The views expressed in this presentation are the views of the author and do not necessarily reflect the

views or policies of the Asian Development Bank Institute (ADBI), the

Asian Development Bank (ADB), its Board of Directors, or the governments they represent. ADBI does not guarantee the accuracy of the data included in this paper and
accepts no responsibility for any consequences of their use. Terminology used may not necessarily be consistent with ADB official terms.

Global Experience
Fiscal policies and
taxes on sugar-
sweetened beverages
Dr Rufaro Chatora
Dr Temo K Waqanivalu
Mr Tomas Roubal
 Main messages from WHO
 Diabetes, Obesity and other non-communicable
diseases: Too big to ignore!
 Sugar Sweetened Beverage Tax works: Don’t miss
the boat!
 SSB tax is Best Practise: You are not alone!
 International commitments by South Africa: Walk the
Talk!
 Leadership by South Africa: You can lead us!
Obesity epidemics is spreading across the world

 In 2014, 39% of adults aged

18 years and older (38% of
men and 40% of women)
were overweight.

 The worldwide prevalence of

obesity nearly doubled
between 1980 and 2014.

 In 2014, 11% of men and

15% of women worldwide
were obese.
Overweight increase is worrying especially
among infants and young children
20
 Obesity coexists with micronutrient def., Type II diabetes
in children is rising starting as early as 7 years old
15
 We’re possibly facing the first generation who would die
before their parents…
10

0
1990 1995 2000 2005 2010 2015
Low-income Lower-middle-income Upper-middle-income High-income
 WHO evidence and guidelines
Intake of free sugars – particularly in the •
form of SSB leads to an unhealthy diet,
weight gain and increased risk of NCDs.

There is strong association between intake •

of free sugars and dental caries

WHO recommends reducing the intake of •

free sugars to < 10% of total energy intake.

A further reduction of the intake of free sugars •

to < 5% of total energy intake.
 How much is 10% of total energy intake?
Source: World Cancer Research Fund International. Curbing
global sugar consumption. Effective policy action to help promote
health diet & tackle obesity
 In recent years many food and drink
companies have pushed the physical activity
message, sponsoring major sporting events.
 The association of ultraprocessed food and
soft drinks with sport and celebrity
endorsement is wrong and gives the
wrong message, particularly to children.
 A child eating a burger and chips, washed
down with a sugary drink, followed by a bar
of chocolate and crisps, would need to run
half a marathon to burn off the calories
consumed.
 (Source: Childhood Obesity Action Plan, www.actionon
sugar.org)
 Sugar Sweetened Beverage Tax works
 SSB tax such as proposed in South Africa will
promote healthier diets and has potential to decrease
obesity

 Taxes that raise the prices of sugar sweetened

beverages by 20 % or more work the best (more
than proportional reductions in SSB consumption and
sugar intake)

 In combination with subsidies for fresh fruits and

vegetables to the greatest health benefits

 The poor and children are most responsive and will

benefit the most by improved health while changing
consumption of SSBs
Source: Report on Fiscal Policies for
Diet and Prevention of NCD (2015)
 Evidence: Lets not miss the boat!

"The critical lesson from tobacco is waiting too long -

50 years from the first evidence. There would not be
one minister of health who doesn't now appreciate
the importance of tobacco control.
Obesity is out of control and there is sufficient
evidence for governments to take urgent action.
Unless nations move now to rein in expanding
waistlines we will have missed the boat.
(WHO at ICO, Sydney Sept. 2006)
 You are not alone!
Country Year Tax Type Rates
Mexico 2014 Sugary drinks, high-calorie Excise US$ 0.07/litre of sugary drinks
foods VAT 8% for high-calorie foods
Chile 2015 Sugary drinks Ad valorem 18% tax levied on value of product
excise
Barbados 2015 Sugary drinks Ad valorem 10% tax levied on value of product
excise before VAT
Mauritius 2013 Soft drinks Excise US$ 0.01/g of sugar
Thailand 2012 SSB Ad valorem US$ 0.012/440ml
Nauru 2007 Sugar, confectionery, SSB, Import duty 30%
cordial, flav. milk
Fiji 2006 Soft drinks Import duty 5%
Excise US$ 0.04/litre
Seychelles 2017 (p) Soft drinks, fruit juices Excise RS 2.50 / litre of beverage
Philippines 2017 (p) SSB Excise 10Pes / litre
Walk the talk, SA commitments and mandate
 …consider economic tools that are justified by evidence,
and may include taxes and subsidies… (Global Action Plan
on NCDs 2013-2020)
 Trade measures, taxes and subsidies are an important
means of guaranteeing access and enabling healthy
dietary choices (Comprehensive Implementation Plan on
Maternal, Infant and Young Child Nutrition: 2012)
 "identify opportunities to achieve global food and
nutrition targets, through trade and investment policies“
(2nd International Conference on Nutrition: 2015)
 Recommends implementation of an effective tax on sugar-
sweetened beverages (WHO Commission on Ending
Childhood Obesity: 2016)
WHO Global Nutrition and NCD Targets by 2025
(adult baseline 13%).

(baseline 6.7%)
(baseline 13%)
 SSB tax will prevent 477,680 deaths
over 40 years
16,000 Compared to a
scenario in which
Cumulative number of avoided

14,000
the policy is not
12,000 put in place

10,000
cases

8,000 Heart Disease

Stroke
6,000
Cancers
4,000

2,000

0
0 10 20 30 40
Time (years)

Source: OECD/WHO CDP Model, 2017

 SSB tax will provide significant savings for the
health sector
0
0 10 20 30 40
Health sector will
Cumulative impact on health

-10
expenditure (Rand/person)

save R1,7 bil over

-20
10 years;
-30 Over 40 years this
-40
becomes R2,7 bil
(3% discounted)
-50

-60
Time (year)

Source: OECD/WHO CDP Model, 2017

 Summary
 Obesity, Diabetes and Dental Caries is a BIG burden on
the poor, children and the whole society!
 Evidence of sugar as contributor to disease and
effectiveness of intervention is CONCLUSIVE!
 Way Forward is CLEAR! SSB TAX as part of a
comprehensive package of interventions is the solution!
 Implementing the agreed global mandate SAVES LIVES
(and money)!
 SA taking LEADERSHIP towards Ending Childhood
Obesity!
 Thank You
afwcozawr@who.int
“Not one single country has managed to turn
around its obesity epidemic. This is not a failure
of individual will-power. This is a failure of
political will to take on big business”.
Margaret Chan,
WHO Director,
General, 2016