LIn the shadow of Table Mountain, Langa is a short drive from the vast vineyards that generate much of South Africa’s tourism revenue. In the City of Cape Town, this is the oldest example of a township, a settlement originally created to segregate the Black African community from the urban area. Currently, Langa is home to just under 90,000 people, many of whom live in wooden or tin huts.

However, Langa and other townships in South Africa have traditionally been plagued by diseases of poverty such as tuberculosis, an infectious disease facilitated by crowded and poorly ventilated living conditions, while diabetes, high blood pressure, stroke, Lifestyle-related diseases such as heart disease are widespread. For the last few decades.

It’s not difficult to understand why. If you take a short walk around Langa, you’ll see Coca-Cola labels plastered all over the walls of storefronts. Thulani Fesi, a community leader in Langa, explains that the town is saturated with sugary drinks at the expense of healthier drinks.

“When you walk into a corner store, they [Coca-Cola] We’re feeding the refrigerators and making sure the refrigerators are filled with drinks,” Fesi said. “It’s very sad because they’re not doing anything in terms of letting people know what they’re consuming and how it affects their bodies.” It’s just a money-grabbing vacuum. ”

Six years ago, faced with rising rates of obesity and related diseases, especially among the poorest segments of the population, the South African government sought to address the problem through a health promotion tax. This is a type of sugar tax that attempts to discourage consumers from buying sugary sodas by effectively raising prices by 11%.

Food policy experts say the tax is already making a big difference. “We found that within two years, sugar-sweetened beverage purchases decreased by 29%, and the decline was greater among low-income households,” said Vital Strategies, an international nonprofit based in South Africa. Advisor Luyanda Mazija says. We are working with governments to strengthen public health systems. “We also found that his calorie intake decreased by 51% as a result of people buying fewer sugary drinks.”

Some benefits have also been seen in the UK, which introduced its own tax on sugary soft drinks in 2018. A study last year showed that the number of children requiring hospitalization for tooth extractions had fallen by 12% by 2020.

But while such taxes are becoming more common, with 108 countries currently imposing some form of sugar tax on soft drinks, there remains a persistent feeling that they have not yet reached their potential. Masu. The World Health Organization (WHO) said in December that in most countries, in some cases, tax levels are relatively low and public health benefits such as subsidizing costs and encouraging people to choose healthier alternatives A report was released stating that the system was not optimized to achieve the target. As an example, the report found that 46% of countries that impose a sugar tax on soft drinks also impose a tax on bottled water.

The lack of a strategy to funnel funds from sugar taxes directly into promoting healthy food, drink and lifestyle choices remains one of the biggest criticisms of existing sugar taxes around the world.

Laura Cornelsen, associate professor of public health economics at the London School of Hygiene and Tropical Medicine, says there is no way to hold the UK government to account for the promises made when the sugar tax was first introduced.

“It is bad that there is no information on what the levy is being used for, even though the government initially promised that all of the levy would go towards providing sports clubs and breakfast clubs in schools.” she says. she says.

The tax was initially focused on soft drinks, but polls conducted around the world found that sugar consumed in this way has a much more direct impact on blood sugar levels and disease risk. Public support has been shown for expanding the scope to include soft drinks. Covers a wider range of unhealthy foods. In a survey conducted in February, times The health board survey found that 53% of respondents supported expanding the ban to salty foods, and 49% supported the introduction of sugary milk-based drinks, such as plant-based milk alternatives.

WHO researchers also found that although fruit juices and sugar-sweetened instant drinks like tea and coffee contain what nutrition experts call free sugars, in most countries It was also revealed that no tax was paid. These include added sugars or, in the case of fruit juices, sugars that are naturally present in the drink, which are absorbed directly into the bloodstream.

The model also predicts that increasing sugar taxes could have significant economic benefits for governments around the world. Increasing the price of sugary drinks by up to 50% could generate $1.4 trillion (£1.1 trillion) in revenue over half a century.

At the recent Partnership for Healthy Cities Summit in Cape Town, supported by WHO, Vital Strategies and the nonprofit Bloomberg Philanthropies, Cape Town Mayor Jordyn Hill-Lewis said: He said addressing the increasing rates of type 2 diabetes and hypertension is an enormous economic burden. It means more widespread taxes are needed.

“I think so,” he says. “Because the state’s costs to deal with these diseases are extraordinary and constantly increasing, so expanding that tax base will help.”

However, history has shown that such attempts have too often been thwarted by well-organized commercial lobbies. A 2019 report found that powerful food multinationals are fighting back using strategies similar to those used by the tobacco industry. These include funding research that deliberately obscures the link between sugar and obesity, threatening job losses related to sugar taxes, and lobbying against proposed government legislation, particularly in low- and middle-income countries. Is going.

Mazija said the South African government had originally planned to introduce a tax that would raise the price of sugar-sweetened drinks by 20%, but powerful industry forces pushed the tax down to 11%. In the United States, aggressive pushback from the sugar industry led to the repeal of a tax in Cook County, Illinois, while Denmark eliminated taxes on saturated fat and Finland eliminated taxes on sweets and ice cream.

In the UK, there has been criticism of too close relationships between politicians and executives in the food industry, with Health Secretary Victoria Atkins insisting there is no conflict of interest after it was revealed that she is married to the managing director. I had no choice but to do it. of British Sugar.

Even in countries that have introduced sugar taxes on soft drinks, levels are generally very low, ranging from 3.4% to 18.4%, limiting the speed at which they can begin to bring about changes in public health, WHO says. Says.

“A 20% tax can reduce non-communicable diseases such as obesity and diabetes much faster than if we levied a tax at a lower rate,” Mazija said.

Mr Cornelsen said while he supported the recommendations published in the National Food Strategy, UK policymakers were reluctant to consider anything that would drive up food prices as the cost of living crisis continued. Ta.

It calls for a tax on sugar and salt to encourage large companies to reduce these additives in their products through reformulating ingredients. “Another option is to tax specific categories, such as sweet snacks, which target more discretionary consumption rather than all foods with added sugar across the food basket,” she said. says.

Many public health experts point to Latin American countries as making the most progress in introducing widespread taxes on unhealthy foods, not just sugar. Cornelsen highlights that Mexico’s 2014 tax on non-essential energy-rich foods was found to have reduced purchases of the commodity by 7% within a year. Colombia passed a “junk food law” in November, becoming one of the first countries to tax industrially processed ready-made foods and other ultra-processed foods that are high in salt and saturated fat.

“We need countries that are willing,” said Luz María de Reguil, WHO’s head of food systems policy and operations. “The double burden of malnutrition has long been a problem in Latin America. [and] The nutrition community is very strong. And in Mexico, a key success factor was that the Institute of Public Health was really a leader in these conversations and actively fought the battle in a variety of ways. ”

But ultimately, food taxes alone will not be a panacea to combat the rise in obesity and chronic disease. Cornelsen also called for restrictions on advertising and promotion of unhealthy foods, simpler and more effective food labels, and most importantly, making healthier alternatives more affordable for low-income households. states that it is necessary. She also argues that the amount of ingredients such as artificial sweeteners, which have been in the spotlight in recent years due to concerns that they may affect our health, should be more clearly labeled. .

“I’m wondering if the amount of sweetener used needs to be more clearly labeled to understand how much sweetener is being consumed in the first place,” she says.

Xu Wen Ng, a professor of nutrition at the University of North Carolina at Chapel Hill, cites several examples that demonstrate that feeding unhealthy foods can directly improve the food environment.

“In Seattle, for at least a year during the pandemic, a significant portion of the revenue from the sugar-sweetened beverage tax went toward food stamps for low-income households,” she says. “So they were able to redirect that revenue to support healthier diets for high-need populations.” And in Philadelphia. [where a 2017 tax was placed on sugar-sweetened and artificially sweetened drinks]It was communicated from the beginning that much of the proceeds would go toward supporting preschool education. ”

Similar measures are desperately needed for Langa and many other places around the world where poverty is endemic. “We need to educate and engage people about the benefits of switching to a healthier lifestyle,” Fesi says. “But the revenue from these taxes also needs to go back to help people living in these tough conditions.”