C’bean moves towards taxing of sugar-sweetened beverages

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WITH skyrocketing rates of overweight and obesity facing Caribbean nations, policymakers are increasingly being challenged to find solutions for this public health emergency.

This challenge was significantly responded to this year in January when the Government of Jamaica implemented guidelines to restrict the sale of sugary beverages in Jamaican schools. This bold move aimed at modifying the drinking habits of young Jamaicans who may be ‘drinking themselves sick’, helped to underscore Jamaica’s leadership role in the Caribbean in implementing progressive health policies, however, more is needed.

The World Health Organisation (WHO), the Pan American Health Organisation, the Caribbean Public Health Agency, and the Healthy Caribbean Coalition (HCC) have all recommended a complete package of policy interventions to effectively halt and reverse obesity.

In the past year, the Heart Foundation of Jamaica in partnership with the Ministry of Health implemented a massive obesity prevention public health campaign built around a likeable Jamaican personality “Rosie”, who challenges Jamaicans to consider the amount of sugar they are consuming in sugary drinks and the negative health effects.

The nationwide mass media campaign has dramatically increased public awareness and dialogue around the dangers of excessive sugar consumption and links with obesity and NCDs. This combined with the Jamaica Moves campaign, which has inspired significant numbers of Jamaicans to get active, suggests that the public may, in fact, be ready for the next step in the implementation of a complete package of policy interventions — namely the imposition of a tax on sugary drinks.

The WHO has identified excessive consumption of sugar in sugar-sweetened beverages (SSBs) as a major contributor to obesity and NCDs and recommends a levy on SSBs which raises their price by at least 20 per cent as one of the key policy measures to curb sugar consumption and combat obesity and NCDs.

In 2016 Caribbean leaders, recognising the challenges posed by obesity, pledged to elevate taxes on foods high in sugar; and in 2017 they expressed concern that obesity in children represented the greatest threat to the health of future generations. Furthermore, many regional leaders have recognised and expressed the view that a failure to address the health challenges posed by obesity and related conditions is likely to slow or reverse socioe-conomic progress.

There is clear evidence that taxation of sugary drinks works. Sugary beverage taxes have led to reduced consumption of SSBs and increased consumption of healthier alternatives globally and in the Caribbean .

In Mexico, the SSB taxation introduced in 2014, resulted in a 9.7 per cent decline in purchases of sugary drinks; and in Berkeley, California, SSB taxation triggered a similar decline in SSB purchases and a 15 per cent increase in bottled water sales. The Barbados sugary drink tax resulted in a 4.3 per cent decline in sales of SSBs and a 7.5 per cent increase in sales of bottled water in its first year.

Barbados was the tenth country in the world and the first country in the Caribbean to implement a tax on sugary beverages in 2015. Dominica followed closely behind, and a few months later implemented a 10 per cent excise tax on sugary drinks. Four years later against the background of increasing recognition of a global and regional epidemic of obesity and mounting evidence demonstrating that taxation reduces SSB consumption, over 36 countries across the globe now tax sugary beverages in an effort to combat obesity and overweight.

By contrast, in the Caribbean, despite growing waistlines, chronically underfinanced health systems and mounting economic instability, only two of the 20 Caricom Member and Associate Member states had implemented this measure at the beginning of 2018. However, the tide may be changing.

In October 2018 Bermuda introduced a 50 per cent SSB tax, which will rise to 75 per cent in April 2019; and in the latter part of 2018 and early 2019, a number of Caricom countries indicated a warming towards taxation.

In January this year, Prime Minister Gaston Browne announced Antigua’s plans to begin taxing sugary drinks in 2019 in order to address the growing social and economic burden of NCDs. A sugar tax also seems to be on the horizon for Trinidad and Tobago, which implemented a nationwide ban on the sale of SSBs in schools in 2017.

In January this year, the St Kitts and Nevis National Commission for Universal Health Care revealed that a range of new taxes, including SSB taxes, will be used to finance universal health care. In The Bahamas, one of the key recommendations emerging out of a public consultation led by the National Health Insurance Authority on a roadmap for universal health coverage was the introduction of a tax on sugary drinks, the revenue from which would be used to fund the universal health care scheme.

The financial impact of obesity and its associated illnesses are significant due not only to the direct costs of provision of treatment and care, but also due to indirect costs related to decreased productivity. An estimate of the costs related to cardiovascular disease and diabetes complications alone in Jamaica between 2017 and 2032 is a staggering $77.1 billion (US$607 million).

Taxing of SSBs offers the double benefit of providing additional revenue to offset these costs while contributing to the anticipated decline in consumption and resulting decrease in the prevalence of obesity, a major NCD risk factor.

There is increasing momentum across the region as the ‘Caribbean Moves’ towards policy measures which build healthy food environments such as taxation of sugary drinks. The Government of Jamaica has made tremendous strides in this arena and stands poised to become one of the first countries in the region to check multiple policy boxes in the fight against childhood obesity.

The HCC and our 120+ members across the region, and our regional and global public health partners congratulate the Government of Jamaica on the progress made thus far and encourage them to continue to lead boldly by implementing a tax of at least 20 per cent on SSBs in 2019.

 

Sir Trevor Hassell is the president of Healthy Caribbean Coalition in Barbados.

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