Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA.
School of Community Health Sciences, University of Nevada, Reno, Nevada, USA.
BMJ Glob Health. 2021 Aug;6(8). doi: 10.1136/bmjgh-2021-005662.
Mexico is the largest soft drink market in the world, with high rates of obesity and type 2 diabetes. Due to strains on the nation's productivity and healthcare spending, Mexican lawmakers implemented one of the world's first public health taxes on sugar-sweetened beverages (SSBs) in 2014. Because Mexico's tax was designed to reduce SSB consumption, it faced strong opposition from transnational food and beverage corporations. We analysed previously secret internal industry documents from major corporations in the University of California San Francisco's Food Industry Documents Archive that shed light on the industry response to the Mexican soda tax. We also reviewed all available studies of the Mexican soda tax's effectiveness, contrasting the results of industry-funded and non-industry-funded studies. We found that food and beverage industry trade organisations and front groups paid scientists to produce research suggesting that the tax failed to achieve health benefits while harming the economy. These results were disseminated before non-industry-funded studies could be finalized in peer review. Mexico still provided a real-world context for the first independent peer-reviewed studies documenting the effectiveness of soda taxation-studies that were ultimately promoted by the global health community. We conclude that the case of the Mexican soda tax shows that industry resistance can persist well after new policies have become law as vested interests seek to roll back legislation, and to stall or prevent policy diffusion. It also underscores the decisive role that conflict-of-interest-free, peer-reviewed research can play in implementing health policy innovations.
墨西哥是世界上最大的软饮料市场,肥胖症和 2 型糖尿病发病率很高。由于国民生产力和医疗保健支出的压力,墨西哥立法者于 2014 年对含糖饮料(SSB)征收了世界上第一个公共卫生税。由于墨西哥的税收旨在减少 SSB 的消费,因此遭到了跨国食品和饮料公司的强烈反对。我们分析了加州大学旧金山分校食品工业文件档案中主要公司的先前秘密的内部行业文件,这些文件揭示了行业对墨西哥苏打税的反应。我们还审查了所有关于墨西哥苏打税有效性的现有研究,对比了行业资助和非行业资助研究的结果。我们发现,食品和饮料行业贸易组织和前沿团体付钱给科学家,让他们进行研究,表明该税收未能实现健康效益,反而损害了经济。这些结果在非行业资助的研究在同行评审中完成之前就已经发布了。墨西哥仍然为全球健康界首次独立的同行评审研究提供了现实背景,这些研究记录了苏打税的有效性——这些研究最终得到了全球健康界的推动。我们的结论是,墨西哥苏打税的案例表明,即使新政策已经成为法律,行业的抵制也可能持续存在,因为既得利益集团试图推翻立法,并拖延或阻止政策扩散。它还强调了无利益冲突、同行评审研究在实施卫生政策创新方面可以发挥决定性作用。