Abstract

ABSTRACT

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems.

Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia.

Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws.

Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization’s recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures.

Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention.

Details

Title
The legal feasibility of adopting a sugar-sweetened beverage tax in seven sub-Saharan African countries
Author
Karim, Safura Abdool 1 ; Erzse, Agnes 1 ; Thow, Anne-Marie 2 ; Hans Justus Amukugo 3 ; Ruhara, Charles 4 ; Ahaibwe, Gemma 5 ; Asiki, Gershim 6 ; Mukanu, Mulenga M 7 ; Ngoma, Twalib 8 ; Wanjohi, Milka 6 ; Abel Karera 9 ; Hofman, Karen 1 

1  SAMRC/Wits Centre for Health Economics and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), School of Public Health, University of the Witwatersrand , Johannesburg , South Africa 
2  Menzies Centre for Health Policy and Director of Academic Titles, School of Public Health, The University of Sydney , Sydney , Australia 
3  Community Health Department, School of Nursing, Faculty of Health Sciences, University of Namibia , Windhoek , Namibia 
4  School of Economics, University of Rwanda , Butare , Rwanda 
5  Economic Policy Research Centre (EPRC), Makerere University , Kampala , Uganda 
6  Health and Systems for Health Unit, African Population and Health Research Center , Nairobi , Kenya 
7  Health Policy and Management Unit, School of Public Health, University of Zambia , Lusaka , Zambia 
8  Oncology of the Ocean Road Cancer Institute (ORCI) and Oncology Department, Muhimbili University of Health and Allied Sciences , Dar Es Salaam , Tanzania 
9  Allied Health Department, School of Nursing, Faculty of Health Sciences, University of Namibia , Windhoek , Namibia 
Publication year
2021
Publication date
Jan 1, 2021
Publisher
Taylor & Francis Ltd.
e-ISSN
16549880
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/16549716.2021.1884358
ProQuest document ID
2866973601
Copyright
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.