The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa

Background: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes. Objective: To identify politico-economic factors relevant to nut...

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Main Authors: Anne Marie Thow, Safura Abdool Karim, Mulenga M. Mukanu, Gemma Ahaibwe, Milka Wanjohi, Lebogang Gaogane, Hans Justus Amukugo, Charles Mulindabigwi Ruhara, Twalib Ngoma, Gershim Asiki, Agnes Erzse, Karen Hofman
Format: Article
Language:English
Published: Taylor & Francis Group 2021-01-01
Series:Global Health Action
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Online Access:http://dx.doi.org/10.1080/16549716.2021.1909267
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author Anne Marie Thow
Safura Abdool Karim
Mulenga M. Mukanu
Gemma Ahaibwe
Milka Wanjohi
Lebogang Gaogane
Hans Justus Amukugo
Charles Mulindabigwi Ruhara
Twalib Ngoma
Gershim Asiki
Agnes Erzse
Karen Hofman
author_facet Anne Marie Thow
Safura Abdool Karim
Mulenga M. Mukanu
Gemma Ahaibwe
Milka Wanjohi
Lebogang Gaogane
Hans Justus Amukugo
Charles Mulindabigwi Ruhara
Twalib Ngoma
Gershim Asiki
Agnes Erzse
Karen Hofman
author_sort Anne Marie Thow
collection DOAJ
description Background: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes. Objective: To identify politico-economic factors relevant to nutrition-related fiscal policies, and to draw lessons regarding strategies to strengthen sugar-sweetened beverages taxation in the region and globally. Methods: We collected documentary data on policy content, stakeholders and corporate political activity from seven countries in east and southern Africa augmented by qualitative interviews in Botswana, Namibia, Kenya and Zambia, and stakeholder consultations in Rwanda, Tanzania and Uganda. Data were analysed using a political economy framework, focusing on ideas, institutions, interests and power, and a ‘bricolage’ approach was employed to identify strategies for future action. Results: Non-communicable diseases were recognised as a priority in all countries. Kenya, Zambia, Rwanda, Tanzania and Uganda had taxes on non-alcoholic beverages, which varied in rate and tax base, but appeared to be motivated by revenue rather than health concerns. Botswana and Namibia indicated intention to adopt sugar-sweetened beverage taxes. Health-oriented sugar-sweetened beverage taxation faced challenges from entrenched economic policy paradigms for industry-led economic growth and was actively opposed by sugar-sweetened beverage-related industries. Strategies identified to support stronger sugar-sweetened beverage taxation included shifting the economic discourse to strengthen health considerations, developing positive public opinion, forging links with the agriculture sector for shared benefit, and leadership by a central government agency. Conclusions: There are opportunities for more strategic public health engagement with the economic sector to foster strong nutrition-related fiscal policy for non-communicable disease prevention in the region.
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spelling doaj-art-565b0db34b6e4b8d808af39dff1acda82025-08-20T03:46:52ZengTaylor & Francis GroupGlobal Health Action1654-98802021-01-0114110.1080/16549716.2021.19092671909267The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan AfricaAnne Marie Thow0Safura Abdool Karim1Mulenga M. Mukanu2Gemma Ahaibwe3Milka Wanjohi4Lebogang Gaogane5Hans Justus Amukugo6Charles Mulindabigwi Ruhara7Twalib Ngoma8Gershim Asiki9Agnes Erzse10Karen Hofman11The University of SydneyUniversity of the WitwatersrandUniversity of Zambia School of Public HealthMakerere UniversityHealth and Systems for Health UnitBoitekanelo CollegeUniversity of NamibiaUniversity of RwandaMuhimbili University of Health and Allied SciencesHealth and Systems for Health UnitUniversity of the WitwatersrandUniversity of the WitwatersrandBackground: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes. Objective: To identify politico-economic factors relevant to nutrition-related fiscal policies, and to draw lessons regarding strategies to strengthen sugar-sweetened beverages taxation in the region and globally. Methods: We collected documentary data on policy content, stakeholders and corporate political activity from seven countries in east and southern Africa augmented by qualitative interviews in Botswana, Namibia, Kenya and Zambia, and stakeholder consultations in Rwanda, Tanzania and Uganda. Data were analysed using a political economy framework, focusing on ideas, institutions, interests and power, and a ‘bricolage’ approach was employed to identify strategies for future action. Results: Non-communicable diseases were recognised as a priority in all countries. Kenya, Zambia, Rwanda, Tanzania and Uganda had taxes on non-alcoholic beverages, which varied in rate and tax base, but appeared to be motivated by revenue rather than health concerns. Botswana and Namibia indicated intention to adopt sugar-sweetened beverage taxes. Health-oriented sugar-sweetened beverage taxation faced challenges from entrenched economic policy paradigms for industry-led economic growth and was actively opposed by sugar-sweetened beverage-related industries. Strategies identified to support stronger sugar-sweetened beverage taxation included shifting the economic discourse to strengthen health considerations, developing positive public opinion, forging links with the agriculture sector for shared benefit, and leadership by a central government agency. Conclusions: There are opportunities for more strategic public health engagement with the economic sector to foster strong nutrition-related fiscal policy for non-communicable disease prevention in the region.http://dx.doi.org/10.1080/16549716.2021.1909267noncommunicable diseasetaxsugar-sweetened beveragepolitical economypolicy
spellingShingle Anne Marie Thow
Safura Abdool Karim
Mulenga M. Mukanu
Gemma Ahaibwe
Milka Wanjohi
Lebogang Gaogane
Hans Justus Amukugo
Charles Mulindabigwi Ruhara
Twalib Ngoma
Gershim Asiki
Agnes Erzse
Karen Hofman
The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
Global Health Action
noncommunicable disease
tax
sugar-sweetened beverage
political economy
policy
title The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
title_full The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
title_fullStr The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
title_full_unstemmed The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
title_short The political economy of sugar-sweetened beverage taxation: an analysis from seven countries in sub-Saharan Africa
title_sort political economy of sugar sweetened beverage taxation an analysis from seven countries in sub saharan africa
topic noncommunicable disease
tax
sugar-sweetened beverage
political economy
policy
url http://dx.doi.org/10.1080/16549716.2021.1909267
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