Elliott Lana M, Waqa Gade D, Ravuvu Amerita L A, Dalglish Sarah L, Topp Stephanie M
Centre for Justice, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia.
Public Health and Tropical Medicine, College of Medicine and Dentistry, James Cook University, Townsville, Australia.
Global Health. 2025 Aug 4;21(1):43. doi: 10.1186/s12992-025-01139-y.
In 2006, the Fiji Government introduced a 0.05FJ$ (0.03USD) per litre excise tax on domestically produced sugar-sweetened beverages (SSBs). Since then, the tax has been abandoned, reintroduced, or adjusted at least ten times, while tariffs on imported SSBs have also undergone reform. These rapid iterations of Fiji's SSB tax raise questions about which interests and motivations underpin the tax, what instigated the multiple adjustments, and implications for its impact on health versus economic and political considerations.
Using case study methodology, this study maps the history of SSB tax adjustments in Fiji and examines the political economy forces that have shaped, and continually re-shaped, this policy landscape. We used policy analysis and theories of power to analyse the intersection of ideas, interests and institutions, drawing on policy documents (n = 304), key informant interviews (n = 32) and direct observations of socio-political events (n = 7) as data sources.
Findings from this study indicate that the introduction of the SSB tax and subsequent adjustments were motivated more by economic, than health, imperatives. The relationship of mutual dependence between the Fiji Government and domestic SSB industry actors led policymakers to make multiple adjustments, seesawing in an attempt to balance the immediate need for revenue and long-term economic development through strengthened local industries. Early SSB tax lobbying from health actors alone had minimal impact. However, a subsequent alliance between government health actors and politically savvy and well-positioned civil society actors proved persuasive in both increasing the tax rate and ensuring a health and rights focus, arguably achieving a health and economic 'win-win'.
Global adoption of SSB taxes is increasing. Examining the protracted history of Fiji's SSB tax reveals the political ebbs and flows that alter how prospective population health 'wins' are weighed up against other policy imperatives. For health-interested actors, these insights point to important strategic in-roads around the explicit use of political economy analysis to complement technical policy insights. Building and maintaining coalitions that extend beyond government and into civil society also proved pivotal. Health system leadership that champions political thinking and cross-sectoral partnerships holds great promise for enhancing health actors' engagement with SSB tax-specific policy making and other multisectoral reform in Fiji and elsewhere.
2006年，斐济政府对国内生产的含糖饮料（SSB）征收每升0.05斐济元（0.03美元）的消费税。自那时起，该税至少被废除、重新引入或调整了十次，同时进口SSB的关税也进行了改革。斐济SSB税的这些快速更迭引发了一些问题，即该税背后的利益和动机是什么，是什么促使了多次调整，以及其对健康的影响与经济和政治考量之间的关系。
本研究采用案例研究方法，梳理斐济SSB税调整的历史，并考察塑造且不断重塑这一政策格局的政治经济力量。我们运用政策分析和权力理论，通过政策文件（n = 304）、关键信息人访谈（n = 32）以及对社会政治事件的直接观察（n = 7）作为数据源，来分析观念、利益和制度的交叉点。
本研究的结果表明，SSB税的引入及后续调整更多是出于经济而非健康方面的必要性。斐济政府与国内SSB行业参与者之间的相互依赖关系导致政策制定者进行了多次调整，摇摆不定，试图通过加强本地产业来平衡眼前的财政收入需求和长期经济发展。早期仅由健康领域参与者进行的SSB税游说影响甚微。然而，随后政府健康领域参与者与政治上精明且地位有利的民间社会参与者结成的联盟，在提高税率以及确保关注健康和权利方面颇具说服力，可以说是实现了健康与经济的“双赢”。
全球范围内对SSB税的采用正在增加。审视斐济SSB税的漫长历史，揭示了政治上的起伏变化，这些变化改变了如何权衡预期的人群健康“胜利”与其他政策需求。对于关注健康的参与者而言，这些见解指出了围绕明确运用政治经济分析以补充技术政策见解的重要战略切入点。建立并维持超越政府范围并延伸至民间社会的联盟也被证明至关重要。倡导政治思维和跨部门伙伴关系的卫生系统领导力，对于增强健康领域参与者参与斐济及其他地区特定于SSB税的政策制定和其他多部门改革具有巨大潜力。
