在乌干达，采用含糖饮料税来预防非传染性疾病的障碍和促进因素：政策分析。
Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Uganda: a policy landscape analysis.
机构信息
Economic Policy Research Centre (EPRC), Makerere University, Makerere, Uganda.
SAMRC Centre for Health Economic and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), University of the Witwatersrand, School of Public Health, Johannesburg, South Africa.
出版信息
Glob Health Action. 2021 Jan 1;14(1):1892307. doi: 10.1080/16549716.2021.1892307.
BACKGROUND
Uganda is experiencing an increase in nutrition-related non-communicable diseases. Risk factors include overconsumption of sugar-sweetened beverages. Fiscal and taxation policies aim to make the consumption of healthier foods easier. However, the adoption and implementation of fiscal policies by countries are constrained by political and economic challenges.
OBJECTIVE
We investigated the policy and political landscape related to the prevention of nutrition-related non-communicable diseases in Uganda to identify barriers to and facilitators of the adoption of sugar-sweetened beverage taxation in Uganda.
METHODS
A desk-based policy analysis of policies related to nutrition-related non-communicable diseases and sugar-sweetened beverage taxation was conducted. Four key informant consultations (n = 4) were conducted to verify the policy review and to gain further insight into the policy and stakeholder contexts. Analysis was framed by Kingdon's theory of agenda setting and policy change.
RESULTS
Nutrition-related non-communicable diseases were recognised as an emerging problem in Uganda. The Government has adopted a comprehensive approach to improve diets, but implementation is slow. There is limited recognition of the consumption of sugar and sugar-sweetened beverages as a contributor to the nutrition-related non-communicable disease burden in policy documents. Existing taxes on soft drinks are lower than the World Health Organization's recommended rate of 20% and do not target sugar content. The soft drink industry has been influential in framing the taxation debate, and the Ministry of Finance previously reduced taxation of sugar-sweetened beverages. Maintaining competitiveness in a regional market is an important business strategy. However, the Ministry of Health and other public health actors in civil society have been successful (albeit marginally) in countering reductions in taxation, which are supported by industry.
CONCLUSIONS
An established platform for sugar-sweetened beverage taxation advocacy exists in Uganda. Compelling local research that explicitly links soft drink taxes to health goals is essential to advance sugar-sweetened beverage taxation.
背景
乌干达正面临营养相关非传染性疾病的增加。风险因素包括过度摄入含糖饮料。财政和税收政策旨在使更健康食品的消费更容易。然而，各国采取和实施财政政策受到政治和经济挑战的限制。
目的
我们调查了与乌干达营养相关非传染性疾病预防相关的政策和政治背景，以确定在乌干达采用含糖饮料征税的障碍和促进因素。
方法
对与营养相关非传染性疾病和含糖饮料征税相关的政策进行了基于桌面的政策分析。进行了四次关键知情人咨询（n=4），以验证政策审查并深入了解政策和利益相关者的情况。分析框架是基于金登的议程设置和政策变化理论。
结果
营养相关非传染性疾病在乌干达被认为是一个新出现的问题。政府已经采取了综合方法来改善饮食，但实施进展缓慢。政策文件中对糖和含糖饮料消费作为营养相关非传染性疾病负担的一个促成因素的认识有限。现有的软饮料税低于世界卫生组织建议的 20%，并且不针对糖含量。软饮料行业在制定税收辩论方面具有影响力，财政部此前降低了含糖饮料的税收。在区域市场中保持竞争力是一项重要的商业战略。然而，卫生部和民间社会中的其他公共卫生行为者成功地（尽管只是略有）抵制了降低税收的行为，这些行为得到了行业的支持。
结论
乌干达已经有了一个成熟的含糖饮料征税倡导平台。必须进行有说服力的本地研究，明确将软饮料税与健康目标联系起来，以推进含糖饮料征税。
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