How policy may boost Nigeria’s fight against non-communicable diseases

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The recent announcement of an excise tax of N10 per litre on all non-alcoholic, carbonated, and sugar-sweetened beverages by the government of Nigeria has been welcomed with mixed reactions.

The minister of finance and budget planning, Zainab Ahmed, while presenting the breakdown of the 2022 budget, made the announcement, saying it was part of the government’s efforts to prevent and discourage excessive consumption of sugar in beverages, which contributes to obesity, diabetes, and other diseases.

But while a section of Nigeria believes the new policy will translate to an increase in prices of beverages for the common men and women on the streets, there are health experts and campaigners who believe it was a policy needed long before now.

In this report, PREMIUM TIMES takes a look at available verifiable statistics to assess the possible implications of the government’s latest decision.

What statistics say

Several studies have linked the intake of excess sugar and sugar-sweetened beverages (SSB) with obesity, type 2 diabetes, overweight, cardiovascular diseases and other non-communicable diseases.

An estimated 184,000 deaths and 8.5 million disability-adjusted life-years worldwide were attributed to SSB consumption in 2010, a report by the World Bank indicates.

Of the various diseases associated with x, obesity and overweight take the lead because they are linked to other health complications such as diabetes, heart diseases, certain types of cancer, and stroke.

A World Bank report published in 2020 stated that obesity-related diseases are now among the top three killers across the globe.

In fact, obesity and overweight are considered a modern epidemic in most parts of the world. They are described as the gravest public health challenges facing the world today, including Nigeria.

As of 2016, more than 1.9 billion adults globally were overweight, out of which over 650 million suffered obesity. These diseases also account for over four million deaths every year.

If this trend continues, by 2030, an estimated 38 per cent of the world’s adult population will be overweight and another 20 per cent will be obese, a report published on pharmacoeconomics shows.

According to the World Health Organisation (WHO), most of the world’s population live in countries where overweight and obesity kill more people than underweight.

Nigeria, Africa’s most populous nation, accounts for over 12 million persons estimated to be obese in 2020, with prevalence considerably higher in women.

Health experts, however, believe that the newly introduced “sugar tax” in Nigeria will not only tackle obesity but will help reduce deaths from other non-communicable diseases.

“The rate at which non-communicable diseases, particularly obesity, diabetes mellitus and cancers are causing very high morbidities and mortalities in Nigeria is disturbing, and the earlier government does something to address the negative trend, the better for us all,” a public health expert, Adamu Alhassan, said in an interview with PREMIUM TIMES.

About SSB Tax

While speaking on the new sweetened beverage tax, the finance minister said the initiative “would discourage excessive consumption of sugar in beverages which contributes to a number of health conditions including diabetes and obesity.”

SSB is categorised as a liquid that contains natural or added sweeteners, including various forms of sugars such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar, and sucrose.

These may include soft drinks, juices, nectars, sweetened coffee, sweetened tea, energy drinks, speciality drinks, and flavoured dairy.

Sweetened drink consumption in Nigeria

In Africa, Nigeria boasts of the largest consumer of soft drinks, according to data from Statista, a global analytics firm.

Data from the analysis shows that Nigerians consume an estimated 40 million litres of soft drinks yearly.

A 2016 global soft drinks market analysis indicates that Nigeria is the fourth highest consumer of soft drinks in the world, after the United States, China, and Mexico.

While some concerned parties are against the government’s decision to introduce the N10 per litre tax, others believe it will discourage people from taking too much-carbonated drinks which have negative effects on their health.

Nigeria is not the first country to impose an excise tax on SSB. Over 50 countries have already introduced SSB taxes to reduce the intake of such drinks and also encourage manufacturers to reduce sugar content.

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Robust evidence has confirmed a drop in SSB consumption following the tax’s introduction in many jurisdictions including in the UK (2018), Mexico (2014), South Africa (2018), and Chile (2014).

Reducing NCD in Nigeria

Epidemiological studies have shown that individuals who consume a higher amount of added sugar than the recommended less than 10 per cent of total calories, tend to gain more weight and have a higher risk of obesity.

Mr Alhassan, the public health expert, said the tax on SSB is timely as it would serve as a major tool to fight obesity epidemic and diabetes in the country.

He said it is scientifically verifiable that obesity, diabetes mellitus, hypertension, and other non-communicable disease are directly linked to cancers and hence the vicious cycle if the consumption of sugary drinks is not reduced or moderated in the country.

Mr Alhassan explained that Tobacco, alcohol, and sugary beverage consumption accounts for a large and growing share of the burden of premature death and diseases in Nigeria.

“Unhealthy diets significantly contribute to the increased risk of obesity and diet-related NCDs including diabetes and cancers.

“This further buttresses the fact that the SSBs tax should be viewed as a component of a comprehensive approach to tackling unhealthy diets and addressing diet-related NCDs,” he said.

In a letter supporting the government’s decision, a group of scholars under the aegis of leading global economics, medical, and public health scholars said SSB often has no nutritional value.

The scholars said hundreds of studies have shown how SSB add to the total caloric intake and impact adversely not only on child and adults but also on infants.

It said the sugars in sugary drinks alter the body’s metabolism, affecting insulin, cholesterol, and metabolites that cause high blood pressure and inflammation.

“These changes to the body increase the risk of type 2 diabetes, cardiovascular disease, tooth decay, and liver disease,” it said.

“Use Tax to fight NCDs”

Mr Alhassan said the government should channel the revenue from the SSB tax towards key preventive measures against obesity, diabetes and other NCD.

He said proper utilisation of the accrued revenue would go a long way in positively changing the alarming statistics of NCDs in the country.

“Considering the alarming statistics of these diseases all over the world, it has therefore become imperative for Government to Chanel the accrued revenue from these taxes into policy formulation for these group of diseases and preventive campaigns and other direct benefits to people affected by these diseases,” he said.

A health coalition, National Action on Sugar (NASR), in a statement obtained by PREMIUM TIMES, commends the government’s efforts to reduce sugar-related diseases in Nigeria.

The coalition calls for the revenue to be invested in the health sector to tackle non-communicable diseases.

“The Coalition considers the tax a protective measure for Nigeria’s poorest, a population that stands to benefit the most from reduced consumption of sugary beverages.

“Tax revenue can be used to curtail the rising burden of disease on the poor and on the nation’s healthcare system,” the statement highlighted.

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