what they are putting in their bodies. 

“Some packaged foods put us at risk of dangerous, life-altering illnesses. South Africans have the right to understand the ingredients in the food they eat. For many consumers, back-of-pack labels are complicated and difficult to read, making it nearly impossible for people to choose healthier alternatives. Regulations will make it easier for us to readily identify foods that are bad for our health and choose better for ourselves. We urgently need easy-to-read warning labels that highlight the dangerous contents in some of these packaged foods,” urges HEALA CEO Nzama Mbalati. 

Sign petition at heala.org

Roadshow Dates

Pretoria, Gauteng: 6 and 7 August 2025

Atlyn Shopping Mall, Khoza St, Atteridgeville, 

Giyani Limpopo: 12 and 13 August 2025

Masingita Mall, Giyani

Durban, KZN: 18 and 19 August 2025

The Workshop, Durban CBD

– Ends – 

About HEALA: 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.

For media enquiries contact:

Mr. Neo Merafi: 071 359 9738 or Neo@maverickbrand.co.za

HEALA statement on Advertising Appeal Committee’s ruling on sugary drinks advert

HEALA is studying the decision by the Advertising Appeal Committee. It is important to note that the Committee does not state that our campaign advert is misleading due to warning the public against the harms of fizzy drinks and fruit juice, and expressly provided that it would not be misleading to warn against the consumption of “excessive sugary drinks” or “regular consumption of sugary drinks”.

The Committee also cites the World Health Organisation in this analysis, indicating even “a single serving (at least 250 ml) of commonly consumed sugary drinks per day” is to be avoided for health reasons. For a full synthesis on the harms of sodas and fruit juice, we direct interested persons to HEALA.org, where we provide an easy-to-read summary of the most up-to-date science as co-developed by several world-leading nutritionists, medical doctors, and public health specialists.

We would like to thank the Advertising Appeal Committee for its express recognition and commendation for the work that HEALA does to further the interests of public health.

For media interviews please contact

Zukiswa Zimela: Communications Manager HEALA

Zukiswa[at]heala.org

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

A Dire Health Crisis: The Economic Burden of NCD’s

Press Release

13 February 2025

FOR IMMEDIATE RELEASE

HEALA adamant that a 20% sugary drinks tax increase will curtail the prevalence of non-communicable diseases in South Africa 

Prior to becoming a professional and passionate caregiver, Lexi Mufukari was in her mid-twenties when she first had to take care of a loved one battling non-communicable diseases (NCDs). Her grandmother, now late, had been managing her hypertension well for decades, until a diabetes diagnosis negatively impacted her health. “Prior to her diabetes diagnosis, my grandmother had been fit, active, energetic and taking her blood pressure medication religiously,” shares Mufukari. Her family, already cash-strapped, hired a full-time caregiver to assist with taking care of Mufukari’s grandmother. “We could not afford a wheelchair so she had to be carried everywhere around the house by one or three family members,” she adds. This firsthand experience of how NCDs can change the family’s trajectory – impacting finances, mental health and relations has led Lexi to believe that the prevention of any NCDs is better than cure. 

South Africa currently faces a dire health crisis. NCDs related deaths  such as cardiovascular diseases, diabetes and chronic lower respiratory diseases rose by a staggering 58.7 percent over the past two decades, according to Statistics South Africa. Diabetes now ranks as the second leading cause of death in South Africa after tuberculosis, with a concerning 25 000 deaths attributed to the disease in 2022. Diabetes affects 12 percent of the adult population in South Africa, wreaking havoc to the family’s livelihood and the individual’s health, work place productivity, – as well as the national fiscus. Diabetes, on diagnosed patients alone, costs South Africa’s health system a whopping R2.7 billion. With undiagnosed patients factored in, the amount would shoot up to R 21.8 billion. 

And this is where increasing the sugar tax from 10 to 20 percent would help. The Healthy Living Alliance (HEALA) still maintains that the South African government has an opportunity to curb the prevalence of NCDs in South Africa, including diabetes, obesity, and related health issues.

In 2023, the World Health Organization (WHO) once again called on governments worldwide to increase taxes on sugary drinks and alcohol to radically decrease the number of people dying from unhealthy diets – adding that unhealthy diets were responsible for approximately 8 million deaths, worldwide, every year. Furthermore, WHO explained that higher taxes would help reduce the consumption of unhealthy products, and therefore incentivise companies to produce healthier products – which would hopefully lead to healthier populations across the board. 

Says HEALA CEO Nzama Mbalati: “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”. 

About HEALA: 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.

For media interviews contact: 
Zukiswa Zimela Communications Manager HEALA

0745210652 or Zukiswa[@]heala.org

Ends.

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

Youtube video
Youtube video

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.

Keep the focus on the health of South Africans.

By Bilal Mpazayabo | 22 October 2024

Media Statement 

22 October 2024

FOR IMMEDIATE RELEASE

Keep the focus on the health of South Africans.

HEALA acknowledges the recent comments from SA Canegrowers, which attempt to question the nature of our organisation as not being “home-grown.” This diversionary tactic is timed to shift attention away from the proven, life-saving effects of the South African Health Promotion Levy (HPL) and the irrefutable connection between excessive sugar consumption and diseases such as diabetes. With the mid-term budget speech approaching, it is vital to stay focused on what matters most: the health of South Africans.

HEALA is fully transparent regarding its staff, organisational journey, and funding sources—all publicly available. Moreover, we collaborate extensively with South African universities and local NGOs in our health promotion efforts, which cover multiple aspects of the food system. These partners, like HEALA, are transparent about their funding, and it is essential to note that none of our funders profit from our food justice advocacy. It is important to underline that philanthropy support has always played a critical role in responding to socio-economic needs in this country and that HEALA’s work is not an exception. In the spirit of transparency, we ask SA Canegrowers to disclose the origin of their funding and confirm whether it is free from any profit-driven motives.

The attempt to distract from the substance of this debate is telling. The policy rationale for the Health Promotion Levy is backed by a wide range of experts, including the World Health Organization, the South African Department of Health, the Treasury, economists, and public health specialists locally and internationally. Sugar taxation has been shown to reduce the amount of sugar added to beverages, discourage the consumption of sugary drinks, and generate government revenue—all while promoting public health. This model has been successfully used for tobacco and alcohol taxes, and it is no different for sugar.

In a country where more than 4.2 million people live with diabetes—now the second-leading cause of death after tuberculosis—this is a critical health intervention. The data is clear: households facing food insecurity are also often dealing with weight-related diseases like diabetes, hypertension, and high cholesterol. These diseases not only threaten lives but also impose crippling financial burdens on families already struggling to make ends meet.

An honest, home-grown debate on the HPL should focus on these realities. It should prioritise South Africans’ long-term health and financial well-being, particularly those most affected by non-communicable diseases. We urge SA Canegrowers and other stakeholders to engage in this debate with the same transparency and commitment to public health that HEALA brings to the table.

“ENDS”

About HEALA: 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.

For media interviews contact:

Bilal Mpazayabo, HEALA Social Media Coordinator

Bilal@heala.org | 0612374651