SPONSORED: The decision to tax sugar-sweetened beverages was taken by the Treasury as part of its 2016 budget process, though the tax is only due to begin in 2017.
This tax is aimed at reducing a growing epidemic in non-communicable diseases and oral health problems.
There is good reason to believe – from both local experience with tobacco and alcohol and international experiences with sugar as well as tobacco and alcohol – that taxes are an excellent mediator of consumer behaviour.
The World Health Organisation’s (WHO) guidelines recommend that adults and children reduce their intake of free sugars to less than 10% of total energy intake.
A further reduction to below 5% or roughly 25g (six teaspoons per day) would provide additional health benefits.
Moreover, the Commission on Ending Childhood Obesity set up by the WHO director-general recommended, inter alia, that taxes on sugar-sweetened beverages would be an important mechanism to reduce childhood obesity.
It is important to note that one 330ml can of Coca Cola, for example, has about eight teaspoons of sugar, and therefore just one serving would provide the full recommended sugar intake per day.
Many other foods and the sauces added to food also contain sugar, not to mention discretionary intake.
While the national Department of Health was not responsible for introducing the tax, this intervention was noted as a “best buy” in the Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013-17 as well as in the department’s Strategy for the Prevention and Control of Obesity 2015-2020.
Research done by Priceless at the University of the Witwatersrand suggests that a 20% SSB tax could lead to a reduction in intake of 3.8% among men and 2.4% among women, or a decrease in obese people of 220,000 – mostly in the first three years.
On the other hand, without a tax, consumption of soft drinks is projected to grow by 2.4% per year, predominantly among poorer people, which could lead to a 16% increase in obesity by 2017 – of which 20% would be due to sugar-sweetened beverages.
While the department has not done specific calculations on costs to the economy, it has noted the global WHO estimates that high BMI (body mass index) values drive 2%–7% of global healthcare spending, with up to 20% of all healthcare spending attributable to obesity, through related diseases such as type-two diabetes and heart disease.
The department does not have figures for the impact of obesity on the economy as a whole, but it would be substantial in terms of absenteeism due to obesity-related illness and attendance at health facilities, lethargy at work and other effects.
A study conducted by the US Chamber of Commerce found the total economic impact due to absenteeism, presenteeism (people who are at work but not working at full capacity due to illness) and early retirement in South Africa to be equal to 6.8% of the gross domestic product.
Obesity and its associated disorders are among the main reasons for this high figure.
Sugar also has a negative impact on dental health and related costs.
Dental diseases, mainly linked to sugar intake, are the most prevalent non-communicable diseases globally, causing pain, anxiety, functional limitation (including poor school and work attendance) and social handicap through tooth loss.
While the department does not have exact costs in South Africa, the treatment of dental diseases is expensive, consuming 5%–10% of healthcare budgets in industrialised countries.
A 2002 survey in South Africa showed that 60% of children of six years of age; 37 percent of 12-year-olds; and 50% of 15-year-olds have dental caries and gum diseases; while 86% of 15-year-olds have unhealthy gums.
Excessive sugar consumption is a serious public health concern worldwide and has led, in recent decades, to a sharp increase in obesity and associated non-communicable diseases such as diabetes (Maliket al, 2010), cardiovascular disease (Yang et al, 2014), cancer (Chocarro-Calvo, García-Martínez, Ardila-González, De la Vieja and García-Jiménez, 2013) and dental caries (Touger-Decker and Van Loveren, 2003).
In 2013, 42% of women and 13.5% of men over 20 years of age had a body mass index greater than or equal to 30 kg per square metre, making South Africa the third most obese nation on the African continent (Murray et al, 2013).
Sugar-sweetened beverages are seen internationally as a good taxation target because:
- liquid sugar calories are especially harmful – drinking just one SSB per day increases an adult’s likelihood of being overweight by 27% and a child’s by 55% (Morenga, Mallard and Mann, 2013);
- they are less satiating than solid sources of sugar, which makes them more likely to be consumed in excess;
- they contain little else apart from sugar, artificial chemicals and water;
- they account for about one-third of all sugar consumed by the average South African;
- they are consumed to quench thirst after a meal, adding more energy;
- such a tax has already been implemented with varying amounts of success in other lower and middle-income countries with epidemics of obesity and related non-communicable diseases; and
- it would send a clear message to the public and raise awareness about sugar, which is necessary in an environment where marketing and other industry practices are confusing the public and undermining consumers’ ability to make healthy choices.
Limited references are used in this article to show the Department of Health’s position on sugar tax is evidence based. For more information, contact Prof Melvyn Freeman, cluster manager: non-communicable diseases, Department of Health, on +27 (012) 395 8020.
This content was provided by the Department of Health. It does not involve Times Media journalists.