Sugar and health in South Africa: Potential challenges to leveraging policy change

ABSTRACT

A growing body of evidence indicates that excessive sugar consumption is driving epidemics of obesity and related non-communicable diseases (NCDs) around the world. South Africa (SA), a major consumer of sugar, is also the third most obese country in Africa, and 40% of all deaths in the country result from NCDs. A number of fiscal, regulatory, and legislative levers could reduce sugar consumption in SA. This paper focuses on a sugar-sweetened beverage (SSB) tax. The purpose of the paper is to highlight the challenges that government might anticipate. Policies cannot be enacted in a vacuum and discussion is focused on the industrial, economic, and societal context. The affected industry actors have been part of the SA economy for over a century and remain influential. To deflect attention, the sugar industry can be expected either to advocate for self-regulation or to promote public–private partnerships. This paper cautions against both approaches as evidence suggests that they will be ineffective in curbing the negative health impacts caused by excessive sugar consumption. In summary, policy needs to be introduced with a political strategy sensitive to the various interests at stake. In particular, the sugar industry can be expected to be resistant to the introduction of any type of tax on SSBs.

KEYWORDS:

• Sugar
• sugar-sweetened beverage tax
• obesity
• non-communicable diseases
• industry challenges

Notes

1 This assumes that prepubescent children will consume between 1200 and 1600 calories in total per day.

2 This approximate figure has been calculated using SASA data on annual per capita sugar consumption for 2012/2013 (36 kg) and data on soft drink sales (Euromonitor International, 2013).

3 Paper currently under review.

4 This paper follows the definition provided by Moodie et al. (2013): ‘Ultra-processed products are made from processed substances extracted or refined from whole foods – e.g., oils, hydrogenated oils and fats, flours and starches, variants of sugar, and cheap parts or remnants of animal foods – with little or no whole foods’ (p. 671).

5 These figures have been calculated by taking the annual per capita sugar consumption for 2012/2013 (36 kg) dividing this by 365, the number of days in the year and then multiplying by 1000 to arrive at an amount in grams. In order to calculate the number of teaspoons, this figure was further divided by 4.2. Figures have been rounded off.

Additional information

Funding

This project was supported by the International Research Development Centre (IDRC, Canada) [grant number PROP020911E]. The funders had no role in study design or analysis methods, decision to publish, or preparation of the manuscript.