The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa

Figures & data

Table 1. Overview of consideration relevant to SSB taxation, nutrition and NCDs in food-related policies

Policy	Botswana	Kenya	Namibia	Rwanda	Tanzania	Uganda	Zambia
whole-of-government Policies
National Development Plan	Mentions the need to address NCDs and their associated lifestyle risk factors and promotion of healthy lifestyle ^a	Mentions need to address food security ^b	Mentions multisectoral approach to prevention and control of NCDs and agricultural production for improved nutrition ^c	Mentions malnutrition as hindering productivity. Supports alleviation of the burden of NCDs and their risk factors ^d	Mentions multi-sectoral action on NCDs ^e	Mentions promotion of healthy lifestyles for NCD prevention ^f	Mentions efforts to reduce NCDs through health promotion and implementing programmes to promote good nutrition ^g
Vision	State of the Nation Address 2018, the President mentioned that government was considering options to reduce consumption of unhealthy products such as SSBs ^h	Mentions food and nutrition security ^i	Mentions creating access to abundant, hygienic, and healthy food based on food security ^j	Mentions food security and NCDs as key to development	Mentions general policy commitment to NCDs ^k	Mentions NCD prevention through healthy lifestyles at household and community level and preventative health system^l	Mentions strengthening nutrition care practices for those affected by NCDs ^m
Health Sector Specific
National Health Policy	Mentions restricting marketing of unhealthy foods and SSBs and introducing fiscal measures to promote healthy diet and discourage unhealthy food ^n	Mentions NCD prevention through addressing major risk factors – including unhealthy diets ^o	Mentions general priorities for public health, which include nutrition and NCDs ^p	Mentions promoting dietary diversity as a way to address overnutrition ^q	Mentions malnutrition and obesity with lack of physical activity identified as a risk factor ^r	Mentions NCDs as a health and nutrition related problem addressed through knowledge and information ^s	Mentions NCD prevention and public policies to promote health to enhance quality of life of the population ^t
National Health Sector Strategic Plan	Mentions developing new guidelines to improve access to healthy food and increasing awareness of NCDs. Also mentions utilising ‘sin taxes’ to generate revenue ^u	Mentions halting and reversing the rising burden of NCDs ^v	Mentions prevention and management of NCDs ^w	Mentions coordination of stakeholders in nutrition programs and production of healthy food crops. Mentions increasing knowledge of good nutrition practices and strengthening intersectoral collaboration for NCDs prevention ^x	Mentions multi sectoral approaches to addressing preventable causes of disease but not specifically NCDs. Mentions nutrition in first 1000 days^y	Mentions provision of NCD prevention and control services: and community awareness of nutritious foods ^z	Mentions embedding nutrition interventions in plan to prevent NCDs. Also commits to multisectoral action to prevent and control NCDs ^aa
National Food and Nutrition Policy	Not identified	Mentions adequate nutrition for optimum health and general food production to increase access for food security ^bb	Focusses on food and nutrition security. Mentions nutrition transition and aims to improve quality of nutrition including through smallholder, local production ^cc	Strategic directions on all forms of malnutrition, to increase knowledge around diet-related NCDs and improve household food security ^dd	Not identified	Acknowledges NCDs require multisector approach ^ee	Mentions need to address challenges of malnutrition ^ff
NCD Strategic Plan	Mentions multisectoral approach to prevention and control of NCDs, specifically mentions creation of a legislative and policy environment conducive to healthy living and provision of subsidies for healthy foods ^gg	Mentions implementation of health-related legislation including limiting salt, saturated and trans fatty acids and sugar content of processed foods and beverages ^hh	Mentions multisectoral approach to minimise duplication and increase coordination ^ii	Mentions that NCD prevention and control should be integrated into existing healthcare system ^jj	Mentions increases in NCD burden as attributable to western fast foods, level of physical activity, alcohol and tobacco usage ^kk	No policy in place at point of field work	Mentions introducing a multisectoral plan and NCD task force to address NCD prevention. Specifically mentions addressing the limitations of industry self-regulation ^ll
Education sector specific
Schools Policy	Not able to obtain	Mentions increasing awareness and intake of adequate, locally available and nutritious foods among school children and their communities ^mm	Mentions access to diverse nutritious food in schools; Scale up school feeding programme; provision of balanced and fortified meals; nutrition education ^nn	Mentions integration of NCD prevention and control in school curricula at various levels of education. Recommends research support to generate evidence for monitoring NCDs risk factors control and NCD policy-making ^oo	Mentions promoting positive behaviour change for prevention NCDs by promotion of healthy life styles and the importance of healthy eating and physical fitness	Mentions that schools may include a variety of foods in the menu to ensure diet adequacy and diversity, with emphasis on fruits and vegetables. ^pp	Mentions plans to improve nutrition status of learners and initiating health promoting activities 43
Agriculture sector specific
National Agriculture policy	Not included	Not included	Mentions food quality, security, self-sufficiency and soveriegnty ^qq	Mentions food and nutrition security through production, accessibility and affordability of healthy foods ^rr	Policy promotes increasing local sugarcane production to meet SSB industry needs ^ss	Mentions promotion of production and consumptions of nutritious foods, including indigenous foods, at the household level ^tt	Mentions addressing food insecurity ^uu
Trade and Economic
Fiscal policy		Excise tax of KES 10 (USD 0.10) per litre on all non- alcoholic beverages, including bottled water and excise tax on sugar confectionary. (at KES 20 (USD 0.20) per kg) ^vv	Mentions VAT zero-ratings or exemptions for some goods and services, such as staple foods ^ww	Excise tax of 39% excise tax on soft drinks, including non-SSBs, with revenue earmarked broadly for government ^xx	Excise tax of TZS 54 (USD 0.02) per litre on non-alcoholic beverages and levy on imports for revenue earmarked broadly for government ^yy	Excise tax of UGX 200 (USD 0.05) per litre on non-alcoholic beverages and levy on sugar with revenue earmarked for HIV/AIDS Trust Fund ^zz	Excise tax of ZMW0 .3 (USD 0.02) per litre on non-alcoholic beverages for with revenue earmarked broadly for government ^aaa
National Trade and related Policy	Mentions restrictions on importing, exporting and licensing of agricultural products to ensure food security ^bbb	Not included	Foreign Investment Act 1995 includes support for food and beverage companies ^ccc	Ensure compliance of traded goods with regulations and that they match ‘the needs of the entire society’ ^ddd		Mentions that growth in trade should support food security, and the importance of compliance with standards that protect health ^eee

Blank cells indicate that the research team did not identify specific policy content relevant to SSB taxation, nutrition and NCDs in the policy document; ‘not included’ indicates that this sector was not included in the country-level study. The summaries of the policy documents presented in the table reflect the best endeavours of the research team to identify and obtain the relevant national policies during the period of data collection, and to accurately extract the relevant information.

Sources:

aRepublic of Botswana. National Development Plan 11 April 2017– March 2023. Botswana: Republic of Botswana, 2016.

bMinistry of Health. The Constitution of Kenya 2010. Nairobi: Government of Kenya, 2010.

cGovernment of Namibia. Namibia’s 5th National Development Plan (NDP5). Namibia, 2017.

dRepublic of Rwanda. 7 Year Government Programme: National Strategy for Transformation (NST 1) 2017 – 2024. Rwanda, 2017.

eMinistry of Finance and Planning. National Five Year Development Plan 2016/17 – 2020/21. Tanzania: The United Republic of Tanzania, 2016.

fThe Republic of Uganda. Second National Development Plan 2015/16– 2019/20 (NDPII). Kampala, Uganda: Republic of Uganda, 2015.

gMinistry of National Development and Planning. Seventh National Development Plan 2017– 2021. Lusaka, Zambia, 2017.

hDr. Mokgweetsi E.K. Massi, President of the Republic of Botswana. State of the Nation Address. Gaborone, Botswana: Republic of Botswana, 2018.

iGovernment of Kenya. Kenya Vision 2030. Nairobi: Government of Kenya, 2007.

jGovernment of Namibia, Office of the President. Namibia Vision 2030: Policy Framework for Long-Term National Development. Windhoek, Namibia: Government of Namibia, 2004.

kThe United Republic of Tanzania. The Tanzania Development Vision 2025. Tanzania: The United Republic of Tanzania, 2000.

lThe Republic of Uganda. Vision 2040. Kampala, Uganda: Government of Uganda, 2007.

mMinistry of Finance. Vision 2030: A Prosperous Middle-Income Nation by 2030. Zambia: Republic of Zambia, 2006.

nMinistry of Health. National Health Policy ‘Towards a Healthier Botswana’. Gaborone, Botswana: Republic of Botswana, 2011.

oMinistry of Health. Kenya Health Policy 2012– 2030. Nairobi, 2012.

pMinistry of Health and Social Services. National Health Policy Framework 2010– 2020. Namibia: Government of Namibia, 2010.

qMinistry of Health. Health Sector Policy. Kigali, Rwanda: Republic of Rwanda, 2015.

rMinistry of Health, Community Development, Gender, Elderly and Children. The National Health Policy 2017. Tanzania: The United Republic of Tanzania, 2017.

sMinistry of Health. The Second National Health Policy: Promoting People’s Health to Enhance Socio-economic Development. Uganda: The Republic of Uganda, 2015.

tMinistry of Health. National Health Policy. Lusaka, Zambia: Republic of Zambia, 2012.

uMinistry of Health. Integrated Health Service Plan: A Strategy for Changing the Health Sector for Health Botswana 2010 – 2020. Botswana: Government of Botswana, 2010.

vRepublic of Kenya. Health Sector Strategic and Investment Plan (KHSSP) July 2013 – June 2017. Nairobi, Kenya: Ministry of Medical Services and Ministry of Public Health and Sanitation, 2013.

wMinistry of Health and Social Services, Primary Health Care Directorate Family Health Division. National Multisectoral Strategic Plan for Prevention and Control of Non-Communicable Diseases (NCDs) in vi 2017/18 – 2021/22. Namibia: Government of Namibia, 2017.

xMinistry of Health. Health Sector Policy. Kigali, Rwanda: Republic of Rwanda, 2015.

yMinistry of Health and Social Welfare. Health Sector Strategic Plan July 2015 – June 2020. Tanzania: United Republic of Tanzania, 2015.

zMinistry of Health. Health Sector Development Plan 2015/16– 2019/20. Kampala, Uganda: The Republic of Uganda, 2015.

aaMinistry of Health. Zambia National Health Strategic Plan 2017– 2021. Zambia: Republic of Zambia, 2017.

bbMinistry of Public Health and Sanitation. National Nutrition Action Plan 2012– 2017. Nairobi: Government of Kenya, 2012

ccRepublic of Namibia, National Food security and nutrition council, Food and Nutrition policy for Namibia. Windhoek, Namibia; 1995

ddMinistry of Local Government, Ministry of Health and Ministry of Agriculture and Animal Resources. National Food and Nutrition Strategic Plan. Kigali, Rwanda: Republic of Rwanda, 2014.

eeMinistry of Agriculture, Animal Industry and Fisheries and Ministry of Health. The National Food and Nutrition Strategy. Uganda: The Republic of Uganda, 2005

ffNational Food and Nutrition Commission of Zambia. National Food and Nutrition Strategic Plan for Zambia 2011– 2015. Zambia: Republic of Zambia, 2011.

ggMinistry of Health & Wellness. Botswana Multi-Sectoral Strategy for the Prevention and Control of Non-Communicable Diseases 2018– 2023. Botswana: Republic of Botswana, 2018.

hhMinistry of Health. Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases 2015 – 2020. Nairobi, 2015.

iiMinistry of Health and Social Services, Primary Health Care Directorate Family Health Division. National Multisectoral Strategic Plan for Prevention and Control of Non-Communicable Diseases (NCDs) in Namibia 2017/18 – 2021/22. Namibia: Government of Namibia, 2017

jjMinistry of Health. Rwanda Noncommunicable Diseases National Strategic Plan July 2014– June 2019. Kigali, Rwanda: Republic of Rwanda, 2014.

kkMinistry of Health, Community Development, Gender, Elderly and Children. Strategic and Action Plan for the Prevention and Control of Non Communicable Diseases in Tanzania 2016– 2020. Tanzania: Government of the United Republic of Tanzania, 2016.

llMinistry of Health. Zambian Strategic Plan 2013 – 2016 Non–Communicable Diseases and their Risk Factors. Lusaka, Zambia: Government of the Republic of Zambia, 2013.

mmMinistry of Education, Ministry of Health, Ministry of Agriculture, Livestock and Fisheries. National School Meals and Nutrition Strategy 2017–2022. Kenya: Republic of Kenya, 2017.

nnRepublic of Namibia; Ministry of Education, Arts and Culture, NAMIBIA SCHOOL: FEEDING POLICY; 2019

ooMinistry of Education. Education Sector Policy. Rwanda: Republic of Rwanda, 2014.

ppMinistry of Health & Ministry of Education and Sports. Uganda School Health Policy. The Republic of Uganda; 2008.

qqMinistry of Education. National School Health and Nutrition Policy. Lusaka, Zambia: Republic of Zambia, 2006.

rrRepublic of Namibia; Namibia Agriculture policy, 2015

ssMinistry of Agriculture and Animal Resources. Strategic Plan for Agriculture Transformation 2018 – 24. Rwanda: Republic of Rwanda, 2018.

ttMinistry of Agriculture, Food Security and Cooperatives. National Agriculture Policy. Tanzania: The United Republic of Tanzania, 2013.

uuMinistry of Agriculture, Animal Industry and Fisheries and Ministry of Health. National Agriculture Policy. Uganda: The Republic of Uganda, 2013.

vvMinistry of Agriculture and Ministry of Fisheries and Livestock. Second National Agricultural Policy. Lusaka, Zambia: Government of the Republic of Zambia, 2016.

wwGovernment of Kenya. Kenya Gazette Supplement: National Assembly Bills 2018. Nairobi, 2018.

xxRepublic of Namibia; Fiscal policy and National Economy . Aligning Public Expenditure with the Medium-Term Development Plan for Socio-Economic Development; 2015

yyMinistry of Trade and Industry. Rwanda Trade Sector for Quality, 2010. Rwanda: Republic of Rwanda, 2010.

zzzThe United Republic of Tanzania. The Excise (Management and Tariff) Act. Sect. 4 (2019).

aaaThe Republic of Uganda. The Excise Duty (Amendment) (NO.2) Act, 2018, (2018).

bbbGovernment of Zambia. The Customs and Excise (Amendment) Act, 2018, (2018).

cccUNCTAD. Trade Policy Framework: Botswana. New York and Geneva: UNCTAD, 2016.

dddGovernment of the Republic of Namibia. Value-Added Tax Amendment Act, Namibia: Government Gazette of the Republic of Namibia, 12 (2015).

eeeThe Republic of Uganda. Uganda National Trade Policy 2007: Trading Out of Poverty Into Wealth and Prosperity; 2007.