A senior health department official has allegedly revealed that South Africa has no choice but to introduce a sugar tax, according to the Democratic Alliance (DA); however the Department of Health has dismissed these claims.
"I was told about two months ago by a very, very senior individual in the health department that they 'have no choice but to introduce a sugar tax'", DA Shadow Minister of Health Wilmot James told Health24.
He said the DA does not agree to a sugar tax. "It is regressive. It will affect the poor the most by driving up food prices; and the economic circumstances presently are not at all conducive to raising taxes."
We should be seen to exercise
James said while the middle and upper classes have resources and choice, more must be done to make choice available and accessible to poor people.
"Then there should be a national campaign about healthy lifestyles led by people who set the example. Far too many of our politicians are unhealthily overweight and will die an early death because of hypertension, diabetes and heart disease. We must eat well and be seen to be eating healthily; and we should be seen to exercise."
The department of health quashed talks of it being involved in a sugar tax campaign.
This despite releasing in December a Strategy for Prevention and Control of Obesity in SA document, highlighting that the most effective way to curb obesity would be to introduce a sugar tax. The document also mentions "influencing fiscal policies related to sugar-sweetened beverages".
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The Minister of Health Aaron Motsoaledi has not made any pronouncements of a sugar tax, said his spokesperson Joe Maila.
"The Minister of Health and the Department of Health have not pronounced on that kind of a tax. We are aware that there are people in the country and elsewhere in the world who have been calling for a sugar tax, but we have never said that as the department of health. We are not Treasury so we can not be pronouncing on things like that in terms of tax. We can only talk about the department of health."
He said the department's view is that in order to deal with the communicable diseases, many factors are considered. "We're not necessarily concentrating on one thing. You cannot deal with the bulk of communicable diseases and only deal with one thing like sugar. You need to deal with all the risk factors."
Maila said some of these include projects focused on balanced eating, reducing alcohol intake and exercising regularly.
There have been widespread calls in South Africa for a sugar tax, which is believed will help curb the obesity rate in the country, which is number one for obesity in Sub-saharan Africa.
Research by the University of Witwatersrand has found that a suggested 20% tax on sugar-sweetened beverages (SSBs) may reduce obesity in 220 000 adults.
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.
Why a sugar tax alone is not a magic pill
However, Health Sociologist Aviva Tugendhaft, one of the authors of the study, told Health24 that a sugar tax is not a silver bullet for obesity.
"Our research shows that a sugar sweetened beverage tax could reduce the number of obese adults by almost a quarter of a million but this needs to be part of a multi pronged approach that also includes things like advertising regulations, easy to understand food labelling, worksite and school based interventions, as well as education campaigns."
Tugendhaft, who is also Deputy Director of PRICELESS SA, which is a research programme providing information on “Best Buys” for public health using SA data, at Wits School of Public Health, said over half of the population is overweight and obese, with 13% of men and 39% of women obese.
"This puts people at high risk for lifestyle diseases like diabetes and stroke."
But sugar is not the only reason South Africans are getting fatter, although it is a huge contributor.
"Drinking one sugary drink a day, for example, increases the risk of being overweight by almost 30% for adults and over 50% for children. This is because these drinks contain about 8 teaspoons of sugar."
We consume about 24 teaspoons of sugar a day
Alarmingly, Tugendhaft pointed out: "South Africans consume on average 24 teaspoons of sugar a day, well above the suggested limit of between 6-12 teaspoons."
There is a lot of sugar in processed foods too and hidden sugars in supposedly healthy products, she cautioned, adding that food choices are shaped by availability, affordability and most significantly relentless marketing.
"The food and advertising environment in SA makes it very difficult to make healthy choices. Lower income groups, who are more vulnerable to disease, are now being targeted more aggressively with unhealthy products as this is where greater growth potential lies for industry."
Tugendhaft said the country needs interventions that target all these issues and that help to make the healthier choice the easier one.
"South Africa needs to act urgently otherwise, as our research shows, obesity rates will soar and health care costs will cripple an already overburdened healthcare system," she warned.
Creating awareness and attention
Dr Sundeep Ruder, Consultant Physician & Endocrinologist, said in his opinion a sugar tax will certainly begin to help curb the obesity problem and it would serve many purposes.
"A sugar tax would bring much needed attention and awareness among civil society of the epidemic of obesity and certainly highlight the contributory role of sugar to this epidemic. As the problem is highlighted through the vehicle of sugar taxes, people will seek knowledge on this and are more likely to change habits."
He said sugar tax may deter people from buying products with high sugar content.
"The argument that low income groups would suffer the consequence of not affording “food” is invalid. As it stands, most sugar sweetened products (SSPs) are cheaper than the healthy food. Obesity and type 2 diabetes continue to affect this group largely at greater cost in terms of poor health, disability, medical expenditure etc.
"The implementation of a sugar tax in Mexico affected this group most, with significant reduction in consumption off SSPs within the first year and freeing up of household income for healthier options. The argument that most SSPs are not really food in that they have very little true nutritional value also needs to be considered," said Ruder.
However, he said a sugar tax on its own is not the answer. "Government need to come on board and assist in providing the correct 'landscape' to truly solve the problem."
Ruder said any revenue generated from a sugar tax could be fed into funding measures to curb the obesity epidemic.
"Government could use such funds for media campaigns, education, supporting medical structures, development of specialists in the field of obesity, infrastructure like parks and other areas of for physical activity.
He also suggested that a legislative effort to force food companies to reduce sugar content gradually over a stipulated period should be implemented e.g. a 20% reduction per year.
"Studies have shown that people are more likely to change behaviours and stick with them if gradual change is implemented. Also, the taste difference over time which is the major driving factor in the consumption of these foods would be minimal," said Ruder.
Cope throws its weight behind sugar tax
The Congress of the People (COPE) told Health24 that the party is in support of a tax on sugar-sweetened drinks, but it said three things must happen:
"First, all products must reflect sugar content in grams and in teaspoons. Secondly, intensive education of the public must follow. Finally, impose a 20% tax," said COPE spokesperson Dennis Bloem.
"All this must happen sequentially inside 24 months. Decisive action is needed and COPE will fully support measures to rescue South Africans from the health minefield they are unknowingly walking into."
Bloem said that poverty, however, is indeed a problem when it comes to healthy living. "Poor people are resource poor, but given knowledge and support, they can improve their lot because of their own innate capabilities."
He said COPE has been asking during budget debates for the creation of viable communities where cultural norms apply.
"Many who migrate from rural areas into cities shake off cultural norms in the townships and give up on healthy diets for sugar laden food. In our view, providing houses without providing opportunities for income generation and gardening, solves one problem while creating two more," said Bloem.
Bloem added: "Food security is a serious problem that will become even more serious going forward."
He recommended that container gardening, using discarded 20 litre containers, is a solution to food production and healthy eating.