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India's "welcome" proposal to impose sin tax on aerated drinks is part of to fight growing sugar consumption

By Amit Srivastava*
A proposal to tax sugar sweetened beverages like tobacco in India has been welcomed by public health advocates. The proposal to increase sin taxes on aerated drinks is part of the recommendations made by India’s Chief Economic Advisor Arvind Subramanian on the upcoming Goods and Services Tax (GST) bill in the parliament of India.
Taxation to reduce consumption of tobacco has been successful when used alongside measures such as public education and restrictions on advertising and marketing to children, and stronger labeling laws.
“All of the evidence we have to date suggests that taxing sugary drinks would be far more powerful and effective for protecting public health than simple education measures. Such taxes also generate funds to further support public health and combat the rising rates of chronic diseases in India,” said Dr Sanjay Basu, assistant professor of Medicine at Stanford University, about the proposed tax.
Countries with high consumption of highly processed foods – high in fats, sugar and salt, or junk food – have seen skyrocketing obesity rates, and associated illnesses such as diabetes, hypertension, and cardiovascular diseases.
The consumption of added sugars in India is still relatively low compared to countries such as the US, UK and Mexico. In the US, where 69% of adults are overweight or obese, 36% of the added sugars consumed come from liquid drinks such as carbonated beverages, juices and energy drinks. As a result, the US is witnessing a strong growing movement to regulate sugar sweetened beverages.
“The proposal to tax sugar sweetened beverages similar to tobacco is a positive and proactive step. Increased sugar intake has been proven to be a bane for public health in countries where it is widely consumed. In addition, the government of India must also regulate marketing and promotion of such products especially targeting children,” said Dr Arun Gupta, a senior pediatrician and regional coordinator of International Baby Food Action Network (IBFAN) Asia.
Public health advocates are also proposing that the sin tax be applied to the whole range of sugar sweetened beverages, including soft drinks, fruit juices and energy drinks. Added sugars in juices are often similar to those found in soft drinks.
Just one can of a 12 ounce (355 ml) Coca-Cola contains 39 grams of sugar, and the World Health Organization (WHO) hasrecommended consuming added sugars no more than 10% of the daily calorie intake, or roughly 12 teaspoons (50 grams) of added sugar per day.
For optimal health benefits, the WHO recommends 6 teaspoons of added sugar (25 grams) per day.
“As the WHO, the UK Ministry of Health, Public Health Foundation of India and the US dietary guidelines have all noted, added sugar in beverages and food is a major cause of increased weight gain, waist circumference and risk of diabetes,” noted distinguished Professor of Nutrition and a PhD economist, Barry Popkin of the University of North Carolina at Chapel Hill.
 “In Mexico, in an article forthcoming in the British Medical Journal, we have shown that tax on sugary beverages reduces added sugar intake significantly commensurate with the tax level. An unpublished study shows that the junk food tax on foods high in sugar is equally effective in Mexico", he said.
"India, with the world’s highest number of diabetics, needs to find ways to cut sugar intake as it is a major cause of diabetes in India. India’s sugar consumption is rapidly increasing and this tax is critical to slow down this very rapid growth of diabetes”, he added.
Leading British cardiologist and founding member of campaign group Action on Sugar Dr Aseem Malhotra said, “A diet high in sugar and refined carbohydrates is driving a massive increase in the prevalence of type 2 diabetes amongst the Indian population. Two out of three persons with type 2 diabetes die from cardiovascular disease, and more than half of these deaths occur prematurely." 
He added, "Unless urgent preventative action is taken deaths and disability from cardiovascular disease is estimated to cost $2.2 trillion dollars to the Indian economy by 2030. Sugary drinks are linked to tens of thousands of deaths worldwide and any government measure to reduce population consumption such as a tax must be welcomed with open arms.”
“The proposed tax would undoubtedly impact population health. Many Indians have disproportionately high rates of type 2 diabetes and non-alcoholic fatty liver disease. There is also some evidence that many Indians have genetic susceptibilities to develop fatty liver on diets excess in added sugars. This is a landmark proposal,” said Dr Laura Schmidt, Professor of Health Policy in the School of Medicine at the University of California at San Francisco.
The proposal to increase sin taxes on sugar sweetened beverages are not new to India, and are part of a rapidly growing global movement to curb the growing consumption of added, and often hidden, sugars in our food.
Last year, in June 2014, the Indian government increased the excise tax on aerated beverages containing added sugars by 5%, citing health considerations as the reason. Earlier this year, the Delhi High court ruled that junk food – high in fat, sugar and salt – must be restricted in schools and a 50 meter radius.
In 2014, Dr Sanjay Basu from Stanford University and colleagues released findings that a 20% tax on sugar sweetened beverages in India would “avert 11.2 million cases of overweight/obesity and 400,000 cases of type 2 diabetes between 2014 and 2023.”
In a study released last week, a leading public health scientist, Dr Barry Popkin and colleagues warn that that in the absence of intervention, the world’s diet will move towards the US model, where “74% of products in the US food supply contain caloric or low-calorie sweeteners, or both.”
“Undoubtedly, the industry will say that it is capable of regulating itself,” said Dr. Raj Patel, Research Professor at the Lyndon B Johnson School of Public Affairs at the University of Texas at Austin. “But recent research suggests that self-regulation stalls meaningful change. The conflict of interest between corporations and public health when it comes to sugar-sweetened beverages is vast." He added, "It is encouraging that India’s policy is tilting more towards public health – and I look forward to hearing how taxes are complemented with other vital policies, ranging from advertising restrictions to the public availability of drinking water, to move India away from a path that has caused so much disease and suffering here in the United States.”
Companies like Coca-Cola and PepsiCo try to mask the negative health impacts of their products through massive advertising and marketing efforts which misleads the public. Taxing these products is the right way forward, and restrictions should also be placed on celebrity endorsements of these unhealthy products, including Bollywood.
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*With India Resource Centre. Website: www.IndiaResource.org

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