ANDREW RUSSELL: Base policy-making on evidence, not emotion

Healthy Living Alliance head of programmes Nzama Mbalati accuses cane growers of manufacturing fake news and spreading disinformation about the Health Promotion Levy (“SA cannot afford the health cost of unregulated sugar products”, December 12). Given what is at stake in this debate, it is important that SA Canegrowers puts the record straight in the interests of the 1-million livelihoods that hang in the balance.

SA Canegrowers has always been an advocate of evidence-based policy-making. Our argument has been — and remains — that the only grounds for maintaining the Health Promotion Levy is if it can be shown to be effective at achieving its stated objective, that is reducing obesity levels in SA and therefore the burden of treating noncommunicable diseases on the fiscus.

Mbalati claims that “there is a lot of evidence supporting the link between sugar and obesity. And there is significant evidence that taxes reduce consumption”. In making these claims, ironically, he does not cite a single piece of evidence. More importantly, showing that the Health Promotion Levy reduces the consumption of sugar-sweetened beverages is not proof that it reduces obesity. If there is no evidence that reduced consumption has reduced obesity, this supports SA Canegrowers’ argument that the levy represents a scapegoating of one small subset of food products in a universe of dietary and nondietary factors that contribute to obesity.

In the absence of any specific data to support his argument, Mbalati resorts to casting aspersions on the research showing the adverse economic effect of the levy. But this simply does not hold water. For one thing, contrary to the allegation that growers have manufactured data to suit its purposes, the research demonstrating the negative effect the levy has already had on employment, investment and revenue in the industry, was commissioned by the National Economic Development and Labour Council.

Moreover, the follow-up study commissioned by SA Canegrowers to model the likely future impact of the levy was conducted by the well-respected and independent Bureau for Food & Agricultural Policy. If Heala doubts the credibility of these studies it can commission its own research.

Perhaps it is the realisation of the weakness of this approach that then leads Mbalati to make the Health Promotion Levy argument about climate change. Surely no serious interlocutor would suggest that an obesity intervention can be justified by biodiversity concerns? If Mbalati cares about the environment he would do well to follow the work the sugar industry is doing to establish a sustainable aviation fuels industry in SA. But that is not relevant to a discussion about the Health Promotion Levy.

Coming back to the real issues, SA Canegrowers is not unsympathetic to Heala’s concern — the need to reduce obesity levels. What SA Canegrowers has repeatedly said is that we need to get to the bottom of the real causes of obesity, and scapegoating one category of products is not going to help us achieve this. We need a holistic approach to this problem that recognises the complexity of the issue and takes seriously the challenge of addressing it. SA Canegrowers has recommended beginning with a comprehensive dietary intake study to understand where South Africans are consuming their calories, because if the levy has reduced the consumption of sugar-sweetened beverages but not obesity, we’re obviously looking for the solution in the wrong place.

By contrast, Mbalati appears to have no appreciation for the plight of the sugar industry. In a country with an unemployment rate of close to 40%, we cannot gloss over the loss of livelihoods. The sugar industry supports 1-million livelihoods. One-million people depend on it for their daily meals, their shelter, their education. An organisation devoted to healthy living should understand the centrality of having sustainable livelihoods to people’s health.

More than 16,000 jobs were lost as a result of the levy in the first year of its implementation alone. Another 16,000 will be lost if the levy is maintained. Even if the Health Promotion Levy had reduced obesity — and there’s no proof that it has — it would still be worth considering whether there are alternatives ways to achieve this goal that have a less destructive effect on much-needed livelihoods in the most rural parts of the country.

Perhaps the most unfortunate part of Mbalati’s argument as it relates to rural livelihoods is how he has chosen to weaponise the challenges the industry has faced to justify the Health Promotion Levy. It is difficult to understand how Heala can list all the problems facing the industry and miss the obvious conclusion — now is not the time to pile more hardship on an already embattled industry. As things stand the sugar industry and government have expended considerable resources to implement the Sugarcane Value Chain Masterplan, to save the livelihoods the industry supports. The Health Promotion Levy has been a drag on these efforts and increasing it will almost certainly undo all the progress made to date.

The interests at stake in this debate are both important — health and livelihoods. What SA Canegrowers is calling for is a decision based on evidence. No-one — not Heala, not government — has provided any evidence of a reduction in obesity, never mind whether any such reduction can be attributed to the Health Promotion Levy. On the other hand, the evidence of the economic harm caused by the levy is in the public domain. Based on the available evidence, there simply is no justification for maintaining the levy.

• Russell chairs SA Canegrowers.