Call for making sugary drinks unaffordable to control diabetes, heart disease

At a time when the prevalence of diabetes in Pakistan is the highest in the world, increasing taxes and duties on sugar-sweetened beverages (SSBs) would not only prevent diabetes, heart disease and several other non-communicable diseases (NCDs) but also result in generating millions of dollars as revenue to be used for health promotion, healthcare professionals and experts said on Wednesday.

“In Pakistan the prevalence of diabetes is around 30.8 per cent, which is the highest in the world,” Prof Abdul Basit, general secretary of the Diabetic Association of Pakistan (DAP), told a consultative meeting in Karachi.

“One of the leading causes of diabetes and other NCDs is high consumption of sugary drinks. We strongly believe that if taxes and duties on SSBs are increased up to 50 per cent, the incidence of obesity and type-2 diabetes can be brought down significantly.”

Senior health experts, nutritionists, activists and people from different walks of life unanimously demanded that the authorities in Pakistan increase taxes and duties on sugary drinks and beverages up to 50 per cent.

They said that evidence from different countries of the world indicates that by making sugary drinks expensive, people can be prevented from getting obese and becoming diabetic.

Speaking at the consultative meeting organised by the DAP in association with the Pakistan National Heart Association (PANAH), the Pakistan Nutrition & Dietetic Society and others, Prof Basit said that the authorities should increase the federal excise duty (FED) on sugary drinks from 20 to 50 per cent.

Sugary drinks are, unfortunately, becoming an increasingly essential part of household food consumption, with more than 10 per cent point increase in the past few years, along with a gradual increase in their production and decrease in their prices, he deplored.

Prof Basit, a renowned diabetologist, said that SSBs, including soft drinks, are any liquids that are sweetened with various forms of added sugars, and include products ranging from sodas to flavoured milk.

“High consumption of these SSBs is one of the major causes of obesity and related NCDs, including diabetes. Unfortunately, SSBs are becoming an increasingly essential part of household food consumption. Increasing intake of SSBs is a major concern for public health experts, as this will continue [the] increase in obesity and related disease like diabetes.”

According to him, the revenue generated by increasing taxes can be used to extend universal health coverage, saying that the Philippines had done the same, and used the revenue for promoting health and preventing diseases.

Munawar Hussain, food policy programme consultant at the Global Health Advocacy Incubator, said that Pakistan’s economy has been facing serious challenges, with debt and liabilities skyrocketing.

“Increased consumption of sugary drinks has put Pakistan into a diabetic emergency, with every third adult citizen living with type-2 diabetes. In this situation, the Ministry of Finance should consider strategic interventions like increasing tax on sugary drinks to reduce the hospital expenditure and generate revenue to meet the shortfall.”

Referring to a study by the World Bank, he said: “If the FED on all sugary drinks is increased to 50 per cent, it would help generate the annual economic value of health impact of $8.9 million and achieve the health gain of 8,500 disability-adjusted life years.”

He added that the WB study also shows that due to this step, the average annual tax revenue would increase to $810 million for the next 10 years.

An increase in excise duty on all sugary drinks to a minimum of 50 per cent in the 2023-24 budget can help prevent diabetes, heart disease, stroke and cancer in thousands of Pakistanis. Increasing tax on sugary drinks can help the government bring some relief to the low-income population through social safety nets.

Sana Ullah Ghumman, PANAH general secretary, said that sugary drinks are not a necessity, and their increased costs will not impact the common population. However, he pointed out, increasing the cost of fuel, energy and agriculture commodities directly impacts everyone.

He said that the Ministry of Finance should prioritise public health over corporate interests, and increase tax on all sweetened drinks, including sodas, energy drinks, juices, including fruit juices, flavoured milk, iced tea, squashes, syrups and sweetened powders used to make drinks.

“Increasing tax on sugary drinks is a triple win for the government, as the policy intervention doesn’t cost anything to the government but helps reduce the disease burden and hospital expenditure, and increase revenue.”

He said that unsweetened milk and bottled water are a healthier alternative to sweetened beverages, so they should not be taxed in order to keep them affordable.

Another renowned diabetologist Prof Zaman Shaikh termed sugary drink manufacturers a “mafia”, and vowed to continue the struggle against their nefarious designs. Renowned gynaecologist Prof Shabeen Naz Masood urged other medical associations as well as the civil society to support the cause of increasing taxes on SSBs up to 50 percent.