Sweetened Beverage Taxes: Lessons from a Decade of Progress

Locally-led advocacy campaigns supported by the Global Health Advocacy Incubator (GHAI) have contributed to the adoption and strengthening of sweetened beverage (SB) taxes in Africa, the Caribbean, Latin America and South Asia. The lessons learned from these campaigns are being applied by advocates around the world to counter the threat caused by SBs in their countries and generate new government revenues.

To read the full case study, click here.

The Case for Advocacy for Sweetened Beverage Taxes

Excessive sugar consumption, including SBs with sugar and/or non-sugar sweeteners, is a key contributor to a global health crisis of diet-related non-communicable diseases (NCDs) that claims approximately 184,000 lives annually. These drinks often displace healthier alternatives in the diets of children, low-income households and other vulnerable populations. These groups are the primary consumers of SBs and the burden of disease, along with its costs, falls disproportionately on them. In addition to driving NCDs and obesity, the consumption of mass produced sugary drinks comes with significant environmental costs. The production of SBs requires hundreds of gallons of water, placing an additional burden on already stressed water resources, while the extensive use of plastic in beverage packaging contributes to environmental pollution.

Taxes on SBs have emerged as an important intervention for mitigating both the health and economic costs of these products. Governments can use taxes to reduce the consumption of these beverages, improve public health and generate revenues that can be used to strengthen sustainable health systems. Like other health excise taxes that impact population-wide consumption habits, SB taxes can contribute to health and economic equity across an entire country. Because of how effective taxes are in driving down the consumption of SBs, the ultraprocessed food and beverage industry aggressively opposes them and as a result, evidence shows that intensive and strategic advocacy.

GHAI’s Role

GHAI partners with civil society organizations around the world to develop and lead advocacy campaigns to pass policies promoting healthier food environments to protect health. GHAI provides partners with intensive technical assistance and financial support for the passage of evidence-based SB tax policies.

Guided by our belief that advocacy should be locally-led and implemented, GHAI provides capacity-strengthening support across domains including developing communications plans, reaching decision-makers, supporting legal action, building effective coalitions and countering industry opposition. GHAI supplies technical tax design guidance to promote best practices, engages academic partners and our own research team to ensure that advocacy campaigns are evidence-informed and convenes national, regional and global communities of practice. To date, GHAI has supported 12 national tax advocacy campaigns.

GHAI and our partners have helped countries advance and defend SB taxation in diverse political and cultural contexts across multiple regions, including South Africa, Barbados, Colombia, Pakistan, Nigeria and Ghana.

Trends Across Countries and Campaigns

While national contexts inevitably differ, several trends were consistent across countries and campaigns.

Designing Taxes to Achieve Public Health Objectives

Lessons learned from the implementation of SB taxes globally demonstrate that the approved taxes must be based on the highest standards and consistent with the principles of tax justice to achieve optimal public health outcomes.
Reaching New Audiences

In Colombia, Ghana, Nigeria and Pakistan, successful advocacy for SB taxes employed diverse strategies to reach new audiences.

Confronting Industry Interference and Legal Attacks

Advocacy campaigns worldwide have grappled with common industry interference tactics and legal attacks that attempt to thwart SB taxes.
Taxing Ultra-Processed Products

Colombia’s move to tax UPPs along with SBs sets a precedent for a comprehensive approach to health taxation with a public health objective. Recognizing the detrimental health and environmental impacts of a wide range of UPPs, including ready-to- eat meals, Colombia’s tax demonstrates a forward-thinking strategy that makes it the first country to tax unhealthy foods based on nutritional content. The success in Colombia emphasizes the potential of adopting a holistic taxation framework that targets a spectrum of unhealthy food and beverage products.
Implementation and Evidence Building

As countries celebrate policy victories, the advocacy focus shifts to sustained impact and continuous improvement. The experiences of Colombia, Ghana, Pakistan and Nigeria underscore the need for ongoing evaluation and adaptation to ensure that the intended goals of these public health measures are achieved.

Lessons Learned

By navigating legal challenges, countering industry interference and building robust public support, countries can use evidence-informed advocacy to pave the way for transformative health policies. Key lessons learned include:

Use Strong Narratives: It is imperative to emphasize the connection between the consumption of UPPs and poverty, decreased access to real food and environmental damage. This narrative serves to counter industry arguments that taxes are regressive for the poor and generate economic damage and job losses.
Build Tax Design Capacity: Given the critical need for an effective tax design, civil society organizations must be equipped to monitor the tax design and contribute to policy discussions.
Engage Diverse Coalitions: Successful advocacy hinges on forming diverse coalitions. The tax campaigns discussed above overcame opposition by bringing together academia, civil society organizations, health professionals, social justice movements and government bodies.
Maintain a Steady Media Drumbeat: Harnessing the influence of traditional and social media is crucial. Advocates should be prepared to carry out continuous industry monitoring to counter arguments effectively.
Employ Tax Justice Principles: Tailoring messages to resonate with diverse communities is essential. Consideration should be given to justifying the tax beyond revenue generation, using arguments related to health, environmental protection and human rights.
Generate Research to Support Advocacy: Generating and leveraging local evidence strengthens advocacy efforts.
Empower Community Champions: Involving key opinion leaders such as Queen Mothers, nurses, professors, religious and traditional leaders amplify advocacy efforts.
Prepare for Industry Opposition: Proactively addressing industry opposition is critical.
Build Public Support: Mobilizing public opinion through consumer surveys, public opinion polls and public awareness campaigns is a strategic advocacy tool.
Be Flexible: Flexibility and adaptability are crucial for responding to changing contexts and opposition.
Collaborate with Government Allies: Collaborating across multiple government bodies and key policymakers is vital for policy adoption and successful implementation.
Monitor Implementation: To ensure long-term effectiveness, advocates must maintain vigilant monitoring and budget accountability measures, verifying that revenue is collected, the tax is implemented as intended and funds are allocated appropriately to maximize the intended health impact.

To read the full case study, including country examples, click here.