Bring on sugar tax say SA's top health experts


Support for a tax on sugar sweetened beverages (SSBs) is mounting with some of South Africa's leading health professionals endorsing the move.

Representatives of the Public Health Community of South Africa have sent a letter to Treasury, signed by 26 leading individuals and institutions.

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They write that the decision to implement a sugary tax is an important first step that has been identified as a cost effective intervention in both the National Department of Health’s Strategic plan for Non–Communicable Diseases and their National Strategic Plan for Obesity.

Consuming large amounts of sugar puts people at high risk for lifestyle diseases like diabetes, stroke and obesity. SSBs include the following: still and carbonated soft drinks, fruit juices, sports drinks, energy drinks and vitamin waters, sweetened ice tea, lemonade, cordials and squashes.

"The implementation of the tax will need to be followed rapidly by a series of other measures to address the staggering obesity epidemic in this country that now rivals HIV and TB."

This must include, among others, a population-wide health promotion campaign so that the public appreciates this tax as an enabling process to support individual and population level health.

"Without urgent preventive measures we will face a dire situation of growing deaths and disabilities in the next few years. This will disproportionately impact women, children and the poor, and overwhelm our health systems."

Read: Sugar secret - What SA needs to know

They say the decision to include the sugar tax in the budget is the start of a far-sighted approach that will have significant impact.

Health experts believe the tax would also prevent dental morbidity, which causes high levels of absenteeism at primary and high school level, particularly among those from disadvantaged backgrounds.

"A higher tax rate would have an even more significant impact on obesity, oral disease, diabetes and other related diseases."

In Finance Minister Pravin Gordhan's budget speech in February, one of the tax proposals put on the table was an "introduction of a tax on sugar-sweetened beverages".

Gordhan said the proposed sugar tax will be implemented in April next year, but did not say how high the levy would be.

"We commend Treasury for including the tax on the agenda and we urge them to stand firm as they meet with the beverage industry on Thursday 21 April 2016."

The Beverage Association of South Africa (BevSA), whose members include Coca Cola, Pepsi and SABMiller, previously claimed the tax was "discriminatory" and was bound to fail.

Read: What’s SA’s most sugary drink?

Following the sugar tax announcement in the budget, a 24-hour snap poll on News24 indicated that 47% (11 992) of readers who participated in the vote were in support of a sugar tax. 28% (7 012) readers were not in favour of it, while 25% (6 492) were neutral.

Researchers at the Wits School of Public Health have shown that a 20% tax could reduce the number of obese people by almost a quarter of a million over the next 3–5 years.

One of the authors of the study, Health sociologist, Aviva Tugendhaft, previously told Health24 that the Treasury have several options available for the type of tax on SSBs.

"Treasury will need to decide on the tax rate and what qualifies to be taxed," said Tugendhaft, who is deputy director of research programme PRICELESS SA at the Wits School of Public Health, which is one of the undersigned participants.

"The government may decide to institute a flat rate on all beverages, as has been done in Mexico, or consider taxing the caloric content of the drinks," she said at the time.

The letter is signed by the following representatives:

1.    Public Health Association of South Africa
2.    World Federation of Public Health Associations
3.    South African Paediatric Association
4.    Rural Health Advocacy Project
5.    SECTION27
6.    South African Food Sovereignty Campaign
7.    PRICELESS SA, School of Public Health, University of the Witwatersrand
8.    Prof Laetitia Rispel, HOD, School of Public Health, University of the Witwatersrand
9.    Dr Veerasamy Yengopal, HOD, Community Dentistry, University of the Witwatersrand and Acting Chair, South African Association of Community Dentistry
10.    Dr Mpho Molete, Specialist in Community Dentistry, University of the Witwatersrand, Chair of PHASA Special interest Group (Dental Public Health)
11.    Dr Sundeep Ruder, Endocrinologist, Associate Lecturer, University of the Witwatersrand, Honorary Consultant Charlotte Maxeke Academic Hospital
12.    Dr Saloshni Naidoo, HOD of the Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal
13.    Prof Mohamed Jeebhay, HOD and Director, School of Public Health and Family Medicine, University of Cape Town
14.    Professor Leslie London, School of Public Health and Family Medicine, University of Cape Town
15.    Prof Lilian Dudley, Department of Community Health, University of Stellenbosch
16.    Prof Usuf Chikte, Executive Head, Department of Interdisciplinary Health Sciences, University of Stellenbosch
17.    Professors Helen Schneider, David Sanders and Thandi Puoane, School of Public Health, University Western Cape
18.    Prof Attie Louw, Head, Community Dentistry, University of the Western Cape
19.    Prof Lekan Ayo-Yusuf, Head of School, Sefako Makgatho Health Sciences University
20.    Dr Ahmed Bhayat, Head, Community Dentistry, University of Pretoria
21.    Aadielah Makerer, Health Promotion and Development Foundation Network
22.    Dr Yussuf Saloojee, Executive Director, National Council Against Smoking
23.    Dr Irwin Friedman, Public Health Physician, Sustainable Enterprise for Enabling Development (SEED) Trust
24.    Prof Sudeshni Naidoo, Chair, Alliance for a Caries Free Future (ACFF), South African Chapter
25.    Centre for Diabetes and Endocrinology (Pty) Ltd (CDE - Your Partner in Diabetes)
26.    Distiller, Kramer & Associates Diabetes and Endocrine Practice, Houghton, Johannesburg

Article resources:

Public Health Community of South Africa

Health24: Sugar tax gets sweet support in News24 poll;

Fin24:  Sugar tax: Beverage industry to meet Treasury;

PLOS ONE journal: "The potential impact of a 20% tax on sugar-sweetened beverages on obesity in South African adults: A mathematical model” by Mercy Manyema, Lennert J. Veerman, Lumbwe Chola, Aviva Tugendhaft, Benn Sartorius, Demetre Labadarios, Karen J. Hofman:

Also read:

Why a 20% sugar tax would be devastating for South Africans

Why too much sugar is bad for you

Carte Blanche reveals the shocking dangers of sugar addiction

Why your body needs sugar

Don't fall for the sugar witch hunt

What's SA's most sugary sauce?

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