Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
SAMRC/Centre for Health Economics and Decision Science - Priority Cost Effective Lessons for Systems Strengthening (PRICELESS SA), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Glob Health Action. 2021 Jan 1;14(1):1909267. doi: 10.1080/16549716.2021.1909267.
: Non-communicable diseases are on the rise across sub-Saharan Africa. The region has become a targeted growth market for sugar-sweetened beverages, which are associated with weight gain, cardiovascular diseases and diabetes.: To identify politico-economic factors relevant to nutrition-related fiscal policies, and to draw lessons regarding strategies to strengthen sugar-sweetened beverages taxation in the region and globally.: We collected documentary data on policy content, stakeholders and corporate political activity from seven countries in east and southern Africa augmented by qualitative interviews in Botswana, Namibia, Kenya and Zambia, and stakeholder consultations in Rwanda, Tanzania and Uganda. Data were analysed using a political economy framework, focusing on ideas, institutions, interests and power, and a 'bricolage' approach was employed to identify strategies for future action.: Non-communicable diseases were recognised as a priority in all countries. Kenya, Zambia, Rwanda, Tanzania and Uganda had taxes on non-alcoholic beverages, which varied in rate and tax base, but appeared to be motivated by revenue rather than health concerns. Botswana and Namibia indicated intention to adopt sugar-sweetened beverage taxes. Health-oriented sugar-sweetened beverage taxation faced challenges from entrenched economic policy paradigms for industry-led economic growth and was actively opposed by sugar-sweetened beverage-related industries. Strategies identified to support stronger sugar-sweetened beverage taxation included shifting the economic discourse to strengthen health considerations, developing positive public opinion, forging links with the agriculture sector for shared benefit, and leadership by a central government agency.: There are opportunities for more strategic public health engagement with the economic sector to foster strong nutrition-related fiscal policy for non-communicable disease prevention in the region.
: 撒哈拉以南非洲的非传染性疾病正在不断增加。该地区已成为含糖饮料的目标增长市场，而含糖饮料会导致体重增加、心血管疾病和糖尿病。: 确定与营养相关的财政政策相关的政治经济因素，并吸取有关加强该地区和全球含糖饮料征税战略的经验教训。: 我们从东非和南部非洲的七个国家收集了政策内容、利益相关者和企业政治活动的文件数据，并在博茨瓦纳、纳米比亚、肯尼亚和赞比亚进行了定性访谈，在卢旺达、坦桑尼亚和乌干达进行了利益相关者磋商，对这些数据进行了分析。分析采用了政治经济学框架，重点关注思想、制度、利益和权力，并采用“拼凑”方法来确定未来行动的战略。: 所有国家都认识到非传染性疾病是一个优先事项。肯尼亚、赞比亚、卢旺达、坦桑尼亚和乌干达对非酒精饮料征收了税，税率和税基各不相同，但似乎是出于收入考虑，而不是健康考虑。博茨瓦纳和纳米比亚表示有意征收含糖饮料税。以健康为导向的含糖饮料征税面临着行业主导的经济增长的既定经济政策范式的挑战，并且遭到了含糖饮料相关行业的积极反对。为支持更有力的含糖饮料征税而确定的战略包括：将经济讨论转向加强健康考虑因素、培养积极的公众舆论、与农业部门建立联系以实现共同利益、以及由中央政府机构领导。: 该地区有机会更战略性地让公共卫生部门与经济部门接触，以促进制定强有力的营养相关财政政策，预防非传染性疾病。
