Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Namibia: a policy landscape analysis

Figures & data

Table 1. Key informants by sectoral interest and type of organisation (N = 13)

Type of organisation	Sectoral interest of respondents^a
National Government (n = 9)	Public health (n = 6) Economic/trade and industry (n = 2) Social welfare (n = 4)
NGO (n = 1)	Economic/industry (n = 1)
Academic institution (n = 3)	Public health (n = 3)

^aThree national Government respondents had dual responsibilities.

Table 2. Summary of findings using three categories of Kingdon’s theory of agenda setting

Kingdon category	Facilitator of SSB taxation	Barrier to SSB taxation
Category 1: Understanding the problem of NR-NCDs and SSB taxation	Government has acknowledged the scope and impact of the problem of NR-NCDs through various policies. A multisectoral approach contributes to effective solution-making.	Unhealthy diets persist with foods with high sugar content, and excessive calorie consumption. Low literacy, poverty and unemployment result in healthy food choices being secondary to other needs. The absence of detailed and granular information about NCDs.
Category 2: Policy related to NR-NCDs and SSB taxation	Policies emanate from several sectors. SSB tax is envisaged in policy.	Several different approaches to the problem have been postulated. Interviewees believe solutions should be ‘gender-neutral’. Resources to combat SSBs are not clear in existing policy documents.
Category 3: Politics of major stakeholders	High-level political acknowledgement of NR-NCDs. Commitment to international and regional treaties. Regional trade partners have adopted an SSB tax	Influence of industry stakeholders is unknown. Perception that NCD management would be in conflict with other socio-economic development goals.

Table 3. Namibian policy documents relating to NR-NCDs and nutrition

Document	Content related to NCDs and nutrition	Responsibility ministry
Namibia’s 5th National Development Plan (NDP5) 2017–2022	Increase productivity in agriculture and improve nutrition; Government will procure locally produced food and urges other organisations to do so.	Ministry of Economic Planning Ministry of Agriculture, Water and Forestry
National Multisectoral Strategic Plan for Prevention and Control of Non-Communicable Diseases (NCDs) in Namibia 2017/18 – 2021/22	Government will provide the fiscal environment and policies necessary for NCD prevention and control; reduce sugar consumption through effective taxation of SSBs.	Ministry of Health and Social Service Ministry of Finance Ministry of Industrialisation, Trade and Small & Medium Enterprise (SME) Development
Ministry of Health and Social Service – Strategic Plan (2017/2018 – 2021/2022)	Refer to implementation of programmes that aim at reducing NCDs; refer to role of Ministry of Agriculture to ensure sufficient food and nutritional security.	Ministry of Health and Social Services Ministry of Agriculture, Water and Forestry Ministry of Finance
Nutrition guidelines for prevention and management of non-communicable diet related diseases January 2013	Recommends limiting daily intake of sugar.	Ministry of Health and Social Services
National Food and Nutrition Security Policy 2018–2028	One of the policy objectives strengthens local production of safe and nutritious foods, especially by smallholder farmers.	Office of Prime Minister Ministry of Agriculture, Water and Forestry Ministry of Health and Social Services Ministry of Information and Communication Technology
Agriculture Marketing, Trade Policy and Strategy 2011	Namibia aims to ensure that all agricultural and agro-industrial products both imports and Namibian originating products – destined for the domestic market meet the set minimum quality standards, technical regulations and food safety requirements.	Ministry of Agriculture, Water and Forestry Ministry of Health Social Services Ministry of Information and Technology Ministry of Finance Ministry of Trade and Industry
Namibia Food Safety Policy 2015	The Namibia Standards Institution under the Ministry of Industrialization, Trade and SME Development is responsible for implementing the Standards Act (2005), which controls standards such as additives, processing aids, and all products traded in Namibia.	Ministry of Agriculture, Water and Forestry Ministry of Health and Social Services Ministry of Fisheries and Marine Resources Ministry of Industrialization, Trade and SME Development
Value-Added Tax Amendment Act 12 of 2015	Prescribes different taxation rates for food and drink products imported into Namibia.	Ministry of Finance Ministry of Trade and Industry
Namibia Vision 2030: a vision for Namibia	Create access to abundant, hygienic and healthy foods, based on food security.	All Government ministries and agencies
National health policy framework 2010–2020	Sets general priorities for public health, which include nutrition and NCDs	Ministry of Health Social Services and all stakeholders in health and social services delivery

Table 4. SSB-related taxation and level of influence – stakeholder analysis findings

Stakeholder	Reason for interest in SSB-related taxation	Perceived level of influence
Office of the Prime Minister (OPM)	To reduce the preventable and avoidable burden of morbidity, mortality and disability due to NCDs in the country, and achieve a healthy and productive population	High, due to coordinator function
Ministry of Health and Social Services	1. To reduce the preventable and avoidable burden of morbidity, mortality and disability due to NCDs in the country, and achieve a healthy and productive population 2. To reduce modifiable risk factors for NCDs and underlying social determinants through the creation of health promoting environments	High, due to interest in health
Ministry of Industrialization, Trade and SME Development	To reduce burden of NCDs on the population and workforce To ensure economic growth and investor confidence	High, due to potential effect on industries
Ministry of Agriculture, Water and Forestry	To ensure increased interest and access to healthy food To increase agriculture production of healthy foods	Medium
Ministry of Finance	To generate revenue through taxation and punitive legislation	High, due to possibility of revenue generation
Ministry of Information, Communication and Technology	To ensure that correct and appropriate health information is disseminated to the population with regard to SSB and NCDs	Low, as they have no direct benefit
Academic institutions	To generate evidence through research to support improvement in public health and reduce burden of NCDs	Medium
Industry	To ensure SSB products remain on the market and generate profit	High, to remain viable