Collect Sugar-Sweetened Beverage Tax, then What? Balancing the arguments for and against SSB tax and earmarking.

• Author: Shyra I. Wattley, LL.B, LEC
• Pages: 96-114

Collect Sugar-Sweetened Beverage Tax, then What?

Balancing the arguments for and against

SSB tax and earmarking.

Shyra I. Wattley, LL.B, LEC

Abstract

An unhealthy diet, including the excess consumption of free sugars, is a modiable

risk factor of noncommunicable diseases. One of the World Health Organization’s

recommendations to address this issue is the reduction of free sugar intake to less

than 10%. Sugar-sweetened beverage tax has emerged, in the Caribbean region and

worldwide, as a policy which could potentially contribute to this health objective, in

addition to producing scal benets. However, there are arguments for and against

sugar-sweetened beverage taxes. On the scal side, SSB tax could potentially generate

revenue which can be used to address public health concerns through earmarking,

which in turn, also has pros, cons and legal intricacies.

Keywords

Sugar-sweetened beverages, tax, noncommunicable diseases, Caribbean, revenue,

earmarking, unhealthy diets.

Introduction

Unhealthy diet is one of the modiable risk factors for a range of diet-related

noncommunicable diseases (NCDs), including type-2 diabetes mellitus, cardiovascular

diseases, cancer and chronic respiratory diseases.1 The excess consumption

of free sug ars is a major component of an unhealthy diet.2 Free sugars include

monosaccharides and disaccharides added to foods and beverages by the manufacturer,

cook or consumer, and sugars naturally present in honey, syrups, fruit juices and

1 World Health Organization, ‘Manual on Sugar-Sweetened Beverage Taxation Policies to promote

healthy diets’ (2022) World Health Organization, ‘Healthy Diet’, Fact Sheet No. 394, Updated

August 2018.

2 Pan American Health Organization (PAHO), ‘Nutrient Prole Model’ (2016).

97 Collect Sugar-Sweetened Beverage Tax, then What? Balancing the arguments for and against

SSB tax and earmarking.

fruit juice concentrates.

3

The Caribbean has experienced a dietary transition.

4

The

World Health Organization (WHO) posits that the evolution of diets over time is

inuenced by the complex interaction of social and economic factors such as income,

food prices, individual preferences, beliefs, cultural traditions, and geographical and

environmental dynamics.5

Four main NCDs (cancers, diabetes mellitus, cardiovascular diseases, and chronic

respiratory diseases) accounted for 2.15 million deaths, representing three-quarters

of all NCD deaths.6 Latin America and the Caribbean possess the highest absolute

mortality-related to SSB consumption worldwide, with approximately 159 deaths

per million adults (compared with 48 deaths per million adults globally) and 80%

of these deaths are diabetes-related.7

To address this issue, WHO and several other international and regional

organisations8 strongly recommend reducing intake of free sugars in both adults

and children to less than 10% of total energy intake.

9

This includes the reduction in

consumption of sugar-sweetened beverages (SSBs). WHO denes SSBs as “beverages

containing added caloric sweeteners, such as sucrose, high fructose corn syrup, or

fruit-juice concentrates. These include, but are not limited to, carbonates, fruit drinks,

sports drinks, energy and vitamin water drinks, sweetened iced tea and lemonade.”

10

SSB taxation has emerged as a cost-eective policy which could potentially

have both scal and health benets. In the dimension of health, the aim is that

SSB tax would aid in reducing the consumption of SSBs and more particularly,

free sugars, one of the drivers of NCDs. The aim is that SSB tax will in turn

contribute to lowering the associated NCD burden in the long run (in combination

with other factors). WHO estimates that a 20% tax increase on sugar y drinks can

3 World Health Organization, ‘Guideline: sugars intake for adults and children’ (2015), 17; Pan

American Health Organization (PAHO), ‘Nutrient Prole Model’ (2016), 15.

4 Dinesh P. Sinha, ‘Changing patterns of food, nutrition and health in the Caribbean’ (1995) 15

Nutrition Research 6; 899-938 .

5 World Health Organization, ‘Healthy Diet’, Fact Sheet No. 394, Updated August 2018, 4.

6 ibid.

7 Sandoval RC and others, ‘Excise Taxes on Sugar-Sweetened Beverages in Latin America and

the Caribbean’ (2021) 21 Revista Panamericana de Salud Pública 1, 1.

8 These include: Pan American Health Organization (PAHO), United Nations Food and Agriculture

Organization (FAO), World Cancer Research Fund (WCRF), the Caribbean Public Health Agency

(CAPHA) and Healthy Caribbean Caribbean (HCC).

9 World Health Organization, ‘Guideline: sugars intake for adults and children’ (2015), 17; Pan

American Health Organization (PAHO), ‘Nutrient Prole Model’ (2016).

10 World Health Organization, ‘Fiscal Policies for Diet and Prevention of Non-communicable

Diseases’, Technical Meeting Report, Geneva, Switzerland (May 2015), 8.