Sugar tax and other lifestyle levies will protect poorest from 'catastrophic' costs, finds study

Argument that new charges will financially punish poorest ignores the major health and economic cost of diseases

Alex Matthews-King
Health Correspondent
Wednesday 04 April 2018 22:02 BST
Sugary drinks and unhealthy snacks 'fuelling obesity epidemic among children'

A tax on sugar, which comes into force in the UK on Friday, and levies on other unhealthy products can play an important role in protecting society’s poorest from “catastrophic” economic and health costs. That is the conclusion of a series of studies on the global burden of so-called lifestyle diseases – cancers, heart disease and diabetes, which aren’t passed on but are caused by our diet and activities instead.

These non-communicable diseases, which account for 38 million deaths worldwide, 16 million of which are in people under 70, are a “major cause and consequence of poverty” according to Dr Rachel Nugent, who headed the taskforce for The Lancet journal’s special edition.

“Taxes on unhealthy products can produce major health gains, and the evidence shows these can be implemented fairly, without disproportionately harming the poorest in society,” added Dr Nugent vice-president of global health charity RTI International.

However this is disputed by soft drinks manufacturers who say there is “no evidence anywhere in the world” that taxes help obesity rates, which have risen steadily for a decade.

Across a series of reviews of the available scientific evidence, The Lancet looked at whether the facts support a number of common objections to taxes on unhealthy products.

Chiefly, that they are “regressive” and place an economic burden disproportionately on those least able to afford it.

One review of 283 international studies showed poor households worldwide already suffer disproportionately from these diseases.

As well as increasing their risk of early death the review found there was a major economic toll.

The households are the least likely to have health insurance meaning they are up to seven times more likely to experience “financial catastrophe” – amounting to a third of their annual income or more.

Results of the impact of a stroke on patients in China found that even among those with health insurance, 53 per cent of patients experienced a financial catastrophe.

This is because diseases made more likely by smoking, obesity and drinking can seriously impact a person’s ability to work, factors which apply equally in countries like the UK.

“The poor, with already shorter life expectancies and bearing the brunt of under nutrition, malnutrition, childhood diseases, major infections, and pregnancy-related conditions, are the most likely to be affected by non-communicable diseases,” said Professor Louis Niessen, from the Liverpool School of Tropical Medicine.

This “ruinous burden” is not factored into complaints about taxes on health harming products, the authors argued.

Another paper, on health taxes in 13 countries, found that while poorer households make up the bulk of revenue raised from tobacco controls, wealthier households spent more on alcohol and sugary drinks and snacks.

In India, for example, alcohol spending was seven times higher in wealthier households, and sugary food spending was three times higher than in the poorest households.

The paper concluded: “The health benefits generated by price policies will be largest for low-income consumers because of their strong response to price changes.”

Benefits can be even greater when the funding raised from taxation subsidises healthy eating initiatives or school sports programmes – as is the intention with the UK sugar tax.

Coming into force on Friday, the levy affects drinks with more than 5g of sugar per 100ml and will require manufacturers to pay 18p per litre to the government, or 24p per litre if the product has more than 8g of sugar.

The tax has already been successful by making more than half of drinks manufacturers reformulate their products to avoid paying a levy, according to the Treasury - most controversially Scottish favourite Irn-Bru.

But some products, like the original versions of Coca-Cola and Pepsi, will remain unchanged and the price of a can of Coke, which contains seven teaspoons of sugar, is likely to rise by around 8p plus VAT as a result.

It will be up to retailers to decide whether they pass on the additional cost of products to the customer, but in countries like Mexico, which added a 10 per cent tax on sugary drinks, overall consumption fell 12 per cent and by as much as 17 per cent in lower income groups.

A spokesperson for Coca-Cola said obesity rates have increased significantly over the past decade even as manufacturers have launched sugar free versions and cut sugar content.

“We think it’s too soon to claim the tax has been a success. There is no evidence from anywhere in the world that shows taxing soft drinks reduces obesity rates,” they added.

Campaigners disagree. Professor Graham MacGregor, chair of Action on Sugar, told The Independent: “The UK sugar levy is both remarkable and unique in that it allows for significant product reformulation by manufacturers in order to avoid the tax. This has already resulted in a much bigger reduction of sugar intake in the UK than originally anticipated.

“Extensive evidence from around the world also shows that taxes on sugary drinks do work.”

While Professor Helen Stokes-Lampard chair of the Royal College of GPs said the sugar tax should be just the start of more stringent taxation.

“Today’s findings from The Lancet provide helpful further evidence that taxes on these unhealthy products are an effective response to combatting higher rates of chronic diseases without disproportionately affecting people from lower socioeconomic backgrounds," she said.

"We need to ensure this new evidence is reflected in future health policies going forward."

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