04 March 2021
“The science is clear on the harmful effects of sugar added to beverages and the strong, beneficial, effects of your current Health Promotion Levy (HPL).”
Over 35 top experts on obesity, diet-related diseases and public health from some of the world’s leading universities have written to Treasury officials to support increasing the current HPL to 20%. They are also very impressed with the results of evaluations done on the current HPL.
The dangers of sugary beverages
Drinking liquid sugar in beverages and the extra calories a person takes in this way have been linked to noncommunicable diseases (NCDs) like diabetes, hypertension, overweight and obesity. These are leading causes of death and disability in later life in South Africa.
- Sugary drinks often have no nutritional value.
- They are particularly harmful to the body in liquid form because the liver absorbs them more quickly than it can process and release. The excess is then stored as fat or glycogen deposits in the liver. This can lead to fatty liver disease and a higher risk for diabetes and other NCDs.
- A person should not consume more than 10% of total calories from added sugar (World Health Organization and the World Cancer Research Fund guidelines).
- But just one 600ml bottle of cooldrink contains 12% of total calories from added sugars for an adult.
- It would require 16 minutes of running and over 1.5 km of walking to exercise it off.
Counting the costs
The COVID-19 pandemic has shown how obesity, diabetes and hypertension add a much higher risk of going to hospital or dying from COVID-19.
- In South Africa, diseases linked to obesity like heart disease, diabetes, stroke, osteoarthritis and some cancers are in the top ten causes of death, killing 4 in 10 people (43%).
- South Africa has the highest obesity rates in Sub-Saharan Africa and the rates are continuing to soar. Nearly 70% of South Africa’s women and just under 40% of men are overweight or obese.
- This burden is increasing rapidly. Lower income and rural populations carry the highest burden of overweight and obesity and have the most untreated diseases like hypertension.
- This is why the failure to increase the levy to 20% will hit the poorest in South Africa, costing the country billions in lost revenue and lives lost to entirely preventable diseases.
Praise for the HPL results
South Africa’s HPL was the first major sugar-sweetened beverage tax based on grams of sugar. Researchers at the University of the Witwatersrand and the University of the Western Cape found that:
- Prices of taxable beverages increased over the first year of the tax, while non-taxable beverage prices did not change meaningfully.
- After the tax was introduced, purchases of taxable beverages by urban households fell by 29%, and sugar content from these purchases fell by 51%. Importantly, poorer households cut the volumes of their sugar sweetened beverage (SSB) by nearly a third, and dropped grams of sugar from SSBs by over half (57%).
- In Langa in the Western Cape, young adults aged 18-39 years reported they drank 37% less SSBs and reduced sugar intake by nearly a third (31%).
- In Soweto, Johannesburg, a study found that heavy consumers of SBBs dropped their intake by seven times a week, and medium consumers by two times a week, between the start of the study and after 12 months. These reductions stayed for two years after the HPL was introduced.
- And contrary to industry’s gloomy predictions, public data on employment in the sugar and beverage industries showed no statistically significant change in employment and followed pre-implementation trends.
Why increasing the HPL remains a great idea
“The HPL will have a long-term effect on excessive weight gain and a direct impact on reducing the risk of diabetes, hypertension and many other NCDs.”
- To further promote health, the global experts urged for the HPL to be doubled to the 20% levy that Treasury itself proposed in June 2016. This will greatly affect sugar consumption and dropping the cut-off level to 1 or 2 grams/100ml will have an even greater impact.
- The HPL has generated revenue of R5.4 billion over the first two years of the tax being in place (approximately 0.2% of total government revenue over the same period).
- The revenue could be used to cover health-related COVID costs, or go towards strengthening health services that focus on preventing disease.
HEALA believes that Government now has plenty of evidence to prove that the HPL is working. It could do even more.
The experience with the HPL shows that public health policies that increase the price of harmful products do reduce consumption.
Even more importantly, South Africans need to know what is in their food and drink so that they can make informed choices about healthy living and take control of their health.