The Ghanaian Parliament on December 20, 2022 debated, voted, and approved a Bill to tax Sugar-Sweetened Beverages (SSBs) and other products – as per the Ghana Excise Duty Amendment Bill, 2022. Over the past three weeks, I have presented my take on this policy intervention – via this four-part article.
In this concluding section of the article, I share how our research and food activism work valorized healthy food policy (including SSB tax) in Ghana. Previously noted, the design, and implementation of an SSB tax intervention is beset with many challenges. Local economies, but also, the power asymmetries between “public” and “private” interests confound promulgation and implementation of these policies. Morocco had a very challenging journey. Morocco repealed its SSB tax passed in 2018 prior to implementation – in response to pressures from the agri-food industry. On a second attempt, the Moroccan parliament considered a more watered-down version of the tax ($0.08 per L VAT) on soft and non-carbonated drinks with ≥5 g sugar per 100 mL; $0.07 per L) on energy drinks; $0.02 per L on nectars. But for the concerted advocacy undertaken by civil society and academia, South Africa’s efforts could easily have been thwarted. As Du et al (2018) describe, the tax, which came into effect in April 2018, experienced multiple delays in its implementation since 2016 when it was originally proposed – due to fervent resistance from food companies. The A4H Coalition pays heed.
As Ghana prepares to implement the policy in 2023 – as per the Excise Duty Amendment Act, 2022, the question is no longer, can it be done? Or will it be done? It is, how effective will it be? Indeed, we have previously articulated that Ghana’s tax experience shows that it can be done. On local evidence, we have over the years generated contextual, fit-for-local purpose to support both the civil society advocacy efforts, as well as provide elucidation to the Ghanaian policymaker of the policy’s rationale and potential impacts. Generating the evidence, we engaged individuals, communities, and local and national stakeholders. The Dietary Transitions in Ghanaian Cities and the ‘MEALS4NCDs Project’ mapped the factors in the social and physical food environments that drive the consumption of energy-dense, nutrient-poor food and beverages. We assessed how unhealthy food and beverages are embedded in everyday life, and engaged national level stakeholders to identify relevant and potentially feasible public health nutrition policy options for Ghana. We used novel qualitative methods to identify factors shaping dietary behaviors. We showed how unhealthy food is advertised and sold through geographical mapping studies. Our television monitoring, outdoor food advertising assessment, and supermarket assessment. The evidence-informed the development of policy recommendations to improve the healthiness of the Ghanaian food environment. Recommendations included the development of policies that account for people’s lived environments and encompass regulatory, legislative, and fiscal measures. But are Ghanaians ready for such? Our community readiness assessments and a recent national poll of about 8,000 Ghanaians helped gauge public support and readiness to accept and implement these policies.
Toward identifying a realistic legal pathway to enact SSB tax in Ghana, the A4H Project commissioned a legal feasibility analysis. The analysis concluded that:
- There is currently no SSB Tax Law in Ghana, although an excise tax exists for multiple commodities, including SSB.
- The existing tax legislations bordering on SSB tax in Ghana, are not robust enough to combat NCDs in Ghana.
- The existing laws in Ghana make it legally feasible to adopt an SSB tax in Ghana with the aim of combatting NCDs.
- The political will and desire to introduce SSB Tax Law is evident; the government of Ghana (led by the Ministry of Health) has officially initiated the process to develop a bundle of food-based policies (including front-of-pack labelling, marketing regulations, and food-related fiscal policies).
The A4H Project together with the HD4HL Project commissioned several systematic reviews, political economy analysis, corporate political activity assessment, policy coherence analysis, modelling studies, and conducted a nationwide poll to provide policy makers and other stakeholders the needed local evidence. Data from a poll involving a sample of 7,794 residents of Ghana reveal that a significant number (84.3%) were concerned about obesity and NCDs (in adults and children). Two out of three respondents (67.7%) support any effort by the government to impose tax on SSBs or any other food deemed to be bad for health. When respondents were told the money from the taxes could be used to support public health interventions, support for the tax increased to nearly 80% (77.4%).
At the time of writing of this article, the Ghanaian government (the Executive and Legislature) had demonstrated resolve to roll out the tax policy. The Parliament of the Republic of Ghana has just passed the Excise Duty Amendment Bill, 2022. The Excise Duty Act, 2014 (ACT 878) is amended. The amendments include imposition of excise duty (20 per centum of the ex-factory price) on sweetened beverages including fruit juices (e.g. grape and vegetable juices unfermented and containing spirits whether or not containing added sugar of other sweetening matter). Other products covered by the Act are cigarette and tobacco products, wines, malt drinks and spirits, plastics and plastic products etc.
Having come thus far, the Ghanaian government deserves commendation. We encourage and commend the First Gentleman of the land as he gives a Presidential Assent to the Bill. Ghanaians await to be impacted positively by the policy. Ghana should not relent on her bid to promote, protect and guarantee the health of her citizens and residents. The A4H Coalition and other civil society organizations should not, and will not relent on their bid to advocate for the health of Ghana. They will monitor, with keen interest, the implementation of the policy and will demand accountability as needed. While expressing our appreciation to the Government of Ghana for embracing the food-related fiscal policy intervention, a number of gaps have been identified in the policy and opportunities exist to address the gaps and strengthen the policy proposal (see Joint Position Statement by the A4H & HD4HL Coalition).
The writer, “Amos Laar, PhD” is a Professor of Public Health Nutrition at the School of Public Health, University of Ghana, Legon and Principal Investigator (PI) of the A4H Project, the HD4HL Project and the ‘MEALS4NCDs Project’ and Co-PI of the Dietary Transitions in Ghanaian Cities. He is a Fellow of the Ghana Academy of Arts and Sciences.
