Signatories to an open letter in support of the tax from the Harvard Chan School of Public Health, Johns Hopkins Medical Institution, New York University, University of London, Wits University, University of Cape Town, Stellenbosch University, Oxford University, Mexico’s Instituto Nacional de Salud Pública, and public Health Associations from South Africa, Australia and Quebec among others, have stated that the science on the role of SSBs is clear – excess sugar consumption is a major cause of obesity and its related diseases.

They have expressed strong support for taxation of sugary drinks in South Africa as a critical highly effective measure and part of a broader programme to address these issues.  They maintain that excess sugar consumption is a major cause of obesity and its related diseases, as excessive sugar intake causes increased risk of diabetes, liver and kidney damage, heart disease, and some cancers.

Between 2001 and 2015, sales of sugary drinks in South Africa grew by over 65%, reaching 262ml per capita per day. Simultaneously, between 1998 and 2012, obesity grew from 30.0%  to 39.2% among women, and from 7.5% to 10.6% among men.

Between 2001 and 2015, sales of sugary drinks in South Africa grew by over 65%, reaching 262ml per capita per day. Simultaneously, between 1998 and 2012, obesity grew from 30.0%  to 39.2% among women, and from 7.5% to 10.6% among men.

The World Health Organization (WHO) and the World Cancer Research Fund recommend that people should consume no more than 10% of total calories from added sugar, and preferably less than 5%.

In a situation where the country’s health system is unable to cope with demand and health resources are focused more on cure than prevention, sugary drink taxes are a winning solution for governments as they reduce consumption while increasing revenue. Studies have demonstrated a 20% tax on sugary drinks in South Africa could reduce obesity prevalence by 3.8% among men and 2.4% among women, and raise annual revenues of R6.4 billion which could be used to address obesity and related diseases.  The tax also increases consumption of healthier beverages, such as water and milk.

Sugary drink taxes are particularly effective among lower income consumers, who are more responsive to price increases and who often suffer disproportionately from the ill effects of obesity.

Globally, taxes have clearly worked. Mexico had the world’s highest intake of sugary drinks. After a modest tax of 10%, the country experienced a meaningful price increase and a significant reduction in sugary drink purchases. Its tax most significantly reduced consumption among lower-income and high-volume consumers, thus achieving health benefits among the two groups with the greatest health risk.1 After the tax was in effect for one year, sugary drink  purchases among the poorest third of the population were reduced by 9%.2 In the second year of the tax, contrary to industry pronouncements, per capita sales and purchases of sugary drinks declined further above the yearlong decline. After the tax, Mexican research showed that consumers were replacing sugary drinks with healthier beverages like water.2

Even in high income, lower sugary drink-consuming Berkeley California, USA, the tax had positive impacts on reducing frequency of sugary drink consumption and increasing water consumption frequency.3

The WHO and other global experts recommend that sugary drink taxes should be 20% or greater in order to be most impactful.4-7 Governments in the UK and many other locations are now promoting 20% or higher sugary drink taxes as an essential strategy for achieving major health benefits.5,8-10

It is critical to note that any tax of sugary beverages should include all forms-sodas, energy drinks, fruit juices, waters, sports drinks, powders and concentrates.

For further information, or to schedule interviews with local and international experts, please contact Tracey Malawana on info@heala.org. 

 Signed by: 

1.     Barry M. Popkin

W. R. Kenan, Jr. Distinguished Professor of Nutrition

University of North Carolina

2.     Carlos A. Monteiro, MD, PhD

Professor of Nutrition and Public Health

Department of Nutrition, School of Public Health

University of São Paulo

3.     Ricardo Uauy, MD, PhD

Professor and former Director INTA

University of Chile

4. Juan Rivera Dommarco, PhD

Director

Centro de Investigacion en Nutricion y salud

Instituto Nacional de Salud Pública

Mexico

5. Dr. Carlos A. Aguilar Salinas

Investigador en Ciencias Médicas F

Instituto Nacional de Ciencias Medicas y Nutrición

6. Walter Willett, MD, DrPH

Professor of Nutrition and Epidemiology

Harvard Chan School of Public Health

7. Frank Hu, MD, PhD

Professor of Nutrition and Epidemiology

Harvard Chan School of Public Health

8. Carlos A. Camargo, MD DrPH

Professor of Emergency Medicine & Medicine

Harvard Medical School

Professor of Epidemiology

Harvard School of Public Health

9. Lawrence J. Appel, MD, MPH
10. David Molina, M.D., M.P.H. Professor of Medicine

Professor of Medicine, Epidemiology and International Health

Johns Hopkins Medical Institutions

Chair, AHA Lifestyle and Cardiometabolic Health Council

10. Barbara J. Moore, PhD, FTOS

President Emeritus, Shape Up America!

11. Marion Nestle

Professor of Nutrition, Food Studies, and Public Health

New York University

12. John D Potter MD PhD
    Professor Emeritus of Epidemiology
    University of Washington
    Seattle, WA, USA

13. Michael I Goran, PhD

Director, Childhood Obesity Research Center

Co-Director USC Diabetes and Obesity Research Institute

Professor of Preventive Medicine; Physiology & Biophysics; and Pediatrics

The Dr. Robert C & Veronica Atkins Chair in Childhood Obesity & Diabetes

USC Keck School of Medicine

14. David L. Katz, MD, MPH

President, American College of Lifestyle Medicine

Founder, True Health Initiative

15. Dr. Tim Lobstein

Director of Policy

World Obesity Federation

16. Professor Corinna Hawkes

Centre for Food Policy,

City University of London

17. Professor Tim Lang

Centre for Food Policy,

City University of London

18. Mike Rayner BA, DPhil

Professor of Population Health,

Director, British Heart Foundation Centre

Nuffield Department of Population Health,

University of Oxford,

19. Michael Moore

CEO: Public Health Association of Australia

President: World Federation of Public Health Associations

20. Lucie Granger

Executive Director Québec Public Health Association

From South Africa

21. Public Health Association of South Africa
22. World Federation of Public Health Associations
23. South African Paediatric Association
24. Rural Health Advocacy Project
25. SECTION27
26. The National Council Against Smoking

27. Professor Laetitia Rispel

HOD, School of Public Health, University of the Witwatersrand

28. Dr. Sundeep Ruder

Endocrinologist

Associate Lecturer, University of the Witwatersrand

Honorary Consultant, Charlotte Maxeke Academic Hospital

29. Professor Stephen Tollman

Director, MRC/Wits Rural Public Health and health Transition Unit (Agincourt)

School of public Health, University of the Witwatersrand

30. Professor Kathleen Kahn

MRC/Wits Rural Public Health and health Transition Unit (Agincourt), School of public Health, University of the Witwatersrand

31. Karen Hofman

Professor and Director

PRICELESS SA

School of public Health, University of the Witwatersrand

32. Aviva Tugendhaft

Deputy Director,

PRICELESS SA

School of public Health, University of the Witwatersrand

33. Nicholas Stacey

Health Economist

PRICELESS SA

School of public Health, University of the Witwatersrand

34. Dr. Mpho Molete

Chair of PHASA

Dental Public Health Group University of Witwatersrand

35. Nadia Mohamed

Department of Paediatric Dentistry, University of the Western Cape

36. Professor Mohamed Jeebhay

HOD and Director, School of Public Health and Family Medicine, University of Cape Town

37. Professor Julia Goedecke

Non-communicable Disease Research Unit, SA Medical Research Council

38. Dr. Yussuf Saloojee

Executive Director, National Council Against Smoking

39. Dr. Veerasamy Yengopal

HOD, Community Dentistry, University of the Witwatersrand

40. Professor Sudeshni Naidoo

Chair, Alliance for a Caries Free Future (ACFF), South African Chapter

41. Professor Usuf Chikte, Executive Head, Department of Interdisciplinary Health Sciences, University of Stellenbosch

42. Centre for Diabetes and Endocrinology (Pty) Ltd (CDE – Your Partner in Diabetes

RESOURCES:

1. Ng SW, Rivera J, Popkin B, Colchero M. Did high purchasers respond differently to the excise tax to sugar sweetened beverages in Mexico. Cuernevaca and Chapel Hill: INSP-UNC; 2016.
2. Colchero MA, Popkin BM, Rivera JA, Ng SW. Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ. 2016;352.
3. Falbe J, Thompson HR, Becker CM, Rojas N, McCulloch CE, Madsen KA. Impact of the Berkeley excise tax on sugar-sweetened beverage consumption. Am J Public Health. 2016;106(10):e1-e7.
4. WHO Regional Office for Europe (Nutrition Physical Activity and Obesity Programme ). Using price policies to promote healthier diets. In: Lifecourse DoNDat, ed. Brussels: WHO European Regional Office; 2015:41.
5. Briggs ADM, Mytton OT, Kehlbacher A, Tiffin R, Rayner M, Scarborough P. Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study. BMJ. 2013;347.
6. Long MW, Gortmaker SL, Ward ZJ, et al. Cost effectiveness of a sugar-sweetened beverage excise tax in the U.S. Am J Prev Med. 2015;49(1):112-123.
7. Veerman JL, Sacks G, Antonopoulos N, Martin J. The impact of a tax on sugar-sweetened beverages on health and health care costs: A modelling study. PLoS ONE. 2016;11(4):e0151460.
8. Encarnação R, Lloyd-Williams F, Bromley H, Capewell S. Obesity prevention strategies: could food or soda taxes improve health? J R Coll Physicians Edinb. 2016;46(1):32-38.
9. Boseley S. Doctors demand a 20% tax on sugary drinks to fight UK obesity epidemic The Guardian2015.
10. Donnelly L. Gordhan announces sugar tax. Mail & Guardian2016.