Delays in increasing the Health Promotion Levy a danger to South Africans

On World Diabetes Day the Healthy Living Alliance, HEALA, embarked on a day of action calling on the government to increase the Health Promotion Levy to the recommended 20% to reduce the over consumption of sugar sweetened beverages (SSB’s) and decrease the incidence of diabetes amongst South Africans. Concerned South Africans gathered outside the offices of the National Treasury demanding for the increase and calling for an expansion of the levy to include fruit juices.

New research points to an alarming trend of a dramatic increase in the consumption of sugar sweetened beverages (SSB’s) in Sub-Saharan region. The sub-Saharan Africa region had the highest increase in SSB consumption between 2005 and 2018 (2 serving/week increase) while in high income countries consumption decreased by about one serving/week.

Experts from Harvard School of Public Health found that those who drink between 1 and 2 cans of sugar sweetened beverages have a 26% greater chance of developing type two diabetes than those who limit their consumption.

There were huge differences in SSB intake between more vs. less educated adults in sub-Saharan Africa (more educated adults consumed over 4 weekly servings compared to less educated adults).

Taxes on sugary drinks have been shown to work in reducing the consumption of these drinks. A South African studyreleased in 2021, three years after the implementation of the Health Promotion Levy, a levy put in place to support of the Department of Health’s deliverables to decrease diabetes, obesity and other related diseases in South Africa, found that there “SSB taxes were associated with reduced sugary drink intake in a low-income population within a middle-income country”.

However, due to government’s inertia in increasing the tax to the recommended 20%, there is danger of eroding gains made from implementing the tax.

“It’s clear we have reached the cross roads as the country and key policy decision to significantly increase the sugar tax presents a unique opportunity to halt Noncommunicable disease rates that have doubled up in the past decade and raise much needed revenue on the fiscals in the dire strain,”  says Nzama Mbalati, Programmes Manager for HEALA.

Dr Dr Lungi Hobe, Chairperson at Rural Doctors Association of SA, says the cost of diabetes on the individual is high.

“This is a multi-organ disease. So it can affect any organ in someone’s body. The reason for that is that it primarily affects your vessels.  Your vessels, as we all know, exist in every organ of our body. You have veins in your eyes that may be affected by diabetes. Patients can end up with what we call diabetes retinopathy. Some patients end up with complete blindness just from diabetes,” Dr Hobe explains.

“You can also affect a vessel in your heart.  So patients with diabetes have a higher risk of having heart attacks, or what we call cardiac devastation. You can have problems with the vessels in your kidneys.  A lot of patients with diabetes will present with kidney failure or chronic kidney disease,” she adds.

Over 4 Million South Africans are currently living with the life altering illness, almost half of those are undiagnosed. The disease comes at a high personal and public cost. In 2018 experts estimated that the public sector costs of undiagnosed type 2 diabetes where R2,7bn. Considering the undiagnosed the number shoots up to a staggering

The country cannot afford any more delays to the increase of the levy. The costs of government’s inaction and pandering to the sugar industry are too high.

“We believe that government will make the right choice and not listen to the food and beverage industry who want to look out for their own interests,” concludes Mbalati.