Case in point: Research informs legislation to shed obesity

November 28th, 2019
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The South African Government implemented a 11% excise tax on sugar-sweetened beverages (SSBs) in 2018. The legislative move was years in the making and throughout the process, work by researchers from Wits University contributed directly to decisions made in and around the policy.

Championing the role of research in policy

The Wits School of Public Health SA MRC Centre for Health Economics and Decision Science, known as PRICELESS-SA began its work on the case in 2013. Evidence from other countries had suggested that a tax on SSBs was likely to reduce consumption and rein in the increasing burden of obesity-related non-communicable diseases (NCDs).

The Wits research indicated that implementing a tax on sugar-sweetened beverages could prevent more South Africans, especially younger ones, from becoming obese.

Informative work by the PRICELESS-SA team including a paper that was published in PLOS ONE on 19 August 2014. Titled, The potential impact of a 20% tax on sugar-sweetened beverages on obesity in South African adults: A mathematical model, the paper gave credence to the suggested tax on sugar sweetened beverages in response to a call by the then Minister of Health, who had raised the need to regulate foods high in sugar to address obesity and its related diseases.

The paper measured the effect of a 20% tax on SSBs on the prevalence of obesity among adults in South Africa, and found that taxing these sugary beverages could impact the burden of obesity in the country, particularly in young adults, as one component of a multi-faceted effort to prevent obesity.

Further substantiating the need for the SSB tax

The introduction of the SSB tax was announced by the then Minister of Finance Pravin Gordhan in the 2016 Budget Speech.

At the time South Africa had a growing obesity burden with 39% of women and 11% of men obese, and was among the top 10 global consumers of sugary drinks. This was highlighted by Professor Karen Hofman and Aviva Tugendhaft Senior Researcher from PRICELESS-SA, as they presented the team’s research based evidence on 20 April 2016.

The researchers stressed that the tax could have an impact on obesity and that in the absence of preventive measures, the country would face increased obesity and related diseases in the coming years. This was strengthened by work done by the advocacy group HEALA who developed an effective campaign based on the evidence.

“While SSBs alone may not be the only reason for an increase in body fat, these fizzy drinks do not contain any essential nutrients, have a high sugar content and a strong link to weight gain. Drinking just one SSB a day increases the likelihood of being overweight by 27% for adults and 55% for children,” said Professor Hofman.

This is not surprising considering that one 330ml serving of a fizzy sweetened drink contains an average of eight teaspoons of sugar and the same size fruit juice contains an average of nine teaspoons of sugar.

Looking past 2020 to SA’s health stakes

The facts, figures and projections provided an important resolution to introduce the new legislation.

Yet the implementation of the SSB tax makes a broader case in point. It proves the importance of evidence-based policy development, which follows a process wherein researchers engage with policy makers and disseminate the evidence both for and against casting the prospective legislation in stone.

On the brink of 2020 it must be reminded that the SSB tax is one of the parts of the National Strategic Plan for Non-Communicable Diseases and the Obesity Strategic Plan in South Africa. If the country is to continue to address the obesity epidemic, such taxation will need to be followed by a series of other measures such as front of pack food labelling and advertising regulations for greater consumer protection.