African countries face a growing burden of noncommunicable diseases. Conditions such as diabetes and hypertension are expected to become the leading causes of death in sub-Saharan Africa over the next 10 years – overtaking communicable diseases such as HIV and tuberculosis.

Around the world countries are adopting policies to reduce consumption of unhealthy food, including beverages that have lots of sugar in them. The reason for this is that they have been linked to increasing rates of obesity and overweight, two of the major risk factors associated with noncommunicable diseases. As a result a host of countries have adopted policies aimed at driving down the consumption of food and drinks that have been shown to have a bad effect on health.

To understand what’s happening in east and southern Africa, a dozen researchers spent over three years looking at the opportunities for exploring such policies in seven countries in the region. Their findings have just been published.

The reasons for the ambitious multi-country study and why it matters are set out by Safura Abdool Karim, Agnes Erzse, Karen Hofman, and Susan Goldstein. Safura Abdool Karim and Karen Hofman explain how countries can go about ensuring any sugar taxes are in line with domestic laws. For their part Agnes Erzse and Karen Hofman unpack why data are key to designing effective policies.

In the case of individual countries, researchers from Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia explored these countries’ readiness to pursue taxes on sugary drinks.

In Rwanda, Mulindabigwi Charles Ruhara looks at how the country can use its existing excise tax on soft drinks to improve public health while from Zambia, Mulenga Mary Mukanu explains how the country has struggled to balance public health with economic policy. And finally, Milka Wanjohi and Gershim Asiki explore the barriers to the introduction of a tax on sugary drinks in Kenya.

Ina Skosana

Health + Medicine Editor (Africa edition)

The competing interests of economic growth and public health aren’t being managed well. Shutterstock

We mapped the landscape for taxes on sugary drinks in seven African countries

Safura Abdool Karim, University of the Witwatersrand; Agnes Erzse, University of the Witwatersrand; Karen Hofman, University of the Witwatersrand; Susan Goldstein, University of the Witwatersrand

Implementing a sugar-sweetened beverage tax in all African countries will require sufficient political will and support from civil society.


African countries must consider legal challenges to sugar taxes before pursuing policies

Safura Abdool Karim, University of the Witwatersrand; Karen Hofman, University of the Witwatersrand

Governments must take urgent action to prevent noncommunicable diseases from becoming an uncontrollable epidemic in sub-Saharan Africa. Sugar-sweetened beverage taxation offers a potential solution.

How Rwanda can use fiscal policies to improve health outcomes

Mulindabigwi Charles Ruhara, University of Rwanda

Rwanda's food policies focus on production to make sure people have livelihoods and enough nutritious food. Not much attention is given to overnutrition.

Why African countries need reliable local data on sugary drinks taxes

Agnes Erzse, University of the Witwatersrand; Karen Hofman, University of the Witwatersrand

Without reliable, local and timely data, countries will miss the potential of sugar-sweetened beverage taxation as a public health intervention.

Kenya doesn’t have a stand-alone tax on sugary drinks: we set out to find out why

Milka Wanjohi, African Population and Health Research Center; Gershim Asiki, African Population and Health Research Center

Between 2018 and 2019 Kenya registered a 30% spike in sugar production and an increase in sugar consumption.

Zambia must find a way to balance the economy and public health in tax policy

Mulenga Mary Mukanu,, University of the Western Cape

Tension between the government’s economic and public health priorities is preventing stronger fiscal measures to address nutrition-related noncommunicable diseases.

New research shows South Africa’s levy on sugar-sweetened drinks is having an impact

Karen Hofman, University of the Witwatersrand

The results are in: South Africa’s ground-breaking health promotion levy, introduced in 2018, is working.

How South African food companies go about shaping public health policy in their favour

Gary Sacks, Deakin University; Eric Crosbie, University of Nevada, Reno; Melissa Mialon, Universidade de São Paulo

The food industry's tactics are designed to reduce the likelihood of the government adopting global recommendations to tackle obesity.


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