Fiscal policies for diet and the prevention of noncommunicable diseases

Fiscal policies for diet and the prevention of noncommunicable diseases

The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020, endorsed by the World Health Organization, provides a roadmap and a menu of policy options for Member States and other stakeholders to take coordinated and coherent action to reduce mortality from noncommunicable diseases (NCDs) and exposure to risk factors.

To address the increasing number of requests from Member States for guidance on how to design fiscal policies on diet, WHO convened a technical meeting of global experts in fiscal policies on 5–6 May 2015 in Geneva. The main objectives of the meeting were to review evidence and existing guidance, discuss country case studies and provide considerations with regards to the scope, design and implementation of effective fiscal policies on diet. The meeting consisted of presentations and discussions during plenary and in working groups on the evidence, country experiences and technical aspects of policy design and implementation.

It was concluded that there is reasonable and increasing evidence that appropriately designed taxes on sugar-sweetened beverages would result in proportional reductions in consumption, especially if aimed at raising the retail price by 20% or more. There is similar strong evidence that subsidies for fresh fruits and vegetables that reduce prices by 10–30% are effective in increasing fruit and vegetable consumption. Greater effects on the net energy intake and weight may be accomplished by combining subsidies on fruit and vegetables and taxation of target foods and beverages. Vulnerable populations, including low-income consumers, are most price-responsive and, in terms of health, benefit most from changes in the relative prices of foods and beverages.

Consistent with the evidence on tobacco taxes, specific excise taxes – as opposed to sales or other taxes – based on a percentage of retail price, are likely to be most effective. In countries with strong tax administration, taxes that are calculated based on nutrient content can have greater impact. A proper situation analysis, good political advocacy, appropriate objective setting and evaluation, should be part of the multidisciplinary development and implementation of such policies.

There are evidence gaps that could be addressed, with more countries developing and implementing such fiscal policies. Lack of standards or criteria for determining exactly what to tax is a challenge experienced by countries and the development of a nutrient profile model for designing and implementing fiscal policies was recommended. In addition, there was a call for a manual on developing and implementing fiscal policies for diet.

It is recommended that:

  • the report of the meeting be disseminated for use by countries as information to assist in the development and implementation of fiscal policies as appropriate
  • the current evidence gap – including the impact of SSB tax on improving weight and health outcomes, and ultimately the prevention of NCDs – be addressed through research and evaluation in countries
  • a nutrient-profiling tool be developed for use by countries for the implementation of fiscal policies
  • an implementation manual be developed to provide further guidance to countries on the development and implementation of fiscal policies for diet
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