Why Africa should resist the power of Big Sugar to undermine public health?

The South African government has decided to tax sugary drinks to help cut excess sugar consumption, which is contributing to a burgeoning epidemic of obesity, diabetes and cardiovascular disease. This follows the lead of Mexico and the US city of Berkeley, where results have been very positive.

In Mexico, research predicts a win-win outcome: it may greatly decrease disease and death from diabetes and cardiovascular disease while reducing health care costs.

What can be expected in South Africa is overwrought and highly emotive opposition from the sugary drink industry. The tax has been described as “murderous” and “highly discriminatory”.

This opposition to an effective measure to protect and improve the public’s health occurs in the context of a seven-decade battle between public health (David) and unhealthy industries (Goliaths). During that time the tobacco, junk food, sugar-sweetened beverage and alcohol industries have become the drivers of the major non-communicable diseases (cancers, lung disease, diabetes and cardiovascular diseases) that now dominate the global health landscape.

The junk food, sugary drink and alcohol industries claim to be part of the solution. The solution requires them to help improve their consumers’ health by decreasing advertising to children, reducing levels of salt, fat and sugar in their products, and labelling food honestly and clearly. These are all measures they are convinced are in conflict with their responsibility to make money for their shareholders.

How can these industries be part of the solution in these circumstances? Expecting them to support effective health measures is like expecting the Springboks to support the Wallabies.

Why industry is not part of the solution

In 2008, as chair of Australia’s Preventative Health Task Force, I did think they might be part of the solution. Our task was to recommend ways to reduce the burden of death and disease due to obesity, tobacco and alcohol.

Big Tobacco was denied any influence on our work and the results have been spectacularly effective: plain packaging, annual increases in tobacco taxes and one of the lowest rates of smoking in the world.

On the other hand, Big Food and Big Alcohol were allowed to be “in the room”. Over the past eight years I have seen them undermine, obstruct and fight tooth and nail every potentially effective policy to diminish death and disease related to overconsumption of their products. I no longer believe they can be part of the solution.

How do these industries oppose the protection and improvement of people’s health? They use a sophisticated long-term approach of tracking, monitoring and attacking key researchers and advocates, attacking and undermining the science of public health and clinicians, influencing bureaucratic and political decision-makers, creating industry front groups, donating to political parties, sponsoring sporting and cultural groups and funding research that is much more likely to produce results that support their own arguments.

They are particularly adept at promoting self-regulation. With this tactic – called regulatory capture – they introduce a form of self-regulation, such as an industry code of practice.

These approaches have been found to be “relatively vague and permissive”, ineffective, and to result in relatively small measurable effects. And, of course, they are non-binding and impossible to enforce.

A prime example of this occurred in 2009, when the Australian Food and Grocery Council and the Quick Service Restaurant Industry introduced “responsible marketing” self-regulation. Both voluntary initiatives promised not to advertise unhealthy food products to children under 12.

At face value this looked like a great initiative. In reality it had no proven effect. Ingeniously designed, these promises encompassed only children’s viewing times – which is not actually when children watch most of their TV.

The industry initiative “captured” any potential for public regulation and resulted in years of continued saturation advertising of junk food and sugary drinks to Australian children. It was a brilliant, but very unhealthy, tactical ploy by the junk food industry. Beware of the industry association bearing gifts.

A related concern is the global consolidation of transnational corporations. An example is the recent merger between the two largest beer producers, AB InBev and SABMiller.

The capacity of these corporate Goliaths to undermine the public’s health and to influence or control health policy is becoming stronger with each merger and takeover. In Africa particularly, governments are susceptible given that their economies are often much smaller than the corporations they are dealing with.

A way to provide healthy sponsorship

Using taxes to diminish the consumption of unhealthy products has been highly successful. The Victorian Health Promotion Foundation started this 30 years ago using a dedicated tax on tobacco. This was used to replace sport and arts sponsorships that tobacco companies had provided.

Sponsorship by Quit – an organisation dedicated to helping people give up cigarette smoking – replaced harmful tobacco sponsorship in sport. A sugary drinks tax in South Africa can be used in this way to replace sponsorship by promoters of unhealthy drinks.

 

 

The sugary drinks industry in South Africa will claim the new tax will wipe out jobs and slash profits. We know, however, from experience in Australia and elsewhere that these industries know how to protect profits. When cigarette taxes are increased, tobacco companies cynically increase their prices – and then blame the government.

The sugary drinks industry will throw everything into stopping the sugar tax in South Africa, just as they tried in Mexico and Berkeley. They do not want sugar taxes spreading across the world. It’s the same motive that drove Big Tobacco to fight so hard against plain packaging in Australia.

The introduction of a tax in South Africa might provoke the ire of the sugary drinks industry, but it will decrease death and disease among the poorest, while providing much-needed finances to improve health and sponsor healthy sports. It’s worth the ire!