Picture: 123RF/KARIN ROACH
Picture: 123RF/KARIN ROACH

Obesity is a major health and economic problem in SA. Over the last decade, obesity in SA has risen and there are now approximately 19 million obese or overweight adults in the country including close to half of all women. What is even more alarming is that close to 20% of children are obese.

At the same time, SA has seen a significant rise in the consumption of processed and ultra-processed foods, including sugary beverages. In 1991, the annual per capita consumption of Coca-Cola products was 132 servings, but had risen to 254 by 2010, placing SA among the top 10 global consumers of Coca Cola products.

The sugary beverage tax, or health promotion levy, which was implemented in 2018 and increased with inflation in 2019, is one step in the right direction to tackling the country’s obesity epidemic.

Added sugar in the diet has been well demonstrated to be a major contributor to obesity, and liquid sugar in the form of sugary beverages is an even more serious offender. These beverages lack nutrients, are excessively high in sugar and are less satiating than solid foods. One 330ml serving of a sugary beverage contains an average of eight teaspoons of sugar, which is above the World Health Organisation's recommended daily limit of added sugar.

The health issues resulting from obesity are many, chronic and often disabling. There are approximately 10,000 new cases of diabetes per month in the public health sector. Those who do not have access to high-quality disease screening and treatment are often diagnosed late and are already experiencing complications such as amputations or blindness.

The cost to the individual, families, the health system and the workplace (through absenteeism and reduced productivity) in SA is enormous. The annual cost of noncommunicable diseases to the economy is estimated at 7% of the GDP.

A tax on sugar-sweetened beverages (SSBs) is recommended by the World Health Organisation as one step in tackling the obesity epidemic. Several countries such as Mexico and Chile have introduced a similar tax. In Mexico the tax reduced the intake of SSBs by 5% in the first year and a further 9% in the second year, projecting that 190,000 cases of diabetes would be prevented to the tune of a health service savings of $983m.

Recently there have been claims by the sugar industry about job losses due to lost revenue from a decline in sales of sugar to SSB manufacturers since the implementation of the tax. Although the loss of jobs is never something to be celebrated, there is no evidence that these job losses are related to the tax. In fact, an international decrease in sugar prices, land allocated to sugar cane being sold for housing, and illegal dumping of sugar in SA contribute more to the job losses.

If consumption of sugary beverages is decreasing and industry is responding by reducing the sugar content in SSBs this is a good thing for the health of South Africans and the economy. Reducing excess sugar intake will help reduce diabetes, hypertension, stroke, cancer and arthritis. This, in turn, will decrease the stress on the overburdened health system.

Lessons from the introduction of the tobacco tax show that job loss claims are often an exaggeration by industry and mostly a short-term problem, in contrast to the tax which has the potential to improve health and reduce the economic strain on the country in the long term. Perhaps the industry should start thinking of solutions to our energy problems, and using sugar as a biofuel, creating a benefit for the industry and the country, rather than bemoan the loss of income off the backs of obese people.

• Goldstein is deputy director of the Wits Medical School school of public health's Priceless SA research unit.