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.