Sugary Drinks Tax

Among all of the countries of the world, South Africa is one of the top 10 for consumption of sugary drinks, fruit juices, energy drinks and similar beverages. Before the campaign, a majority of people didn’t know how much sugar was in these drinks and the negative effects consuming them could have on their health.

Obesity rates have been rising worldwide for decades, especially in low- and-middle-income countries like South Africa. More than two-thirds of South African women and 31% of men, are either overweight or obese and 13% of children under the age of 5 are obese – twice the global average of 6.1%. At least 10,000 new cases of diabetes are reported each month, according to the Healthy Living Alliance (HEALA), one of Vital’s partners in South Africa. Noncommunicable diseases, most of which are associated with obesity, account for 43% of deaths in the country.

In 2016, with Vital Strategies’ technical support, a coalition of civil society partners developed and launched an agenda-setting mass media campaign, targeting the public and policymakers.

The Public Health Association of South Africa (PHASA) encouraged its members, especially civil society partners and academics, to support the demand for a sugary drinks tax. Leading up to the campaign launch, social justice and health professionals collaborated with HEALA to advocate for a 20% or greater tax on sugary drinks, the level that the World Health Organization deems necessary to effectively reduce consumption.

HEALA’s efforts were bolstered by the national mass media campaign as it aimed to emphasize the problems caused by sugary drinks, build public demand for the proposed tax, and support policymakers to act by proposing evidence-based policy solutions.

The campaign targeted two specific audience groups in two phases with messaging, designed to engage the public, that focused on personal consequences of sugary drinks consumption. One phase generated support from the general public, and the second urged policymakers to enact the levy.

“Are you drinking yourself sick?” queried one ad, which featured a father and daughter drinking soda and used graphics to illustrate how sugar gets into the bloodstream and affects vital organs, causing obesity, Type 2 diabetes and heart disease. It invited the public to sign petitions through a campaign website to pressure the government to enact the tax.

“Journey: What sugary drinks did to me,” the second phase, was aimed more at policymakers. It documented a “day in the life” of a woman as she fueled herself with fruit juice at breakfast, an energy drink during her commute, an afternoon iced tea pick-me up, and a few glasses of soda over dinner. It then showed her experiencing the potential health effects of consuming more than 50 teaspoons of sugar a day, which is not atypical in South Africa.

Both national campaigns ran for 12 months across multiple platforms, including television, radio, billboards and posters, and in print publications. Radio versions were broadcast in English, isiZulu and isiXhosa.

Stakeholders and community members amplified the message by protesting outside Parliament and Coca-Cola’s Johannesburg headquarters to expose the industry and highlight the harms caused by sugary drinks, in demonstrations organized by HEALA.

The push also had to win over emerging Black farmers in the sugar industry and employees working in the sugar and beverage sectors, concerned about their jobs, though it was clear that beverage companies could refine their drink formulations in response to a tax.

A post-campaign survey found that support for the tax had increased: After the campaign, 76% of respondents favored government action against sugar-sweetened beverages and junk food, compared to 67% before the campaign. In addition, 78% of survey participants recalled the main message of the campaign.

While the initial push was for a 20% tax, what passed was 11%, after the beverage industry protested that the resultant drop in sales would damage their bottom line and raised the specter of job cuts.

“This was a victory for all South Africans,” Mbalati said. “And we will continue to steadfastly defend them against industry giants that care more about profit than people.”