Israel’s Decision to Revoke Sugar Tax is ‘Grievous Blow to Public Health’ Nutrition & Physical Activity 02/02/2023 • Maayan Hoffman Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Sugary drinks are linked to diabetes and other NCDs. Israeli and international public health professionals have published a letter in the Lancet expressing deep concern over an Israeli government decision to cancel the country’s sweetened beverage tax, which was only passed in November 2021. These senior scholars said the decision to revoke the tax sends a message that the government lacks respect for science and evidence. Calling it a “grievous blow to public health,” they said it will harm Israel’s population and the country’s international standing. “Revoking the tax will undoubtedly harm lives and increase the direct and indirect economic costs to Israel’s health system and economy, both in the short term and long term,” the scholars wrote. “More broadly, this act undermines hard-won progress made elsewhere around the world. It is a serious setback for evidence-based public health policy and will be celebrated by vested interests who promote their products and disregard the need for policies that uphold the public’s health and welfare.” No consultation The revocation was the first decision announced by Israel’s incoming finance minister, a member of the Orthodox Jewish community in Israel, which consumes a high level of sugary drinks, according to multiple Israeli reports. He made the decision on his first day in office, without consulting civil service professionals in the ministries of health or finance, or without conducting any other independent expert review, according to the letter. The letter was supported by a number of leading health experts, including Aron Troen, director of the Nutrition and Brain Health Laboratory at Hebrew University in Jerusalem; Ana Paula Bortoletto Martins, a senior researcher in the Center for Epidemiological Research in Nutrition and Health at the University of São Paulo; Ildefonso Hernandez Aguado, a professor of public health at the University Miguel Hernández; Barry Popkin, a professor of nutrition at the University of North Carolina Gillings School of Global Public Health, and Hagai Levine, a faculty member of the School of Public Health and Community Medicine at Hebrew University. The government decision is open to comments until 4 February. As such, the scholars are “calling on the government of Israel to reconsider and retract this ill-conceived and hasty decision. “Instead let the revenue from the soda tax be used to combat chronic diseases including obesity, as well as promote nutrition security by increasing economic access to healthy diets, narrowing health disparities, improving the health and welfare of all Israeli citizens, and setting an example for world health leadership,” they wrote. Links to NCDs Too much sugar consumption has been associated with the development of non-communicable diseases (NCDs), including hypertension, liver and kidney damage, heart disease, obesity and some cancers, an article written by Popkin and colleague Shu Wen Ng and published in PLOS MEDICINE in 2021 showed. A report published by the World Health Organization in 2017 found that people who drink as little as one to two cans of sugar-sweetened beverages a day have a 26% greater risk of developing Type 2 diabetes than people who don’t. Additionally, new evidence is showing a link between people’s diets and planetary health, the PLOS article noted. There are environmental costs related to the production of sugary drinks, particularly in water use and carbon emissions, it said. Sugar-sweetened beverages (SSB) taxes have “gained momentum because of their relative ease of implementation compared to other food/nutrition policy options. Taxes collected from manufacturers, bottlers, and distributors can often be built into existing taxation frameworks and collection systems, and these health taxes are a potential source of revenue,” according to Popkin and Ng. A meta-analysis on the impact of SSB taxes on purchases and dietary intake published in 2019 by Obesity Reviews showed that the average consumer will lower his/her SSB purchases by 10% if SSB prices rise 10%. Further evaluations suggest that the reductions affected by SSB taxes translate to five to 22 kilocalories (kcals) per capita per day, the PLOS article pointed out. “These levels of reductions, even if sustained, are insufficient, to meaningfully impact the broad swath of health outcomes in a timely manner, although research shows that the 10- to 20-year time horizon will produce important results,” Popkin and Ng wrote. For most of the last decade, WHO came under fire for not promoting SSB taxes enough. But in December, the organization published a “manual on sugar-sweetened beverage taxation policies to promote healthy diets.” At a ceremony celebrating the guide’s launch, Dr Rudiger Krech, WHO’s director of health promotion, said that food prices have been found to be a key determinant of food purchases. “Raising taxes has proven to be the single most potent and most cost-effective strategy for reducing tobacco use, and similarly, we know that raising taxes on alcohol beverages is also a potent and cost effective strategy for decreasing harmful use,” said Krech. SSB taxes reduce consumption South Africans campaign in favour of a tax on sugary drinks in 2017 To date, more than 45 countries, cities and regions have instituted SSB taxes. Another country that implemented one and then revoked it was Nigeria, whose government taxed sugar-sweetened beverages, alcoholic drinks and tobacco as luxury items to raise revenue between 1984 and 2009. The SSB tax was removed in 2009 but reinstituted again in 2022. In the Middle East region, where Israel is located, other countries such as Saudi Arabia, Qatar and the United Arab Emirates have instituted 50% to 100% excise taxes on subsets of SSBs. Bermuda, similarly, has implemented a 75% import tax on SSBs and candies. In most cases, the taxes have worked. For example, in Mexico a 10% tax on sugary drinks since 2014 has led to a 12% reduction in consumption, Mexico’s Vice Minister of Health Hugo Lopez-Gatell said at the World Health Assembly (WHA) in June. In a more striking example, a 10% SSB tax implemented in 2018 in South Africa has thus far translated to a nearly 40% decline in sugar consumption, according to an observational study published by the Lancet in 2021. In the United Kingdom, the most recent data showed that “the levels of sugar in drinks that are subject to the levy have come down by 46%,” Dr Victoria Targett from the Office of Health Improvement, said at the WHO launch event. At the end of last year, Columbia’s Congress voted to impose taxes on SSBs and other ultra-processed or sugary foods like cereals, sausages and jellies. The tax will only be implemented later this year at 10%, but is expected to rise to 15% in 2024 and 20% in 2025. Image Credits: Heala_SA/Twitter, Kerry Cullinan. Share this:Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Facebook (Opens in new window)Click to print (Opens in new window) Combat the infodemic in health information and support health policy reporting from the global South. 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