The evidence is clear: Sugary beverages are harmful; SA’s Health Promotion Levy is helpful

04 March 2021

The science is clear on the harmful effects of sugar added to beverages and the strong, beneficial, effects of your current Health Promotion Levy (HPL).

Over 35 top experts on obesity, diet-related diseases and public health from some of the world’s leading universities have written to Treasury officials to support increasing the current HPL to 20%. They are also very impressed with the results of evaluations done on the current HPL.

The dangers of sugary beverages

Drinking liquid sugar in beverages and the extra calories a person takes in this way have been linked to noncommunicable diseases (NCDs) like diabetes, hypertension, overweight and obesity. These are leading causes of death and disability in later life in South Africa.

  • Sugary drinks often have no nutritional value.
  • They are particularly harmful to the body in liquid form because the liver absorbs them more quickly than it can process and release. The excess is then stored as fat or glycogen deposits in the liver. This can lead to fatty liver disease and a higher risk for diabetes and other NCDs.
  • A person should not consume more than 10% of total calories from added sugar (World Health Organization and the World Cancer Research Fund guidelines).
  • But just one 600ml bottle of cooldrink contains 12% of total calories from added sugars for an adult.
  • It would require 16 minutes of running and over 1.5 km of walking to exercise it off.

Counting the costs

The COVID-19 pandemic has shown how obesity, diabetes and hypertension add a much higher risk of going to hospital or dying from COVID-19.

Praise for the HPL results

South Africa’s HPL was the first major sugar-sweetened beverage tax based on grams of sugar. Researchers at the University of the Witwatersrand and the University of the Western Cape found that:

  • Prices of taxable beverages increased over the first year of the tax, while non-taxable beverage prices did not change meaningfully.
  • After the tax was introduced, purchases of taxable beverages by urban households fell by 29%, and sugar content from these purchases fell by 51%. Importantly, poorer households cut the volumes of their sugar sweetened beverage (SSB) by nearly a third, and dropped grams of sugar from SSBs by over half (57%).
  • In Langa in the Western Cape, young adults aged 18-39 years reported they drank 37% less SSBs and reduced sugar intake by nearly a third (31%).
  • In Soweto, Johannesburg, a study found that heavy consumers of SBBs dropped their intake by seven times a week, and medium consumers by two times a week, between the start of the study and after 12 months. These reductions stayed for two years after the HPL was introduced.
  • And contrary to industry’s gloomy predictions, public data on employment in the sugar and beverage industries showed no statistically significant change in employment and followed pre-implementation trends.

Why increasing the HPL remains a great idea

The HPL will have a long-term effect on excessive weight gain and a direct impact on reducing the risk of diabetes, hypertension and many other NCDs.”

  • To further promote health, the global experts urged for the HPL to be doubled to the 20% levy that Treasury itself proposed in June 2016. This will greatly affect sugar consumption and dropping the cut-off level to 1 or 2 grams/100ml will have an even greater impact.
  • The HPL has generated revenue of R5.4 billion over the first two years of the tax being in place (approximately 0.2% of total government revenue over the same period).
  • The revenue could be used to cover health-related COVID costs, or go towards strengthening health services that focus on preventing disease.

HEALA believes that Government now has plenty of evidence to prove that the HPL is working. It could do even more.

The experience with the HPL shows that public health policies that increase the price of harmful products do reduce consumption.

Even more importantly, South Africans need to know what is in their food and drink so that they can make informed choices about healthy living and take control of their health.

202102 Global Experts Call for 20HPL

Media Release: Doubling the sugary beverage levy could raise billions for Covid-19 fight

If South Africa doubled its sugary beverage levy, it could raise billions to help fund the fight against Covid-19.

In 2018, South Africa introduced a health promotion levy of about 11% on sugary beverages to help curb the country’s sugar consumption, which is fuelling a rise in non-communicable diseases, such as diabetes, high blood pressure and obesity. 

Currently, beverages are taxed about 2.21 cents per gram of sugar for anything over a 4-gram threshold. The current levy adds about 46 cents to the price of an average can of original taste Coca-Cola, for instance. The levy does not apply to natural fruit juices or sweetened dairy products.  

Within its first two years, the health promotion levy has generated R5.4 billion for government. This would have been enough to finance South Africa’s down payment for Covid-19 vaccines from the Covax facility almost 20 times over despite the health promotion levy’s relatively small contribution to government’s overall budget. 

If the National Treasury doubled the health promotion levy now, it could net the government around R2 billion to help fund the fight against Covid-19 in the short term, head of the Healthy Living Alliance (HEALA) Lawrence Mbalati says. This estimate is based on current consumption levels and the revenue raised by the levy already.

If Treasury doubled the levy and raised R2 billion, that would be enough to pay for several thousand new nurses and doctors, as well as tens of thousands of community healthcare workers based on average salary ranges. 

“This is a watershed moment for the country,” Mbalati explains. “Government revenues are under immense pressure and funding the fight against Covid-19, including vaccines, remains critical.”

“Policymakers, and in particular the National Treasury, have an opportunity now to decide to increase the health promotion levy to 20% to raise additional revenue in the short-term,” he says. “In the long-term, we know that a health promotion levy of 20% will reduce the amount of sugar people eat, decreasing their chance of developing conditions such as diabetes, obesity and high blood pressure that also put people at a higher risk of dying from Covid-19.”

Globally, being obese has been shown to increase a person’s risk of dying from Covid-19 by almost 50% and more than doubles the risk of being hospitalised, according to a recent analysis published in the journal Obesity Reviews.  

South Africa’s health promotion levy has already led some beverage makers to reduce the amount of sugar in their drinks. One study by PRICELESS SA found that the levy also reduced sugary beverage consumption by 60% among people in Soweto who consumed a lot of sugar.

Meanwhile, there is no evidence to date that the levy has led to job losses in the sugar or beverage industry, contrary to industry claims. 

A health promotion levy of 20% in the long-term could reduce sugar consumption, saving lives both from non-communicable diseases but also Covid-19 as many scientists expect the virus to remain with us in the foreseeable future. 

HEALA is therefore calling on the National Treasury to act now.

“Raising the health promotion levy to 20% is absolutely critical to not only funding the Covid-19 fight but also to saving lives now and in the future.”

For interviews, contact:
Lawrence Mbalati, head of the Healthy Living Alliance (HEALA)
082 734 5414 

Click here to download and read the pdf

Read more:
What you need to know about South Africa’s health promotion levy

Healthy Living Alliance Media Briefing: Increase the HPL to 20%

Fact Sheet: Evidence to support increasing South Africa’s Health Promotion Levy (HPL) to 20% in 2021

South Africa implemented its Health Promotion Levy, or HPL, in April of 2018. The HPL is a sugar-sweetened beverage (SSB) tax of approximately 11%, based on sugar content. Initial research on the price impact of the HPL has shown prices increased commensurate with the tax for taxed beverages but did not change for non-taxable beverages and reduced consumption.

Click here to download and read the pdf

Embargoed For Release

Big Food Used Global Pandemic to Aggressively Promote Unhealthy, Ultra-Processed Food & Sugary Drinks

A new report finds that the food and beverage industry giants directly and indirectly blocked. Healthy food policies while putting vulnerable consumers at even greater risk.

WASHINGTON, D.C. – A new report released by the Global Health Advocacy Incubator [GHAI] details how food and beverage corporations – such as Coca-Cola, McDonald’s, Nestlé, and PepsiCo – seized the coronavirus pandemic as a unique opportunity to promote their ultra-processed foods to especially vulnerable populations around the world.

Facing Two Pandemics: How Big Food Undermined Public Health in the Era of COVID-19

Reveals how the lack of healthy food regulations worldwide enabled “Big Food” to use the global COVID-19 crisis, publicly portraying themselves as do-gooders while directly and indirectly influencing policy and putting disadvantaged people at even greater risk. These same corporations – whose ultra-processed food and sugary drinks were already contributing to rising rates of obesity, malnutrition, and diet-related diseases – used the pandemic to position themselves and their unhealthy products as essential and safe, putting those compromised populations at even higher risk of coronavirus complications and mortality. GHAI collected more than 280 examples from 18 countries between March and July 2020.

“Based on the examples we gathered, it quickly became clear that Big Food was working hard to position themselves as a crucial part of the pandemic solution,” said Holly Wong, GHAI Vice President, “while furthering their own gains by hindering the advancement of public health policies.”

The GHAI report outlines key ways “Big Food” exploited the coronavirus pandemic to their advantage:

  • They polished their public images with pandemic “solidarity actions,” while aggressively promoting their junk food and sugary drink brands. They donated ultra-processed products to children in school programs and low-income populations when these people needed nutritious foods. They also donated and promoted baby formula, breaching the International Code of Marketing of Breastmilk Substitutes. In South Africa, Coca-Cola collaborated with a nonprofit to donate “cooldrinks” – soft drinks – to local healthcare centers, including an obesity care center.
  • They touted unhealthy ultra-processed food and drinks as essential, safe products, equating food safety with healthy food. In Brazil, the industry group ILSI (International Life Science Institute) highlights that processed foods are allies in the fight against COVID-19 touting their high safety levels that reduce the risk of chemical and physical contamination.
  • They funded online educational platforms aimed at helping children learn during quarantine, dangerously blending marketing with educational information, and positioning these corporations as reliable sources of health-related information. An online learning platform used by schoolchildren in the US featured junk food advertising.
  • They spun a health and wellbeing narrative publicly while leveraging the pandemic as a way to delay healthy food policy. In México, they attempted to use COVID-19 as an excuse to postpone implementing a new front-of-package warning label law.
  • They promoted junk food as a tonic for tough times, linking unhealthy food with appealing sentiments such as comfort, nostalgia, and family togetherness. In Brazil, Burger King promoted its fast-food delivery service under the guise of helping people to stay safe at home.
  • They linked their ultra-processed food and drinks with charitable causes, helping consumers feel good about unhealthy purchases. In the US, Coca-Cola partnered with Uber Eats to donate one meal to Feeding America for every order placed.

These corporate interventions enabled Big Food to improve their image, strengthen their brands, ally with decisionmakers to gain political influence, and position their businesses as public-health partners during an emergency – even as they used these opportunities to advance their own unhealthy products.

Ultimately, the GHAI report underscores the urgent need for evidence-based healthy food policies and regulations, as well as stronger conflict-of-interest protocols, worldwide.

“This is a wake-up call for governments to implement evidence-based public policies designed to create healthier food environments and to protect the right to adequate food,” said Lawrence Mbalati, Programmes Manager of South Africa’s Healthy Living Alliance.

“Such policies will help consumers make healthier nutritional choices during vulnerable times like these. The bottom line is, governments must prioritize public health above private interests and profits.”


Click here for the report:

For media interviews, please contact Lawrence Mbalati, HEALA Programmes Manager,
082 734 5414; Please note, in addition to English, Lawrence speaks Xitsonga (first language), Tshivenda, Sepedi, Sesotho/Setswana and can also speak isiZulu and isiXhosa.

About the Healthy Living Alliance (HEALA)

HEALA is a  leading alliance of civil society and academic organisations fighting for every person’s right to healthy food in South Africa. Launched in 2016 by the civil society organisations and academic institutions, HEALA successfully campaigned for the Sugary Drinks Tax implemented by South African Government in April 2018.

HEALA’s current campaigns include advocating for clear warning labels on ultra-processed foods, healthy food environment, marketing restrictions of junk food and sugary drinks to under-age children in South Africa.

Calls for Finance Minister to increase health promotion levy (HPL) and include fruit juices

The Healthy Living Alliance (HEALA) and Rural Health Advocacy Project (RHAP) call for an increase in the so-called sugar sweetened beverage tax and inclusion of fruit juices to reduce diet-related disease and death, and raise much-needed revenue amidst COVID-19 health demands and budget deficits.

Johannesburg, 4 November: Advocacy groups for healthy food in South Africa have made a strong call backed by scientific evidence for an increase from 11% to 20% of the Health Promotion Levy (HPL), and to include fruit juices in the levy.

Responding to Finance Minister Tito Mboweni’s 2020 Medium Term Budget Policy Statement last week, the Healthy Living Alliance and Rural Health Advocacy Project highlight how South Africa is grappling with both a COVID-19 epidemic and an obesity epidemic.

Nearly 70% of South African women, 31% of men and 13% of children under five are considered overweight. This is fuelling noncommunicable diseases (NCDs) such as type 2 diabetes and heart disease which put people at greater risk of severe COVID-19 illness and death. South Africa has the highest recorded number of cases and deaths in Africa. The collision of the COVID-19 and the NCD epidemics has significantly increased demands on the country’s health system.

“Sugar sweetened beverages (SSBs) such as sodas and fruit juices, as well as ultra-processed foods (industrially made ‘ready to eat and heat’ foods such as cereals and processed meats) contribute to obesity, a key risk factor for type 2 diabetes,” said Mr Lawrence Mbalati, HEALA’s programmes manager.

In 2018, South Africa was the first country in the African Region to introduce a tax on sugary beverages, a strategy which the World Health Organization (WHO) recommends as an effective way to reduce sugar consumption and address NCDs. South Africa’s HPL aimed to address rising rates of overweight, obesity and diet-related NCDs, and raise much needed revenue for health promotion.

According to National Treasury data, the HPL raised R3.195 billion in the first fiscal year (April 2018 – October 2019). While the tax is currently set at 11%, HEALA and RHAP have urged the Finance Minister to increase this to WHO’s recommended rate of 20%, which could drop demand by 24%.

“We don’t know the impact of the HPL because NEDLAC’s study on this has still not been completed. We are repeating our call for fruit juices to be included. Excluding them leads people to believe that juices are healthier, when in fact the sugar content is similarly high to soft drinks. Marketing fruit juice as a ‘healthy alternative’ to children and parents puts them at risk of consuming excessive amounts of sugar. Fresh fruits are fine on their own, but when turned into fruit juice, much more fruit is needed to make up the volume. Our bodies process these additional sugars in the same way as SSBs,” he said.

“Now more than ever, South Africa will benefit from an increased HPL tax for additional revenue and help to reduce risks related to obesity,” concluded Mr Mbalati.


Issued by Healthy Living Alliance (HEALA) and Rural Health Advocacy Project (RHAP)
For media interviews, please contact Lawrence Mbalati, HEALA Programmes Manager, 082 734 5414

New study exposes political practices of food and beverage industry in South Africa

First evidence of food and beverage industry tactics to counter public health policies in South Africa indicates partnerships with government and calls for greater transparency to stop undue influence

Johannesburg –29 July In the first study of its kind, researchers have uncovered the variety of strategies used by the food and beverage industry in South Africa to negatively influence policies aimed at promoting health, including building relationships with South African government departments.

The article by lead author Dr Mélissa Mialon of the University of Sao Paulo in the International Journal of Public Health (29 July 2020),  maps additional major industry interference techniques which include lobbying government officials, influencing scientific research, and attempting to refocus policy issues by diverting attention away from the role of unhealthy products which contribute to ill health.

“Industry’s corporate political activity influences public opinion and potentially hinders proven health policies to reduce diet-related conditions such as obesity and diabetes which are so prevalent in South Africa,” said Dr Mialon.

Over four million people in South Africa live with diabetes, which is emerging as a major risk factor for severe COVID-19 disease and death, and nearly 70% of women and 40% of men in the country are either overweight or obese.

The researchers found a total of 107 examples of political practices from publicly available documents from January 2018 to April 2019 from ten major food and beverage entities (Tiger Brands, Pioneer Foods, Clover, Parmalat, Nestlé, Coca-Cola South Africa, the South African Sugar Association (SASA), the Consumer Goods Council of South Africa (CGCSA), the Beverage Association of South Africa (BEVSA) and the International Life Science Institute (ILSA)).

These practices included partnerships between industry and government departments such as the Department of Basic Education, the Department of Sport & Recreation, and the Department of Health on company-branded school breakfast programmes, the donation of sugar to food security efforts, and educational funding for students. Industry was found to engage directly in policy processes, including heavy lobbying against the sugar-sweetened beverage tax. A total of 51 examples revealed how industry reframed arguments to divert attention away from the role of unhealthy products in health, and 49 cases of industry building partnerships with third parties to influence health policy efforts.

The authors could find no details about conflicts of interest of government officials or information on interactions and correspondence between industry and government officials.

At the World Health Assembly in 2019, the South African delegation called for urgent action to respond to what it called the ‘commercial determinants of health’ – corporate activities that affect health – which includes corporate political activity of the food and beverage industry.

“It is critical that there is greater knowledge, transparency and monitoring of industry strategies and practices,” the researchers conclude.


“This study reveals the range of tactics that South Africa’s food and beverage industry deploys, putting profits before people and undercutting critical public health initiatives. To have over 100 examples, and only those publicly available, means this is likely just the tip of the iceberg. It highlights the urgent need for transparency to expose undue influence on public health policy,” said Mr Lawrence Mbalati of the Healthy Living Alliance.

“South Africa needs transparency mechanisms to restrict the food and beverage industry’s influence on policy issues, including policies to ensure interactions between industry and government officials are transparent, and in certain cases prohibited, particularly during the policy decision stage. The health of South Africans cannot be put further at risk,” he said.


Issued by Health Living Alliance (HEALA)

Endorsing Organisations to Press Statement

  • Right to Know
  • Section27
  • Peoples Health Movement (PHM)
  • Amandla.Mobi
  • Rural Health Advocacy Project (RHAP)
  • Health-e News
  • Southern African Faith Communities’ Environment Institute (SAFCEI)

The article is available at:

For media interviews, please contact: Gugulethu Myeza

Contact Number : 0837934783