Globally, diabetes is one of the 10 leading causes of death. According to the International Diabetic Federation (IDF), Nigeria has the highest occurrence of diabetes patients and people with impaired fasting glucose in Africa. In 2020, a meta-analysis reported that approximately 5.8% (about 6 million) of adult Nigerians are suffering from diabetes.
Like other middle and low-income countries, two-thirds of those with diabetes are undiagnosed. Diabetes is a lifelong disease in which the body cannot produce enough insulin. In some other cases, it cannot use the insulin it produces. In both instances, this leaves the affected person with an excess amount of sugar or glucose in the body, which is then ferried around in the blood, capable of causing damage to all the tissues and organs of the body.
Insulin is the key hormone involved in the storage and controlled release of glucose in the blood. Sugar is transported into the muscles and fat cells with the help of insulin for use as energy. Without insulin, glucose remains in the blood, which over time can cause serious health problems such as heart disease, vision loss and kidney disease.
The walk and rally was designed to draw tbe attention of the Federal Government to the menace of diabetes and the need to control it by implementing the taxation on sugar-sweetened beverages. Speaking at the rally which took place in Abuja, Felicia Anumah, Professor of Endocrinology & Diabetology, Director, Centre for Diabetes Studies, University of Abuja stressed the urgent need for taxation on sugar-sweetened beverages in Nigeria. According to her, obesity is a worldwide epidemic and a major risk factor for the growing burden of non-communicable diseases (NCDs) including diabetes, heart diseases and some cancers.
“In the past three decades, globalization and urbanization a shift in food culture and convergence in consumption habits. In this ‘nutrition transition,’ the consumption of foods high in fats, sugars, salt and sweeteners has increased throughout the developing world. This transition therefore is implicated in the rapid rise of obesity and diet-related chronic diseases, worldwide,” she said.
According to the World Health Organisation (WHO) report 2022, more than one billion people have obesity: 650million adults, 340 million adolescents and 39 million children less than 5 years. Four million people die every year as a result of obesity. Obesity is linked to 30-53% of new cases of diabetes. Obese people also have seventy one (71% ) higher risk of cancer than normal weight people.
Worldwide, about 537 million people had diabetes in 2021 and projected that 784 million people will have diabetes in 2045. In Africa, 24 million had diabetes in 2021, 55 million will have diabetes in 2045. As at 2018, about 5.77 pet cent of 200 million Nigerians have diabetes.
Sugar sweetened beverages
Anumah defined sugary drinks as all types of beverages containing free sugars and these include carbonated or non-carbonated soft drinks, fruit/ vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready-to-drink tea, ready-to-drink coffee, and flavoured milk drinks.
“These have been linked with obesity and some researchers have suggested that such beverages may be the single largest driver of the obesity epidemic. Over-consumption of sugar is a major contributor to obesity, diabetes and tooth decay. People who consume sugary drinks have a 26 per cent greater risk of developing type 2 diabetes than people who rarely consume such drinks,” she said.
Anumah stressed that Nigeria is the fourth highest consumer of Sugar Sweetened Beverage drinks. According to her, SSBs are a significant contributor to energy intake, they provide little or no nutritional value, but they are marketed very “aggressively and are easily accessible” to all age groups including children in homes, at the shops, restaurants, schools, cafeterias and in vending machines.
Anumah noted that evidence has shown that with respect to obesity, an effective starting point to reduce unhealthy food consumption will be through taxing of SSBs.
“There is therefore a need to combine programmes that target individual behaviour change with a fiscal policy such as excise tax on SSBs. “Escoba et al in 2013 looked at nine different studies from USA, Mexico, Brazil and France, the first global overview of the effect of SSB price on consumption and body weight. The result showed that higher prices are associated with a lower demand for SSBs and subsequently, decrease in the prevalence of overweight and obesity. According to WHO, a major action aimed at reducing consumption of sugars is taxation of sugary drinks.
Just as taxing tobacco helped to reduce tobacco use, taxing sugary drinks can help reduce consumption of sugars. Taxes on sugary drinks will reduce consumption and prevent obesity. Evidence shows that a tax on sugary drinks that raises prices by 20 per cent can lead to a reduction in consumption of around 20 per cent, thus preventing obesity and diabetes. Small changes in diet for many individuals can translate into large population health gains at relatively low cost.
Estimates suggest that, over 10 years, a tax on sugary drinks of one cent per ounce in the United States of America would result in more than USS 17 billion in healthcare cost saving. In the United States of America, soft drink revenue is approximately $70 billion per year, So a modest tax would generate billions of dollars. Also in China, a tax on sugary drinks of 1 yuan (USS 0.16) per litre in China would generate an estimated 73.6 billion yuan (USS 11.8 billion) in revenues.
Anumah suggested that Revenue generated by these taxes could be spent on efforts to improve health care systems, encourage healthier diets, increase physical activity, or to finance Health Promotion organizations that could advocate for healthy eating including further reductions in the consumption of SSBs. “in addition, in areas where people drink SSBs because they do not have access to clean water, ensuring universal access to clean, piped water should be a priority and build capacity for effective tax administration. “According to WHO (2017), SSB taxes can be a win-win-win strategy: a win for population health, a win for government revenue and a win for health equity,” she said
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