South Africa faces interrelated burdens of disease resulting from a mixture of communicable diseases such as HIV/AIDS and tuberculosis as well as non-communicable diseases such as type 2 diabetes, obesity, hypertension, cardiovascular diseases and cancers. Prevalence rates of obesity and type 2 diabetes are especially high among women. In 2010, approximately 9% of men and 11.8% of women in South Africa had diabetes, a nearly twofold increase since 1980. Approximately 90% of this group suffers from type 2 diabetes mellitus, of which 60.1% is estimated to be unscreened and undiagnosed.
Policy Research
Policies
Rates and Monetary Amounts and Amendment of Revenue Laws Act 2017, Act No. 14 | Implemented April 1, 2018
Health Promotion Levy
For all non-alcoholic beverages and beverage concentrates, manufacturers & distributors taxed:
- R0.021 ($0.0014 USD) per gram sugar in excess of 4 g/100 mL.
- If sugar is not labeled, product taxed at default rate based on containing 20 g sugar/100mL (R0.336/100 mL or $0.023 USD).
Exempt: 100% juice, dairy beverages
Developing
Front-of-package warning labels
After conducting focus groups to test and determine the most effect shape, color, and style for the proposed warning labels, the research team in South Africa conducted a randomized controlled trial to test the warning label alongside a traffic light label and Guideline Daily Amounts label. This experiment was led by Rina Stewart as part of a Department of Health task force. UWC compiled an extensive technical report that summarized all of their research on nutrient profiling models and front-of-package labels, which they presented to the National Department of Health with their evidence-based policy recommendations. This report is currently not available to the public. The draft front-of-package warning label regulation is now in the Department of Health's hands.
In-Country Research Partners
In-Country Team Leads
- Karen Hofman, MD - Professor, PRICELESS
- Susan Goldstein, MD - Professor, PRICELESS
- Nicholas Stacey - Senior Researcher, PRICELESS
- Rina Swart, PhD - Professor, University of the Western Cape
- Tamryn Jenkings - Project Manager, University of the Western Cape
GFRP Team Leads
Resources
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Taxes on unhealthy foods and beverages
Global maps showing countries and smaller jurisdictions with taxes on sugary or sweetened beverages and/or unhealthy foods, that were implemented with a goal of curbing sugar, salt, saturated or trans fat, and excessive calorie consumption and improving public health. Included are brief descriptions of each tax structure and dates of passage or implementation.
Publications
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Are intentions to change, policy awareness, or health knowledge related to changes in dietary intake following a sugar-sweetened beverage tax in South Africa? A before-and-after study
Authors: Michael Essman, Catherine Zimmer, Francesca Dillman Carpentier, Elizabeth C. Swart, Lindsey Smith Taillie
Published in: International Journal of Behavioral Nutrition and Physical Activity, October 28, 2022 -
Effect of different front-of-package food labels on identification of unhealthy products and intention to purchase the products – A randomised controlled trial in South Africa
Authors: Makoma Bopape, Jeroen De Man, Lindsey Smith Taillie, Shu Wen Ng, Nandita Murukutla, Rina Swart
Published in: Appetite, August 24, 2022 (online ahead of print) view full text -
Perceived effect of warning label on parental food purchasing and drivers of food selection among South African parents — An exploratory study
Authors: Makoma Bopape, Lindsey Smith Taillie, Rina Swart
Published in: Frontiers in Public Health, August 5, 2022 view full text -
Decomposing consumer and producer effects on sugar from beverage purchases after a sugar-based tax on beverages in South Africa
Authors: Maxime Bercholz, Shu Wen Ng, Nicholas Stacey, Elizabeth C. Swart
Published in: Economics & Human Biology, March 21, 2022 view full text -
South Africa’s Health Promotion Levy on pricing and acquisition of beverages in local spazas and supermarkets
Authors: Alexandra Ross, Elizabeth C. Swart, Tamryn Frank, Caitlin M. Lowery, Shu Wen Ng
Published in: Public Health Nutrition, March 7, 2022 view full text -
Applying and comparing various nutrient profiling models against the packaged food supply in South Africa
Authors: Tamryn Frank, Shu Wen Ng, Donna R. Miles, Elizabeth C. Swart
Published in: Public Health Nutrition, February 16, 2022 view full text -
Examining the news media reaction to a national sugary beverage tax in South Africa: A quantitative content analysis
Authors: Michael Essman, Fernanda Mediano Stoltze, Francesca Dillman Carpentier, Elizabeth C. Swart, Lindsey Smith Taillie
Published in: BMC Public Health, December 2021 view full text -
South African consumers' perceptions of front-of-package warning labels on unhealthy foods and drinks
Authors: Makoma Bopape, Lindsey Smith Taillie, Tamryn Frank, Nandita Murukutla, Trish Cotter, Luyanda Majija, Rina Swart
Published in: PLOS ONE, September 27, 2021 view full text -
A fit-for-purpose nutrient profiling model to underpin food and nutrition policies in South Africa
Authors: Tamryn Frank, Anne-Marie Thow, Shu Wen Ng, Jessica Ostrowski, Makoma Bopape, Elizabeth C. Swart
Published in: Nutrients, July 28, 2021 view full text -
South Africa's health promotion levy: Excise tax findings and equity potential
Authors: Karen Hofman, Nicholas Stacey, Elizabeth Swart, Barry Popkin, Shu Wen Ng
Published in: Obesity Reviews, May 31, 2021 view full text -
Taxed and untaxed beverage consumption by young adults in Langa, South Africa before and one year after a national sugar-sweetened beverage tax
Authors: Michael Essman, Lindsey Smith Taillie, Tamryn Frank, Shu Wen Ng, Barry M. Popkin, Elizabeth C. Swart
Published in: PLOS Medicine, May 25, 2021 view full text -
Changes in beverage purchases following the announcement and implementation of South Africa's Health Promotion Levy: An observational study
Authors: Nicholas Stacey, Ijeoma Edoka, Karen Hofman, Elizabeth C. Swart, Barry Popkin, and Shu Wen Ng
Published in: The Lancet Planetary Health, April 1, 2021 view full text -
Sugar-based beverage taxes and beverage prices: Evidence from South Africa’s Health Promotion Levy
Authors: Nicholas Stacey, Caroline Mudara, Shu Wen Ng, Corne van Walbeek, Karen Hofmam, Ijeoma Edoka
Published in: Social Science & Medicine, October 1 2019 view full text