In Mexico, as in other countries in the Americas and Africa, obesity, diabetes and hypertension have taken an immense toll on our population. In fact, diabetes is referred to as "azucar" (sugar) in our region because it is the sugar in our diet that is such a powerful cause. While many factors must be attended to reduce obesity and diabetes, the World Health Organisation (WHO) has declared that consumption of sugary beverages is a major cause of obesity, diabetes and dental caries, and taxing sugary beverages is the best strategy to curtail sugary beverage intake.
The Mexican government agrees, and Mexico became the first country to institute a meaningful tax on sugary beverages, although it was still below recommended taxation levels.
At the same time, Mexico set to work on other interventions such as taxing high-energy nonessential food (junk food), reducing children’s exposure to advertising of unhealthy food, implementing better nutritional labelling on the front of packaging, and improving school food policy.
However, the sugary-beverage tax is the first component of this comprehensive attempt to prevent obesity and diabetes that has produced evidence of its positive effects.
Sugary drinks are not the only product that has high sugar. But because they do not satisfy hunger and lack beneficial nutrients, sugary drinks have a proportionally large effect on obesity.
Moreover, sugary drinks provide most of the total added sugar intake in the diet of the Mexican population. That is why reducing the consumption of sugary drinks can have a greater effect on reducing obesity and diabetes, particularly among children.
As countries such as Colombia, SA, the UK and Ireland consider and implement taxes on sugary beverages, it is important to ensure that accurate information informs the public debate around this issue.
Unfortunately, opponents of sugary-drinks tax have used misleading statistics and arguments to suggest that the tax is not working in Mexico, one of the few jurisdictions in which a sugary-drink excise tax has been implemented and evaluated. Recent critiques suggest the volume of cooldrink sales has not fallen in Mexico, and that employment has been negatively affected.
These critiques are not true, and as leader of the Mexican team and a co-author of the only set of peer-reviewed scientific studies on the effect of that measure in Mexico (conducted in collaboration with an eminent group of international scholars that include economists, nutritionists and epidemiologists), I want to set the record straight on the results.
Our first question after implementation of the tax was whether the tax was passed on to the price of sugary drinks. We published the answer to this question, using the Monthly Surveys of the Manufacturing Industry looking from 2011 to 2013 ( before the tax implementation) and in 2014 (after the tax was implemented). Results indicate that, on average, the tax was passed on to consumers for all sugary drinks.
This meant we would expect a reduction in purchases, since we had previously published a paper showing that demand for sugary drinks drops as a response to changes in price.
Since implementing its sugary-beverage tax (of about 10%) in 2014, Mexico has started to stem the tide of its extremely high (and unhealthy) per-capita soda consumption rate.
In our study, published in leading health journal BMJ in January 2016, we found that, based on pretax trends, purchases of sugary drinks fell by an average of 6% in the first full year the tax was in place. Moreover, lower-income households, which have the highest rates of untreated diabetes, bought 9% less sugary drinks.
In place of these sugary drinks, Mexican households were purchasing 4% more water, a healthy substitute.
To follow up on this, recent analysis using data through June 2016 found that the sugary-drink tax in Mexico resulted in a reduction of 6% in sales of these beverages in 2014 (consistent with the BMJ results), 8% in 2015 and 11.1% in the first half of 2016. So the tax is not only lowering demand in the short term, but will also help further lower the demand for sugary drinks over time.
In addition, a recent study took the shifts in drinks purchases and combined them with the 2012 national nutrition survey data on food consumption to estimate the effect on total energy intake. They then used a model to estimate conservative effects on the health of adults aged 35 and older.
Over 10 years, the reduction in sugary-drink consumption resulting from the tax will probably prevent at least 189,300 new cases of type 2 diabetes, 20,400 strokes and heart attacks, and 18,900 deaths among adults aged 35-94 years old.
In addition, the sugary-drinks tax and resulting consumption decline are expected to save $983m on healthcare costs associated with diabetes.
The success of the tax in lowering demand for these unhealthy drinks is precisely why opponents (mainly the beverage manufacturing companies) are fighting it so strongly. Ironically, they claim it does not work.
Meanwhile, they also cite negative employment effects. Their two arguments are contradictory. How can a tax that is not working to lower the demand for sugary drinks have an effect on jobs?
Which brings us to the opposition’s claims regarding unemployment. In the research we have done using Mexico’s national statistics on employment, we did not find a decrease in total employment following the introduction of the sugary-drink tax in the manufacturing sector for beverages and nonessential foods.
Likewise, analysis of Mexico’s Monthly Surveys of the Commercial Establishments showed that employment in commercial stores selling food and beverages did not decrease after the tax was implemented.
Additionally, using data from the National Occupation Surveys, we found that Mexico’s overall unemployment rate did not increase after the tax was implemented. This is likely because sales of healthier beverages, which are also produced by the beverage industry, rose while sales of sugary drinks fell. In other words, the opposition’s claims are false.
Opponents to the tax are being shortsighted. As shown by the changing consumer preferences in response to the tax, there are opportunities for them to improve their product offering options, such as lowering the sugar content in their products, expanding their bottled water lines, and directing their marketing dollars towards healthier beverages rather than unhealthy ones.
A healthier consumer base also benefits them in the long run, as people live longer and will continue buying and using their products. Rather than fighting these obesity and disease prevention efforts, the industry should become part of the solution.
If we are to tackle obesity successfully, diabetes and other diet-related diseases, lower healthcare costs and encourage our children to make healthy choices, policy makers must use every tool at their disposal.
As shown in the Mexico example, a tax on sugary drinks is an effective one and needs to be used.
I urge key decision makers in SA to support the passage of a tax on sugary drinks of at least 20%, as recommended by the Pan American Health Organisation and the WHO as a critical measure to tackle the rising prevalence and burden of obesity and diabetes.
• Rivera is director of the Mexican National Institute of Public Health’s centre of nutrition and health.
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