Generating Political Commitment for Regulatory Interventions Targeting Dietary Harms and Poor Nutrition: A Case Study on Sugar-Sweetened Beverage Taxation in Australia.

Tristan Dry,Phillip Baker

doi:10.34172/ijhpm.2021.174

Abstract

Sugar-sweetened beverage (SSB) taxes are an effective public health policy intervention for improving nutrition and public health. Although implemented in over 50 jurisdictions worldwide, this intervention remains vastly underutilised, and in Australia political commitment for such a tax is low. The aim of this study is to understand the politics of SSB taxation in Australia, what factors have constrained political commitment for a tax, and what might enable such commitment in future. We adopted a case study design, guided by a theoretical framework developed from the political economy of nutrition literature. Data were collected from 16 interviews with informants from multiple sectors, supported by media articles, journal articles, and grey literature. Data were coded and organized by thematic analysis, and synthesised into the final results. Nutrition actors have made significant progress in generating commitment for a SSB tax by producing relevant evidence, raising awareness, advocating for action, employing resonating frames, collaborating with civil society organisations, and forming coalitions increasing their overall cohesion. Nevertheless, political commitment for a SSB tax is low and was found to be impeded by the powerful influence of the food, beverage, and sugar industries, opposition from both major Australian political parties, ideological resistance to regulation, a low quality monitoring and surveillance system for food and nutrition, and limited public advocacy. The influence of nutrition actors was also impeded by weak connections to key policy-makers and missed collaborative opportunities with pro-SSB tax organisations. The identification of several impediments provides an explanation for why political commitment for a SSB tax is low in Australia and reveals several opportunities for how it might be generated in the future. Political commitment may come about through, for example, actions to limit the influence of industry in policy decision-making, and by strengthening the existing pro-SSB tax coalition.

Highlights

Unhealthy diets and poor nutrition are the most important preventable risk factors affecting health globally.[1]
We provide a number of recommendations for ways to counter these undermining industry influences by increasing the transparency of government-industry relationships and thereby contribute to generating political commitment for a sugar-sweetened beverage (SSB) tax, other nutrition issues, and issues more broadly that suffer from opaque government-industry relationships
Evidence of Political Commitment for a SSB Tax From at least 2016 onwards, significant publications and activity by pro-SSB tax individuals and organisations were immediately followed by political expressions of no support for a SSB tax.[32,47]

Summary

Introduction

Unhealthy diets and poor nutrition are the most important preventable risk factors affecting health globally.[1] there has been limited global adoption of effective policies for their prevention.[2,3] Leading international health authorities call on governments to adopt a comprehensive policy approach to improve nutrition, involving the adoption of multiple synergistic interventions, and a strong role for government and the use of law and regulation.[4,5,6] One nutrition policy action that has recently gained worldwide momentum are sugar-sweetened beverage (SSB) taxes, which have been introduced in over 50 jurisdictions.[7] SSBs are non-alcoholic beverages that contain caloric sweeteners such as carbonated soft drinks, energy drinks, sports drinks, milk-based drinks, juice drinks, and sweetened waters.[7] Consumption of SSBs show strong dose-response associations with several noncommunicable diseases including obesity,[8] type 2 diabetes,[9] and dental caries and erosion.[10] One important political objective of SSB taxes is to reduce this disease burden by increasing retail prices, reducing consumption, generating public awareness, and incentivising non-price industry responses (eg, product reformulation).[7,11] Whilst evaluations reveal SSB taxes to be effective in reducing purchases and intake of SSBs, SSB taxes are underutilized globally.[3,12]

Objectives

Methods

Results

Discussion

Conclusion