The tax on sugar-sweetened beverages (SSB), known as the Health Promotion Levy (HPL), has been ineffective in reducing the nation’s sugar intake and obesity levels.
According to the Division of Human Nutrition and the Centre for Statistical Consultation at Stellenbosch University, there are still questions about whether the tax, which was introduced in 2018, will be enough to reduce obesity, which is regarded as a risk factor for non-communicable diseases (NCDs) such as heart disease.
The research surveyed dietitians and key industry role-players on their awareness and opinions of the HPL, who said that more needs to be done to fix and reduce the nation’s obesity levels.
“Dietitians and KIRs were positive about the HPL, although the majority agreed that the implementation of a sugar tax alone will not make a difference because multiple factors contribute to NCDs and obesity. They believed the HPL of 11% was too little to have an impact on the purchasing behaviour of consumers.”
“Dietitians did report a perceived decrease in the daily purchasing of SSBs by their clients in favour of mainly sugar-free beverages and water since the implementation of the HPL. Some dietitians were concerned that SSBs were substituted with other sugar-containing food items.”
The researchers said that this corresponds with other studies that have shown that nutrition interventions targeting specific goods can lead to other adverse compensatory behaviour, such as increased consumption of other unhealthy foods and beverages.
Although the food industry said that they understood why the government introuded the HPL, they also said that consumers lacked knowledge on the issue,
“Consumers’ lack of knowledge as well as their habitual purchasing of sugary drinks were regarded as key barriers to the successful implementation of the HPL.”
Educating consumers about the sugar tax was seen as a key factor in successfully implementing the HPL.
“Some dietitians confirmed using the HPL as a motivational tool to encourage reduced consumption of SSBs, while others taught their clients to read the nutritional information table with an emphasis on total sugar content and glycaemic carbohydrates, and how to understand endorsement logos.”
There were also question marks from dieticians and KIRs in regard to how the revenue generated through the HPL would be used.
“They held the opinion that the revenue should be earmarked for the treatment and prevention of NCDs and for health promotion to garner consumers’ trust and facilitate change. However, they were sceptical and believed that the money will only benefit Government.”
There were also concerns that the sugar tax could be seen as intrusive by consumers and inappropriate for those not at risk of developing obesity or NCDs.
What has to change
The researcher said that integrated intervention strategies that required multi-sectoral engagement were needed to reduce the consumption of sugary drinks.
“The HPL should form part of a multi-pronged approach that includes fiscal measures, consumer education and controlled marketing of SSBs to create a supportive environment in which consumers make healthy choices, for instance, the combination of education, effective food labelling and banning of marketing SSBs to children.”
“Politicians, the SSB industry, consumers, trained dietitians and public health experts all have a part to play.”
“Health professionals, in particular, play a crucial role in facilitating behaviour change and creating an enabling environment to support successful implementation of the sugar tax, especially if they use their expertise to influence policy-makers and the media.”
The researchers also noted the importance of an enabling environment that supports the availability and accessibility of healthy food choices in creating an effective HPL.
More also needs to be done in educating South Africans on the sugar tax and creating a supportive environment to improve overall health and nutritional status.