Strengthening prevention of nutrition-related non-communicable diseases through sugar-sweetened beverages tax in Rwanda: a policy landscape analysis

Abstract

Background : Food and beverages high in sugar are recognized to be among the major risk factors for nutrition-related non-communicable diseases. The growing presence of ultra-processed food producers has resulted in shifts to diets that are associated with non-communicable diseases and which include sugar-sweetened beverages. Sugar-sweetened beverage taxation presents an opportunity to prevent non-communicable diseases but it comes with challenges. Objectives : To describe the policy landscape, identify and analyse the facilitators of and barriers to strengthening taxation on sugar-sweetened beverages in Rwanda. Methods : We conducted a desk-based policy analysis to assess the facilitators of and barriers to strengthening sugary beverage taxation policy. We consulted eight stakeholders to validate the findings of the desk review. Results : Non-communicable diseases are recognized as a public health challenge in Government health and non-health policy documents. However, sugar intake is not explicitly identified as a risk factor for non-communicable diseases and existing policies do not clearly aim to reduce sugar consumption. The Rwandan Government's commitment to growing the local sugar industry and the substantial economic contribution of Rwandan beverage producers are potential barriers to fiscal policies aimed at reducing sugar consumption. However, the current 39% excise tax levied on all soft drinks could support the adoption of future sugar-sweetened beverage policies. Conclusions : The landscape for strengthening a sugar-sweetened beverage tax in Rwanda is complex. The policy environment provides both facilitators of and impediments to strengthening the existing tax. A differential tax could be introduced by leveraging on the existing excise tax and linking it to the sugar content of beverages.

An exploration of stakeholder views and perceptions on taxing tobacco, alcohol and sugar-sweetened beverages in Ghana

“…While stakeholders in our study were generally supportive of health taxes through the presence of an enabling environment (ongoing stakeholder discussions for tobacco tax review) and global or regional momentum (by the Economic Community of West African States and the United Nations Development Programme), a strong industry presence (mainly alcohol and SSBs) was observed. Similar to countries such as Uganda54 and Rwanda,55 perceived tensions exist between health and economic policies. Nevertheless, despite industry efforts and existing tension within ministries, taxation is gaining more attention from policy makers as a win–win–win policy measure for public health, domestic resource mobilisation and equity (although contested) 36…”

Politics–evidence conflict in national health policy making in Africa: a scoping review

“…Out of the total, 11(25.6%) [ 24 – 34 ] originated from Western Africa only, 11(25.6%) [ 35 – 45 ] from Southern Africa only, 11(25.6%) [ 46 – 56 ] from Eastern Africa only and 3(7.1%) [ 57 – 59 ] from Eastern and Southern Africa. Also, 1(2.3%) [ 60 ] from Northern only, 1(2.3%) [ 61 ] from Central only, 1(2.3%) [ 62 ] from Eastern and Western, 1(2.3%) [ 63 ] from Western and Northern, 1(2.3%) [ 64 ] from Western and Southern, 1(2.3%) [ 65 ] from Central, Eastern, Western and Southern, and 1(2.3%) [ 66 ], thus, cutting across the entire continent. The approaches adopted by these articles included quantitative 2(4.5%) [ 39 , 66 ], qualitative 39(91%) [ 24 – 32 , 35 – 38 , 40 – 51 , 53 – 65 ] and mixed method 2(4.5%) [ 33 , 52 ].…”

Economic priorities over population health: A political dilemma in addressing noncommunicable diseases in developing countries

“…The study identified low awareness on the motives of the levy, and were influenced by addiction and branding effect to purchase SSB 36,37 . Moreover, implementation of taxation in sugar based on sugar content might counteract this effect 38 …”

“…36,37 Moreover, implementation of taxation in sugar based on sugar content might counteract this effect. 38 The introduction of taxation that can have a positive effect on the public health faces challenges due to the conflict of interest from government authorities and different globalization stakeholders. 39,40 This is mainly due to lack of common understanding or agreement of the purpose or goal of taxation imposed to these products.…”