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Press Statement: The TRUE Cost of Diabetes

Posted on by Zukiswa Zimela

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

Posted on by Zukiswa Zimela

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 beverages. These 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.

Posted on by Bilal Mpazayabo

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

HEALA extends a warm welcome to the newly elected Health and Finance Ministers, Dr Aaron Motsoaledi and Mr Enoch Godongwana. 

Posted on by Zukiswa Zimela

In congratulating both Ministers, HEALA also urges them to prioritise the implementation of evidence-based policies that will address the triple burden of hunger, food insecurity, and obesity – and ultimately improve the health of ordinary South Africans. 

To date, South Africa faces alarming levels of hunger, food insecurity, and obesity stemming from a broken food system. Globally, ultra-processed foods high in salt, sugar, and fat are more available than ever before, particularly in low and middle-income countries such as South Africa. Diets high in these components significantly increase the risk of people developing non-communicable diseases (NCDs) such as obesity, high blood pressure, type 2 diabetes, and heart disease. 

According to Statistics South Africa, more and more people are dying from NCDs than ever before. Diabetes, hypertension, and heart disease rank among the top ten leading causes of natural deaths in South Africa, based on the latest figures from 2017.

“HEALA particularly wishes for the Health Minister, Dr Motsoaledi, to speed up regulation on food labelling to assist ordinary South Africans in making informed food choices, to initiate coordinated mechanisms and resource mobilisation towards government and civil society as well as support improvement of the school food environment, champion taxation and regulation of unhealthy products such as sugary drinks, tobacco and alcohol,” says HEALA CEO Nzama Mbalati. 

HEALA believes the government has ample evidence demonstrating the effectiveness of the Health Promotion Levy (HPL) and Front-of-Pack Warning Labels (FOPL) in addressing many of the health issues plaguing ordinary South Africans.

Previous HPL evidence has shown that public health policies, which increase the price of harmful products, can reduce consumption. However, there is potential to do even more. Government can allocate the funds generated from the levy towards addressing issues of hunger and poverty by increasing the Child Grant and subsidising healthier foods.  

HEALA calls on Finance Minister Mr Godongwana to protect the gains made by the levy by increasing it to 20%, and expanding it to include fruit juices. We also urge Health Minister Dr Motsoaledi to fast-track the implementation of easy-to-read warning labels and empower ordinary South Africans to make better food choices.

In South Africa, essential nutritional information is buried at the back of canned products, boxes, and bottles, making it difficult for consumers to read or decipher the food labels. Implementing front-of-package labelling can translate necessary nutritional information into simple language and prominently display it on the front of food products.

The FOPL regulation will also protect children from predatory marketing practices employed by food manufacturers who use fancy marketing strategies to seduce vulnerable children into being addicted to unhealthy food.

The South African health system is buckling under the weight of NCDs. Two years ago, researchers found that “overweight and obesity cost South Africa’s health system R33 billion (US$1.9bn) a year. This represents 15.38% of government health expenditure and is equivalent to 0.67% of GDP. Annual per person cost of overweight and obesity was R2 769”. The cost of inaction in addressing this issue for both the state and the individual is too high. 

 HEALA remains committed to holding government leaders accountable for their responsibility in ensuring that the food environment benefits ordinary people rather than industry profits.

We are calling on the newly elected ministers to put food justice on the political agenda and create a healthier, more equitable future for all South Africans.

“HEALA is confident in Dr Motsoaledi’s expertise, enthusiasm and the political will he demonstrated in his previous tenure as Health Minister,  during which he prioritised pivotal public health policies and initiatives aimed at improving the health of all South Africans,” concludes Mbalati. 

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

Zukiswa Zimela | HEALA Communications Manager

zukiswa[@]heala.org

South Africa can show BRICS leadership with a new sugar approach

Posted on by Zukiswa Zimela

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.

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

Posted on by Zukiswa Zimela

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

Tell Minister Mboweni a 20% sugary drinks tax is long overdue! Sign the petition to increase the sugary drinks tax and help save lives.

Posted on by Zukiswa Zimela

Sign the petition below:

HEALA calls for 20% tax on sugary drinks

Posted on by Zukiswa Zimela

The alliance has been encouraged by public support on proposals for an increase in the Health Promotion Levy (HPL)

Gathered outside number 40 Church Street in Tshwane, activists and people living with non-communicable diseases (NCDs) have submitted a memorandum to Treasury, calling for an increase on the health promotion levy.

The levy, also known as the sugary drinks tax, is currently 11% and the Healthy Living Alliance (HEALA) is demanding that it be increased by an additional 9% which will put the levy at 20%.

According to the organisation, the increase in the levy by April 1 will assist in reducing the high number of NCDs such as type 2 diabetes, hypertension and stroke, which are currently regarded as a burden to the health system.

Support from citizens 

Nosipho Msiza (32) was diagnosed with hypertension almost five years ago and is one of the people who support the proposal to increase the levy.

“My cholesterol levels, blood pressure, and blood sugar levels were ridiculously high when I went to the clinic for a screening. And it was a tough wake-up call for [me] especially, because when you come from a family of obese people, you don’t see anything wrong with it.”

She says that the idea of having to be on medication for the rest of her life encouraged her to make a lifestyle change and shed some weight.

“I used to weigh 115kg and I have lost some weight now. I also realised that it is possible to lose weight and be healthy at the same time. I now educate people in my community about eating healthy and the increase in the levy will be good for everyone.”

Msiza also believes that government should increase the promotion of healthy food options and to also ensure that healthy food is affordable.

One step to tackling NCDs 

Mandla Magaza, an activist for the Treatment Action Campaign (TAC) Tembisa branch, says that the increase will cement government’s commitment to addressing NCDs.

“For us, it is difficult because during clinic hours, we do health talks and it sometimes becomes a challenge to encourage healthy eating when unhealthy foods such as sugary drinks are not taxed as they should be, and are readily available. The tax increase would make it easy for us to spread the message on healthy eating as we would have government’s full support when it comes to discouraging people from consuming sugary drinks.”

While delivering the memorandum, HEALA informed representatives from Treasury about public support shown in a petition on Amandla.mobi, which received over 11 000 signatures in support of expanding sugary drinks tax to fruit juices.

“We call Minister Tito Mboweni to commit to this in the upcoming Budget Policy Statement. Unlike the VAT hike which we were not consulted on, a sugary drinks tax has public support and means healthier people and more funding for health,” says HEALA programme manager, Lawrence Mbalati.

Treasury applauds HEALA 

Treasury Chief of Staff Marlon Geswint received the memorandum on behalf of the minister and gave assurance that he would share the document with relevant role-players.

“There has been previous engagement on this so rest assured that this will be shared with the relevant authorities. As you, we look forward to seeing how the minister is going to respond to it,” he says.

Geswit also commended HEALA on their activism in promoting healthy living. “We must commend you that you are busy with a really good initiative. And we want to wish you everything of the best as you continue to educate the general public and move forward in your cause. So on behalf of the ministry, I accept the memorandum.”

Following a study done by PRICELESS (Priority Cost Effective Lessons for System Strengthening) which found that the HPL resulted in higher prices for sugary drinks, and untaxed healthier beverages like water did not increase in price.

“This is a first indication that the tax could motivate consumers to pick healthier options that are not taxed rather than taxed sugary drinks, which is very encouraging,” adds Mbalati.

The Minister of Finance’s budget speech, which will held at the end February, is expected to yield positive news for HEALA.

“We are happy that somebody from Treasury accepted our memorandum so we are now hoping that they will consider our recommendations and we will be looking at the upcoming budget speech that will be taking place at the end of this month to see if our call of the increase of the sugary drinks tax from 11% to 20% and not only that but to also further include 100% fruit juices has been taken seriously or not,” says Mary-Jane Matsolo, campaign and advocacy coordinator for HEALA.

Matsolo adds that they also hope to see government not giving in to pressure from unhealthy food and beverage manufacturers, but to put the health of South Africans into consideration especially when it comes to fighting to reduce the burden the health system faces because of the rising numbers of people who need treatment for NCDs. – Health-e News

Health-e News is a media partner of the Healthy Living Alliance.

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