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22 January 2026

Assessing the Efficiency and Sustainability of Sugar-Sweetened Beverage Tax in the African Context: A Systematic Review of Evidence

and
Department of Management Accounting & Finance, Faculty of Economic and Financial Sciences, Walter Sisulu University (WSU), Mthatha 4099, South Africa
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Sustainability2026, 18(2), 1128;https://doi.org/10.3390/su18021128 
(registering DOI)

Abstract

Introduction: The World Health Organisation (WHO) and health advocates have called on governments across the globe to introduce a sugar tax to reduce the intake of sugar-sweetened beverages (SSBs), to prevent obesity and type 2 diabetes. Despite efforts to introduce a sugar tax, there are limited data on the efficiency and sustainability of the sugar tax in the African continent. Methods: We conducted a systematic literature review to identify studies from Africa and selected countries across the world from 2014 to 2024, to determine the efficiency and sustainability of the sugar tax regarding its impact on beverage intake in the African context. Studies were selected according to their report of the impact of sugar tax on consumption, the decline in beverage products high in sugar content, the reformulation of sugary beverages, and the public acceptability of the tax. Conclusions: There is evidence that the introduction of a sugar tax has resulted in mixed reactions but has generated increased revenue in some African countries: for example, South Africa. The majority of countries in Africa have not introduced the tax. The failure or absence of the tax in Africa has commonalities with some countries elsewhere across the globe. In some developed economies, the tax was introduced but withdrawn one year after its implementation. In addition, limited studies have reported on the sustainability of the tax in Africa.

1. Introduction

Sugary products are a significant component of the global food market [1,2,3,4], and their exports account for over one quarter of global production [5]. The consumption of sugar-sweetened beverages (SSBs) is widely believed to be a major contributing factor to overweight, type 2 diabetes, and obesity [6,7]. Obesity and diabetes are major global health concerns, with significant mortality rates between 13% and 29% [8]. An SSB is any beverage that contains added sugar or other caloric sweeteners: for example, high-fructose corn syrup and fruit juice concentrates [9]. However, much controversy exists about the high protection given to the sugar market by the USA, Japan, and the European Union (EU) [10].
Sugar taxes have arisen as a regulatory strategy to reduce the consumption of SSBs [11,12,13]. The main objective of a sugar tax is to increase the price of the SSBs and in turn reduce consumers’ intake, obesity, and diabetes, and thus improve consumers’ health [14,15,16].
The introduction of the sugar tax has garnered extensive research on its impact on SSB intake and thus the economics and health of nations across the world [17,18], but few studies exist on the efficiency and sustainability of the tax on the African continent. Studies have been conducted by Lucas and Horton (2019) and Osman et al. (2021) [19,20] on great food transformation and what works best for sustainable consumption; both indicated that a shift to the intake of healthier food and beverage alternatives is critical in attaining the UN Sustainable Development agenda. Surprisingly, in Africa, there is less empirical literature examining the efficiency and sustainability of the tax in reducing the consumption of SSBs [21].
Even though a sugar tax has been regarded as efficient in some developed countries, some studies have questioned its efficiency as a tool to address obesity and diabetes in Africa, as the burden of this tax falls mainly on the low-income group [22]. In Denmark and some jurisdictions in the USA, the tax was abolished one year after its introduction [22,23,24]. In other countries, the sugar industry aggressively lobbied against the tax, which resulted in a reduction in the tax rate [25,26,27]. Based on the resistance to the tax and its abolition in these countries and jurisdictions, there is a need to consider a range of variables influencing the adoption of an efficient sugar tax, especially on the African continent.
Originality/value—Previous studies have mainly focused on the impact of a sugar tax on the intake of SSBs and its social and economic impacts. This study evaluates the pricing mechanism, public awareness, policy design, and acceptability of the sugar tax on the African continent. To evaluate this inquiry, we developed the following hypothesis: H1 ‘Sugar tax is efficient in reducing the intake of SSBs in the African context.’

2. Literature Review

2.1. Assessing the Efficiency of a Sugar Tax

As of January 2012, 33 states in the United States of America (USA) had adopted a sales tax on SSBs at an average rate of 5.2% [28]. Experts suggest that a price increase in this range may not significantly influence manufacturers and consumers’ behaviour [29,30,31,32]. As in other economies, the American Beverage Association (ABA) opposed the sugar tax due to job losses within the SSB sector [33,34]. Meanwhile, in Denmark, a sugar tax was introduced and abandoned one year later [35]. Following the resistance to and abandonment of the Danish sugar tax, similar legislation prohibiting levying taxes on foods and SSBs was passed in the states of Michigan [36], Arizona [37], and California [38]. Although California’s legislation allowed sugar taxes in Berkeley, San Francisco, Oakland, and Albany [39], it prohibited any further increases in the tax rate [40].
In Brazil, sugar is produced not only for human consumption but also to manufacture ethanol, a renewable source of energy [41]; the share of soft drinks in household diets increased by 525.0% between 1974 and 2003 [42]. The intake of SSBs in Brazil and some low-income countries has been linked to undernutrition [43,44]. The government of Brazil passed an excise tax on alcoholic, energy, and sports drinks and fruit juices but excluded regular and diet soft drinks [45]. Studies revealed that a 1% increase in the prices of SSBs led to a decrease in intake of 1.03% for low-income, and 0.63% for high-income, households [46,47].
In the United Kingdom (UK), Adam et al. (2013) [48] indicated that a 10% increase in the price of SSBs resulted in a 9% decline in consumption. However, Cawley et al. (2020) [49] were of the view that the extent of a reduction in intake is determined by the extent to which manufacturers and retailers shift the burden of the sugar tax to consumers. Meanwhile, an evaluation of individuals and households’ consumption of SSBs found that more than 75% of respondents described their intake as ‘out of habit’ [50]. According to Kottasova (2017) [51], even though some producers have reduced the sugar content in their beverages by more than 30% to avoid the sugar tax, some consumers prefer the high-sugar-content beverages. The studies of Grierson (2017) and Rogers et al. (2023) [52,53] revealed that sweet taste, low prices, and availability are some of the factors influencing their intake.
In South Africa, the introduction of a sugar tax was widely viewed as regressive in nature, as it affects the majority of the low-income groups [54,55]. The Beverages Association in South Africa (BEVSA) opted for self-regulation rather than a sugar tax [56]. Despite resistance, the South African government implemented the flat levy option. This option warrants all sugary beverages to be levied at the same rate on a per-litre basis, regardless of the sugar content [57]. From an administrative perspective, this is simpler and less costly to administer [58]. This approach allows for a minimum sugar content to be tax-free, and only added sugar contents above this threshold are to be taxed [59]. Policymakers in the UK and South Africa implemented this approach as the preferred option [60,61]. With this strategy, there is a tax-free allowance of 5 g of sugar per 100 mL. In South Africa, the tax has increased from 2.1 cents in 2018 to 2.21 cents per gram of sugar content over 4 g per 100 mL in 2019 [62].
Despite the implementation of a form of sugar tax by some African countries, certain governments have subsidised SSBs products to ensure their availability and affordability to the low-income groups [63]. Some other governments, such as Egypt, have opted to educate their population and create awareness on the impact of the over-consumption of these beverages instead of applying a sugar tax [64]. According to Abbas et al. (2024) [65], a further challenge to the implementation of a sugar tax in the North African region was the public protests and resistance because of increased prices of food, including SSBs.

2.2. Evaluation of a Sustainable Sugar Tax in Africa

In Africa, research indicates that an estimated 41% of deaths in people under the age of 60 years are related to overweight- and obesity-associated illnesses, as compared to 18% in high-income countries [66]. The International Diabetes Federation (IDF) projected there were 2.28 million people living with diabetes in South Africa alone in the year 2015 [67]. Ghana, Egypt, and many other African countries have witnessed a significant rise in the importation and consumption of sugary products since 2001 [68,69]. In 2022, the government of Ghana published a policy paper containing restrictions on the advertisement of processed food and beverages, and an attempt at policy formulation was resisted by the beverage industry [70,71].
Interestingly, the national awareness campaign has led to public awareness that the development and implementation of healthy food and beverage policies will cause especially unhealthy beverages to be unaffordable and unavailable and lead to a significant reduction in their intake [72]. Currently, the government of Ghana is imposing an excise duty of 20% on sweetened beverages, a front-of-pack nutrition labelling policy, and restrictions on the direct marketing of unhealthy beverages to children [73]. Despite studies indicating that fiscal policy measures can reduce the intake of excess sugar in the younger age group [74,75], others have warned that its effective implementation in Africa is challenging due to the protection of the interests of the private sector and low-income groups [76,77].
In Nigeria and Namibia, there is growing concern about the increased intake of SSBs, especially by those in high-income groups [78]. Health experts presume that the lack of policy intervention to address the over-consumption could lead to increased healthcare costs to the governments [79,80]. The sale of SSBs in Namibia was expected to rise from 9.6% to 11.5% between 2019 and 2022 [81]. According to Wang et al. (2014) [82], an effective sugar tax policy formulation may reduce government expenditure on healthcare and contribute to a significant reduction in the intake of the SSBs. In Egypt, research found that the intake of yoghurt, milk products, and sugary beverages has increased over the years [83,84]. A multidisciplinary approach involving policymakers, social partnerships, and academics was implemented to counter the price promotion strategy by SSB associations and increase consumer awareness on beverage intake [85,86,87,88].
The study by Bridge et al. (2020) [89] suggested that an incremental price approach to a sugar tax will force manufacturers to reformulate their products and consequently lead to a reduction in sugar intake in the long term. On the other hand, Lehner et al. (2016), Osman et al. (2021), and Hansen and Jespersen (2013) [20,90,91] are of the view that a public policy measure to reduce the consumption of a particular product is an infringement on consumers’ choices and often does not lead to sufficient behavioural change. Similar to the public opinion of a fat/sugar tax in Denmark, the majority of low-income groups in Africa view a sugar tax as unfair and mainly for revenue generation rather than for health promotion [92]. Despite the views of the majority of low-income groups regarding the impact of a sugar tax, White and Lockyer (2020) and Xanthos and Walker (2017) [93,94] found that the taxation of certain products can positively influence consumer behaviour; for example, the GBP 0.05 Plastic Bag Tax has led to a reduction in the use of plastic bags by about 83% since its introduction in 2015.

3. Study Methods

3.1. Study Design

We undertook searches in the following bibliographic electronic databases: PLoS ONE, BMC Medicine, Social Science and Medicine, Health Policy Management, Endocrinology, Metabolism and Diabetes, Public Health Nutrition, Business and Social Science, and Google Scholar. In this study, we carried out a systematic literature review, and analyses were conducted using estimates from studies from Africa and selected countries across the world published between 2014 and 2024. We selected studies that reported on one or more of the following variables: sustainable sugar tax; declines in sales of beverage products; the impact of prices, reformulation, awareness, fairness, and public acceptability of a sugar tax. In addition, we were interested in data relating to a regressive tax, where the poor spend a higher proportion of their household income on the sugar tax.
To realise the objective of this study, we developed the following themes: price movement and its impact on SSB intake, the reformulation of beverage products, public awareness and behavioural change, the economic impact of a sugar tax, sugar tax efficiency reports, fairness, public acceptability, and the sugar tax policy design. In developing these themes, we considered the fundamental importance of the need to address the social determinants of health, particularly in low-income countries [95,96]. These social determinants of health seek to promote research, develop policies that are inclusive, and take account of the needs of the entire population with specific attention to vulnerable groups (Table 1).
Table 1. Eligibility criteria for inclusion in the study.

3.2. Data Extraction

A total of 30 articles were selected and analysed. From this total, there were 24 qualitative studies and 6 quantitative studies. In addition, 14 of the studies involved Africa, and 16 of the studies were conducted across the rest of the world. The review and analysis of the selected articles were classified into five regions, as follows: Australia and New Zealand, Europe, Asia, the USA, and Africa. The purpose of the classification of the articles into regions was to prevent the researchers from selecting more studies from only some world regions.

4. Review and Analysis of the Selected Studies

4.1. Price Movement and Its Impact on SSB Intake

A total of three articles were reviewed and analysed in the Australia and New Zealand region. Even though the Australian government has not adopted a sugar tax, Carter et al. (2019) [98] indicated that sugar tax implementation in countries such as Denmark, Hungary, the UK, the USA, and Mexico have showed promising early results. Their results, along with those of Colchero et al. (2017) [99], suggest that a sugar tax is effective in reducing the intake of SSBs, especially among low-income groups. Their studies confirm that the low-income group is sensitive to increased prices and show the largest reduction in the purchase and intake of SSBs.
In the European region, we reviewed five articles. The review of the study by Amoutzopoulos et al. (2020) [100] found that the intake of free sugars ranged between 9% and 13%. They indicated that this intake was higher in children and teenagers compared with adults. The availability and low prices of the SSBs were identified as factors influencing their intake. According to Csákvári et al. (2023) [101], in Hungary, the current sugar tax has not significantly decreased the production, purchase, or intake of SSBs but rather generated increased revenue for the government. Meanwhile, in Spain, the intake of taxed beverages fell by 39%, while that of untaxed beverages remained stable [102]. According to Royo-Bordonada et al. (2019) [102], the participants of their study indicated that the increase in prices and the creation of awareness are the main reasons for their reduction in intake.
In the Asia region, three articles were reviewed. The study by Zhuang et al. (2021) [103] in China indicated that increased pocket money and the availability of SSBs are some of the factors that influence children’s consumption. Meanwhile, the review of the study by Bipasha et al. (2017) [104] in Bangladesh found that sweet taste, low prices, accessibility, and availability have a negative influence on the efficacy of sugar tax. Five studies were reviewed in the region of Canada, the USA, and Mexico. The evaluation of the study by Kao et al. (2020) [105] revealed that a 20% sugar tax was estimated to reduce intake by about 15% annually. The pass-over tax burden was estimated at between USD 39.00 and USD 44.30 per person, with the low- and middle-income households bearing the highest burden of the tax. Nevertheless, the study predicted a significant health benefit, especially for the low- and middle-income groups in Canada.
The analysis of the study by Roache and Gostin (2017) [106] in the USA revealed that price increases can significantly reduce the consumption of SSBs and at the same time generate revenue to support government health programmes. They further recommended that the reformulation of SSBs should be considered a global strategy, especially in low-income countries. Similarly, Allcott et al. (2019) [107] supported the use of a sugar tax to reduce intake but argued that the tax is not a complete cure for the obesity epidemic. In addition, the review of the study of Colchero et al. (2016) [108] in Mexico indicated that the sale of SSBs decreased by 7.3%, and there was an increase of 5.2% in sales of plain water between 2014 and 2015. Research has indicated that the evaluation of the sustainable impact and efficiency of a sugar tax should be based on a medium- to long-term perspective [108].
In the African region, a total of fourteen studies were analysed. The study by Fernandes et al. (2020) [109] in South Africa found that, besides the low-price influence, other factors—for example, to stay awake (31%), to be more alert (14%), and for concentration purposes (15%), —also contributed to the increased intake of SSBs. In Nigeria, Ukegbu et al. (2017) [110] found that, despite the increase in the prices of SSBs, the intake by the young population was not affected. Their study proposed the inclusion of nutrition education programmes to curb the rising trend in overweight and obesity, especially among the young population. In addition to factors that influence the intake of SSBs, Gissing et al. (2017) [111] uncovered that in Morocco, sweet taste and strong cultural and religious beliefs were identified as possible determinants of over-consumption of SSBs.
The assessment by Cawley et al. (2021) [112] in Mauritius found that the increased price of SSBs had a positive influence on youth consumption. Our assessment on the impact and purpose of sugar tax implementation in Kenya, Zambia, Rwanda, Tanzania, and Uganda found that these countries had some form of taxes on non-alcoholic beverages [73]. Interestingly, the taxes varied in rates and tax base and appeared to be motivated by revenue generation rather than health promotion.

4.2. Manufacturers’ Reformulation of Beverage Products

The analysis of the study by Allen and Allen (2020) [113] revealed that some manufacturers have responded positively by reformulating their products to reduce the sugar content. On the other hand, Vandevijvere et al. (2017) [114] found that the excessive marketing of SSBs to the young age group has a negative influence on the efficacy of a sugar tax. Meanwhile, Bandy et al. (2020) [115] found that in the UK, the sale of SSBs between 2015 and 2018 declined by about 30%, while that of low- and zero-sugar (<5 g/100 mL) (reformulated) beverages rose by about 40%.
The assessment by Essman et al. (2021) [116] on the impact of a sugar tax found that in South Africa, the tax has generated increased revenue for the government. The study found that due to increased prices, the tax has led to a positive change in some consumers and manufacturers’ behaviour. Some consumers have switched to low- or zero-sugar beverages, and some manufacturers have reduced the sugar content in certain beverages [117].

4.3. Lack of Public Awareness and Acceptability of a Sugar Tax

According to Subaiea et al. (2019) [118], the participants of their study associated their intake of SSBs with advertising on media (46.7%), the stimulating and invigorating effects (37.5%), fatigue relief (64.6%), and long driving trips (75.7%). They further indicated that the lack of knowledge, awareness, and acceptability of the tax contributed to their over-consumption of the beverages. In Canada, a study by Acton et al. (2017) [119] found that little is known about consumers’ level of knowledge and awareness of the added sugars in food and beverage products.
Meanwhile, Coetzee et al. (2019) [120] found that increasing the level of awareness of the risk of over-consumption of SSBs, limiting the availability and access to SSBs, and the use of a sugar tax may assist in contributing to a significant decline in sugar intake. Meanwhile, Fungai (2017) [121] pointed out that low prices, lack of awareness, and the brand were found to be factors that influence the intake of SSBs in Zimbabwe. In addition, a study by Yamoah et al. (2021) [122] revealed that the marketing strategy of unhealthy beverages negatively affects the efficacy of a sugar tax. They are of the view that increased consumer awareness and a reduction in the container size of the SSBs could reduce the amount of sugar intake.

4.4. Report on the Economic Impact and Fairness of a Sugar Tax

The WHO (2017) [123] indicates that consumption taxes are often regressive in nature and should not be regarded as a fair tool for generating revenue. Therefore, in order for a sugar tax to be sustainable, the health benefits obtained from the tax must outweigh its burden, especially for the low-income group.
In Israel, a sugar tax came into effect in January 2022, and Kamin-Friedman et al. (2023) [124] observed a 10% decrease in purchases of high-sugar-content beverages. Despite evidence that the sugar tax could reduce intake, the government of Israel repealed the tax in January 2023 on the basis that it was an economic burden to certain households. Following the repeal of the tax, Troen et al. (2023) [125] indicated that policymakers must demonstrate that the implementation of a sugar tax is not an economic sanction to manufacturers or an attack on specific households but a means to promote public health in Israel.
Meanwhile, the analysis of the study by Hangoma et al. (2020) [126] in Zambia revealed a sugar tax rate of 15% and a pass-on rate to consumers of between 80% and 100%. It is anticipated that the obesity prevalence reduced by 0.49% points (95%CI 0.41 to 0.57) as a result of the burden of the tax on the consumers [126]. The study by Mmbaya et al. (2020) [127] indicated that restriction of access in school environments and increased public awareness can reduce obesity in the long term. On the other hand, Sassi et al. (2018) [128] and Van Wyk and Dlamini (2018) [129] found that even though sugar tax generates revenue for the government, a 1% increase in prices imposes an unfair financial burden and reduces household welfare by about 21.3%, especially for low-income households in Africa.

5. Discussion

The governments of Germany, China, Australia, New Zealand, and many other countries, including many in Africa, have not implemented a sugar tax. Instead, some countries have focused on beverage reformulation, product labelling, and restricting the marketing of beverages as a strategy to combat their excessive intake. Our review found that reducing container size and the universal reformulation of beverages by manufacturers may sustainably reduce their intake, especially on the African continent.
Furthermore, some studies recommend health education programmes, dietary guidelines, and public awareness campaigns to reduce the intake of excess sugar. Studies in Australia and some jurisdictions in the USA reported that 42% of the public supported a sugar tax as an effective strategy to reduce the intake of SSBs. A further 66% would approve a sugar tax strategy if the revenue generated were to be used to promote health programmes.
Meanwhile, in New Zealand and some African countries, the evidence for the effectiveness of a sugar tax is mixed. Our evaluation found that even though the prices of SSBs have increased, pure fruit juices are more expensive for the majority of low-income households in Africa. Beverage associations have contended that the sugar tax alone is inefficient in reducing the intake of SSBs, and it will instead lead to unemployment in the SSB sector, especially in Africa. Saxena et al. (2019) [130] indicated that the implementation of the tax will instead lead to an unfair financial burden and reduce households’ welfare for low-income groups. The Beverage Association in South Africa (BEVSA) instead opted for nutrition education, increased physical activity, and a proposed government subsidy on healthy beverages as alternative approaches to a sugar tax.
A review of the majority of studies from the rest of the world found mixed results. In some countries—for example, Hungary—the current sugar tax has no significant impact on consumers’ behaviour, while in Spain, the intake of taxed beverages fell by about 39%. Furthermore, in Berkeley, the intake of taxed beverages decreased by about 21%, and the intake of the beverages increased by about 4% in cities that did not introduce a sugar tax. In Africa, despite the tax being criticized for its regressivity, its health benefits, especially for the low-income group, is being recognized. In South Africa, our review found that the tax led to a positive change in manufacturers’ behaviour. Some manufacturers reformulated beverages with a reduced sugar content.
Our review of some simulation model studies indicated that the productivity gains associated with a sugar tax are significant in reducing healthcare costs. The results found that the implementation of a sugar tax from a social perspective provides a more comprehensive estimate of the cost-effectiveness of the tax. In Zambia, the tax was predicted to generate USD 5.46 million annually. The tax is likely to decrease the intake of SSBs and hence the prevalence of type 2 diabetes, especially in women. The revenue from the tax could potentially contribute to healthcare promotion in Zambia.
In Canada, as reported by CTV News (2025) [131], the absolute difference in economic burden of CAD 5.30 per person per year between the middle- and highest-income households is justified by the magnitude of health benefits associated with the sugar tax. In Israel, according to Crosbie and Davis (2022) [132] and Lauber et al. (2022) [133], the repeal of the sugar tax was motivated by manufacturers who sought to protect their profits. Additionally, our review indicated that, although obesity was recognized as a public health concern, the majority of the public did not view the sugar tax as an effective tool to reduce the intake of SSBs.
Lastly, we found that less evidence exists in the majority of African studies regarding the sustainability of a sugar tax on the African continent. In Africa and some low-income countries, studies suggest that taxing sugar content in SSBs is a preferred option as it protects low-income households [134,135]. Other researchers, such as Fan et al. (2021) [136], have suggested that subsidizing healthy beverages and investing sugar tax revenue into the production of healthier beverage alternatives could reduce the intake of sugar and the prevalence of obesity and type 2 diabetes in Africa.

6. Findings from African Studies

From the analysis of sugar tax studies in Africa (Table 2), we found that the notion of consumer awareness, public opinion on the tax, and its public acceptability were, to some extent, neglected in the majority of the studies. Additionally, limited simulated studies have been conducted to assess the impact of the tax, particularly in countries that have not yet implemented a sugar tax. Numerous studies, especially in South Africa, have called on the government to increase the current sugar tax rate and regulate the marketing of SSBs.
Table 2. Evaluation of some selected studies from the African region.
The low-income group reported mixed reactions, with concerns about the unfairness of the tax and affordability. Except for in South Africa, limited studies have reported on consumer awareness and the shift to the intake of alternative beverages. Even though some beverage manufacturers have undertaken the production of alternative beverages with reduced or zero sugar content, they still manufacture the original high-sugar-content beverages. Our review indicates that in South Africa, a growing number of consumers from the middle- and high-income groups are beginning to consume the reformulated beverages, leading to a decrease in overall sugar intake.

7. Conclusions

A decline in SSB sales and consumption was observed in developed countries and in jurisdictions in the USA that implemented a sugar tax. Besides this observation, other economies in the rest of the world have implemented and then repealed the tax on the basis of a lack of scientific evidence of its efficiency and it being a financial burden on the low-income group. In Africa, sweet taste, low prices, lack of consumer awareness, excessive marketing, and the high price of pure fruit juice were some of the factors influencing the over-consumption of the beverages.
The resistance of the beverage associations and the protection of the interests of the low-income groups can be seen as hindrances to the effective implementation of a sugar tax in the majority of African countries. In addition, the implementation of the tax in African countries was found to be mainly for revenue generation rather than health promotion. Furthermore, the association of the intake of the beverages with strong cultural and religious beliefs in Egypt may render a sugar tax ineffective.

8. Implications of the Study

We suggest that governments worldwide should force manufacturers of SSBs to reduce their container size and impose a complete ban on the marketing of SSBs. To gain the public’s confidence, policymakers and sugar tax advocates should demonstrate that the introduction of a sugar tax is not an economic sanction on the manufacturers or an attack on the low-income group, but a means to promote public health.
For a sugar tax to be sustainable in reducing the intake of SSBs in Africa, it must tax all sugar-sweetened beverages to prevent consumers from switching to other untaxed sweetened beverages. Furthermore, regular research to review the tax rate and its design is necessary to access its relevance, efficiency, and sustainability over time.

Author Contributions

Conceptualization, R.O.E., methodology, R.O.E., formal analysis, R.O.E., investigation, R.O.E., data curation, R.O.E., writing—original draft preparation, R.O.E., supervision, F.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Data Availability Statement

The data presented in this study are available upon request from the corresponding author.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Svatoš, M.; Maitah, M.; Belova, A. World sugar market-basic development trends and tendencies. Agris Line Pap. Econ. Inform. 2013, 5, 73–88. [Google Scholar]
  2. Malik, V.S.; Hu, F.B. Sugar-sweetened beverages and cardio-metabolic health: An update of the evidence. Nutrients 2019, 11, 1840. [Google Scholar] [CrossRef] [PubMed]
  3. World Health Organisation. Guideline: Sugar Intake for Adults and Children. Retrieved from Geneva; WHO: Geneva, Switzerland, 2015; Available online: https://www.who.int/publications-detail/9789241549028 (accessed on 1 October 2025).
  4. Cuadrado, C.; Dunstan, J.; Silva-Illanes, N.; Mirelman, A.J.; Nakamura, R.C.; Suhrcke, M. Effects of a sugar-sweetened beverage tax on prices and affordability of soft drinks in Chile: A time series analysis. Soc. Sci. Med. 2020, 245, 112708. [Google Scholar] [CrossRef] [PubMed]
  5. Seleka, T.B.; Dlamini, T.S. Competitiveness of ACP Sugar Exporters in the Global Market. Int. Trade J. 2020, 34, 247–277. [Google Scholar] [CrossRef]
  6. Scientific Advisory Committee on Nutrition. Carbohydrates and Health. 2015. Available online: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf (accessed on 1 October 2025).
  7. Tseng, T.S.; Lin, W.T.; Gonzalez, G.V.; Kao, Y.H.; Chen, L.S.; Lin, H.Y. Sugar intake from sweetened beverages and diabetes: A narrative review. World J. Diabetes. 2021, 12, 1530–1538. [Google Scholar] [CrossRef]
  8. Ong, K.L. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023, 402, 203–234. [Google Scholar] [CrossRef]
  9. Friedman, R.R.; Brownell, K.D. Sugar-Sweetened Beverage Taxes. An Updated Policy Brief. Yale Rudd Center for Food Policy and Obesity Website. 2012. Available online: https://www.healthycaribbean.org/newsletters/aug-2015/Rudd_Policy_Brief_Sugar_Sweetened_Beverage_Taxes.pdf (accessed on 1 October 2025).
  10. Mahadevan, R. The Less Than Sweet Solution to Fiji’s Sugar Industry Problems. J. Int. Dev. 2009, 21, 126–136. [Google Scholar] [CrossRef]
  11. Von Philipsborn, P.; Stratil, J.M.; Burns, J.; Busert, L.K.; Pfadenhauer, L.M.; Polus, S.; Holzapfel, C.; Hauner, H.; Rehfuess, E. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. Cochrane Database Syst. Rev. 2019, 6, 1465–1858. [Google Scholar] [CrossRef]
  12. Miller, C.; Ettridge, K.; Wakefield, M.; Pettigrew, S.; Coveney, J.; Roder, D.; Durkin, S.; Wittert, G.; Martin, J.; Dono, J. Consumption of Sugar-Sweetened Beverages, Juice, Artificially Sweetened Soda and Bottled Water: An Australian Population Study. Nutrients 2020, 12, 817. [Google Scholar] [CrossRef]
  13. Caro, J.C.; Corvalán, C.; Reyes, M.; Silva, A.; Popkin, B.; Taillie, L.S. Chile’s 2014 sugar-sweetened beverage tax and changes in prices and purchases of sugar-sweetened beverages: An observational study in an urban environment. PLoS Med. 2018, 15, e1002597. [Google Scholar] [CrossRef]
  14. The South African Income Tax Act 58 of 1962. (2018/2019). In SAICA Student Handbook; LexisNexis: New York, NY, USA, 2024.
  15. Haupt, P.; Haupt, E. Notes on South African Income Tax; H & H Publications: Cape Town, South Africa, 2025. [Google Scholar]
  16. Bawadi, H.; Khataybeh, T.; Obeidat, B.; Kerkadi, A.; Tayyem, R.; Banks, A.D.; Subih, H. Sugar-Sweetened Beverages Contribute Significantly to College Students’ Daily Caloric Intake in Jordan: Soft Drinks Are Not the Major Contributor. Nutrients 2019, 11, 1058. [Google Scholar] [CrossRef]
  17. World Cancer Research Fund. Sugary Drink Taxes; World Cancer Research Fund: London, UK, 2017. [Google Scholar]
  18. Andreyeva, T.; Chaloupka, F.J.; Brownell, K.D. Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue. Prev. Med. 2011, 52, 413–416. [Google Scholar] [CrossRef] [PubMed]
  19. Lucas, T.; Horton, R. The 21st-century great food transformation. Lancet 2019, 393, 386–387. [Google Scholar] [CrossRef] [PubMed]
  20. Osman, M.; Schwartz, P.; Wodak, S. Sustainable Consumption: What Works Best, Carbon Taxes, Subsidies and/or Nudges? Basic Appl. Soc. Psychol. 2021, 43, 169–194. [Google Scholar] [CrossRef]
  21. Hagmann, D.; Ho, E.H.; Loewenstein, G. Nudging out support for a carbon tax. Nat. Clim. Change 2019, 9, 484–489. [Google Scholar] [CrossRef]
  22. Bødker, M.; Pisinger, C.; Toft, U.; Jørgensen, T. The rise and fall of the world’s first fat tax. Health Policy 2015, 119, 737–742. [Google Scholar] [CrossRef]
  23. Morning Spin: Cook County Pop Tax Goes Away Today. Chicago Tribune. 2017. Available online: http://www.chicagotribune.com/news/local/politics/ct-cook-county-soda-pop-tax-20171201-story.html (accessed on 1 October 2025).
  24. Tamir, O.; Cohen-Yogev, T.; Furman-Assaf, S.; Endevelt, R. Taxation of sugar sweetened beverages and unhealthy foods. A qualitative study of key opinion leaders’ views. Isr. J. Health Policy Res. 2018, 7, 43. [Google Scholar] [CrossRef]
  25. Myers, A.; Fig, D.; Tugendhaft, A.; Mandle, J.; Myers, J.; Hofman, K. Sugar and health in South Africa: Potential challenges to leveraging policy change. Glob. Public Health 2017, 12, 98–115. [Google Scholar] [CrossRef] [PubMed]
  26. Mpemnyama, Z. South African Soft Drinks Industry to Meet Treasury Next Week over Proposed Sugar Tax; Reuters: London, UK, 2016. [Google Scholar]
  27. Thow, A.M.; Downs, S.; Jan, S. A systematic review of the effectiveness of food taxes and subsidies to improve diets: Understanding the recent evidence. Nutr. Rev. 2014, 72, 551–565. [Google Scholar] [CrossRef] [PubMed]
  28. Malik, V.S.; Pan, A.; Willett, W.C.; Hu, F.B. Sugar-sweetened beverages and weight gain in children and adults: A systematic review and meta-analysis. Am. J. Clin. Nutr. 2013, 98, 1084–1102. [Google Scholar] [CrossRef]
  29. Chaloupka, F.J.; Powell, L.M.; Warner, K.E. The use of Excise Taxes to Reduce Tobacco, Alcohol and Sugary Beverage Consumption. Annual. Rev. Public Health 2019, 40, 187–201. [Google Scholar]
  30. Mytton, O.T.; Clarke, D.; Rayner, M. An increasing number of countries are introducing taxes on unhealthy food and drinks. However, will they improve health? BMJ 2012, 344, e2931. [Google Scholar] [PubMed]
  31. Falbe, J.; Thompson, H.R.; Becker, C.M.; Rojas, N.; McCulloch, C.E.; Madsen, K.A. Impact of the Berkeley excise tax on sugar-sweetened beverage consumption. Am. J. Public Health 2016, 106, 1865–1871. [Google Scholar] [PubMed]
  32. Zhong, Y.; Auchincloss, A.; Lee, B.; Kanter, G. The short-term impacts of the Philadelphia beverage tax on beverage consumption. Am. J. Prev. Med. 2018, 55, 26–34. [Google Scholar] [CrossRef] [PubMed]
  33. Chriqui, J.F.; Edison, S.S.; Chaloupka, F.J. State Sales Taxes on Regular Soda; Bridging the Gap Program, Health Policy Center, Institute for Health Research and Policy, University of Illinois: Chicago, IL, USA, 2014. [Google Scholar]
  34. Oosting, J. Michigan Senate Votes to Ban Local Soda Taxes. 2017. Available online: https://www.detroitnews.com/story/news/politics/2017/10/04/michigan-senate-soda-tax-ban/106297524 (accessed on 1 October 2025).
  35. Vallgårda, S.; Holm, L.; Jensen, J.D. The Danish tax on saturated fat: Why it did not survive. Eur. J. Clin. Nutr. 2015, 69, 223–226. [Google Scholar] [CrossRef]
  36. Associated Press. Snyder Signs Bill to Prohibit Local Food, Beverage Taxes; Associated Press: New York, NY, USA, 2017. [Google Scholar]
  37. Gardiner, D. Arizona Bans Extra Taxes on Soda, Sugary Drinks. 2018. Available online: https://www.azcentral.com/story/news/politics/legislature/arizona-bans-extra-taxes-soda-sugarydrinks/433235002 (accessed on 1 October 2025).
  38. O’Connor, A.; Sanger-Katz, M. California, of all Places, has Banned soda Taxes. How a New Industry Strategy is Succeeding. The New York of Times, 17 July 2018. [Google Scholar]
  39. Backholer, K.; Sarink, D.; Beauchamp, A.; Keating, C.; Loh, V.; Ball, K.; Martin, J.; Peeters, A. The impact of a tax on sugar-sweetened beverages according to socio-economic position: A systematic review of the evidence. Public Health Nutr. 2016, 19, 3070–3084. [Google Scholar] [CrossRef]
  40. Dillon, L. California Bans local Soda Taxes. 2018. Available online: http://www.latimes.com/politics/la-pol-ca-soda-tax-ban-20180628-story.html (accessed on 1 October 2025).
  41. Stein-Lobovits, S.; Lagroneii, C.; Patelii, R.; Srivastavai, A. Sugar-Sweetened Beverage Taxation. (A Policy Guide for India); A Project of the India Resource Center: New Delhi, India, 2016. [Google Scholar]
  42. Claro, R.M.; Levy, R.B.; Popkin, B.M.; Monteiro, C.A. Sugar Sweetened Beverage Taxes in Brazil. Am. J. Public Health 2014, 102, 178–183. [Google Scholar]
  43. Zehner, E. Promotion and consumption of breastmilk substitutes and infant foods in Cambodia, Nepal, Senegal and Tanzania. Matern. Child. Nutr. 2016, 12, 3–7. [Google Scholar] [CrossRef]
  44. World Health Organization. Controlling the Global Obesity Epidemi; WHO: Geneva, Switzerland, 2016. [Google Scholar]
  45. Studdert, D.M.; Flanders, J.; Mello, M.M. Searching for Public Health Law’s Sweet Spot: The Regulation of Sugar-Sweetened Beverages. PLoS Med. 2015, 12, e1001848. [Google Scholar] [CrossRef]
  46. Briggs, A.D.M.; Mytton, O.T.; Madden, D.; O’Shea, D.; Rayner, M.; Scarborough, P. The Potential Impact on Obesity of a 10% Tax on Sugar Sweetened Beverages in Ireland, an Effect Assessment Modelling Study. BMC Public Health 2013, 13, 860. [Google Scholar] [CrossRef]
  47. Dahms, J. Evaluating the Effectiveness of Sugar Tax to Combat South Africa’s Sweet Tooth. Int. J. Econ. Financ. Stud. 2017, 9, 1309–8055. [Google Scholar]
  48. Adam, D.M.B.; Oliver, T.M.; Kehlbacher, A.; Tiffin, R.; Rayner, M.; Scarborough, P. Overall and income-specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: Econometric and comparative risk assessment modelling study. BMJ 2013, 347, 6189. [Google Scholar] [CrossRef]
  49. Cawley, J.; Frisvold, D.; Hill, A.; Jones, D. Oakland’s sugar-sweetened beverage tax: Impacts on prices, purchases and consumption by adults and children. Econ. Hum. Biol. 2020, 37, 100865. [Google Scholar] [CrossRef] [PubMed]
  50. Timpson, H.; Lavin, R.; Hughes, L. Exploring the Acceptability of a Tax on Sugar-Sweetened Beverages. British Nutrition Foundation Seminar on Food Taxes; Centre for Public Health; Liverpool John Moore University: Liverpool, UK, 2015. [Google Scholar]
  51. Kottasova, I. Soda Wars: The UK’s Tax on Sugary Drinks is Working. CNN Money, 9 March 2017. [Google Scholar]
  52. Grierson, J. Coca-Cola Says Sugar Cuts Have Not Harmed Sales; The Guardian: London, UK, 2017. [Google Scholar]
  53. Rogers, N.T.; Cummins, S.; Forde, H.; Jones, C.P.; Mytton, O.; Rutter, H.; Sharp, S.J.; Theis, D.; White, M.; Adams, J. Associations between trajectories of obesity prevalence in English primary school children and the UK soft drinks industry levy: An interrupted time series analysis of surveillance data. PLoS Med. 2023, 26, e1004160. [Google Scholar] [CrossRef] [PubMed]
  54. Francis, N.; Marron, D.; Rueben, K. The Pros and Cons of Taxing Sweetened Beverages Based on Sugar Content; Urban Institute: Washington, DC, USA, 2016. [Google Scholar]
  55. BevSA. Response to the Taxation of Sugar-Sweetened Beverages; Policy paper; BevSA: Bryanston, South Africa, 2016. [Google Scholar]
  56. Pfister, K. Leaked: Coca-Cola’s Worldwide Political Strategy to Kill Soda Taxes; Medium: San Francisco, CA, USA, 2016. [Google Scholar]
  57. Lombard, M.; Koekemoer, A. Conceptual framework for the evaluation of sugar tax systems. S. Afr. J. Account. Res. 2020, 34, 63–90. [Google Scholar] [CrossRef]
  58. Bollinger, B.; Sexton, S.E. Local excise taxes, sticky prices, and spillovers: Evidence from Berkeley’s soda tax. Quant. Mark. Econ. 2023, 21, 281–331. [Google Scholar] [CrossRef]
  59. Bellová, J. A Review of the Sugar Tax in the uk and an Evaluation of Other Possible Alternatives to the Tax. Stud. Iurid. Cassoviensia 2018, 6, 1. [Google Scholar]
  60. Public Health England. Sugar Reduction and Wider Reformulation Programme. In Report on Progress Towards the First 5% Reduction and Next Steps; Public Health England: London, UK, 2018. [Google Scholar]
  61. Scarborough, P.; Adhikari, V.; Harrington, R.A.; Elhussein, A.; Briggs, A.; Rayner, M. Impact of the announcement and implementation of the UK Soft Drinks Industry Levy on sugar content, price, product size and number of available soft drinks in the UK, 2015–2019: A controlled interrupted time series analysis. PLoS Med. 2020, 17, e1003025. [Google Scholar] [CrossRef]
  62. Essman, M.; Taillie, L.S.; Frank, T.; Ng, S.W.; Popkin, B.M.; Swart, E.C. Taxed and untaxed beverage intake by South African young adults after a national sugar-sweetened beverage tax: A before-and-after study. PLoS Med. 2021, 18, e1003574. [Google Scholar] [CrossRef]
  63. Egypt Implements 2 kg Sugar Ration Increase in January. Available online: https://www.businesstodayegypt.com/Article/1/3850/Egypt-implements-2-KG-sugar-ration-increase-in-January (accessed on 1 February 2024).
  64. Baker, P.; Jones, A.; Thow, A.M. Accelerating the worldwide adoption of sugar-sweetened beverage taxes: Strengthening commitment and capacity: Comment on “The untapped power of soda taxes: Incentivizing consumers, generating revenue, and altering corporate behaviour”. Int. J. Health Policy Manag. 2018, 7, 474–478. [Google Scholar] [CrossRef]
  65. Abbas, H.; Guarnizo-Herreño, C.C.; El Tantawi, M.; Tsakos, G.; Peres, M.A. Challenges and way forward for implementation of sugar taxation in the Middle East and North Africa (MENA). Community Dent. Oral Epidemiol. 2024, 52, 375–380. [Google Scholar] [CrossRef] [PubMed]
  66. Islam, A.N.M.S.; Sultana, H.; Refat, M.N.H.; Farhana, Z.; Kamil, A.A.; Rahman, M.M. The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis. J. Pmedr. 2024, 46, 102882. [Google Scholar]
  67. International Diabetes Federation. Unite for Diabetes; International Diabetes Federation: Brussels, Belgium, 2015. [Google Scholar]
  68. Adu Gyamfi, C.; Commey, V.; Adu Amankwah, J. Food choices of adolescents and its associated health implications in Adansi North District of Ghana. Int. J. Curr. Res. 2017, 9, 47633. [Google Scholar]
  69. Izah, S.C.; Inyang, I.R.; Angaye, T.C.N.; Okowa, I.P. A Review of Heavy Metal Concentration and Potential Health Implications of Beverages Consumed in Nigeria. Toxics 2016, 5, 1. [Google Scholar] [CrossRef] [PubMed]
  70. Ministry of Health in Ghana. National policy and Strategy for the Management, Prevention, and Control of Chronic non-Communicable Diseases in Ghana; Ministry of Health in Ghana: Accra, Ghana, 2022. [Google Scholar]
  71. Du, M.; Tugendhaftb, A.; Erzse, A.; Hofman, K.J. Sugar-Sweetened Beverage Taxes: Industry Response and Tactics. Yale J. Biol. Med. 2018, 91, 185–190. [Google Scholar]
  72. Laar, A.; Amoah, J.M.; Massawudu, L.M.; Pereko, K.K.A.; Yeboah-Nkrumah, A.; Amevinya, G.S.; Nanema, S.; Odame, E.A.; Agyekum, P.A.; Mpereh, M.; et al. Making food-related health taxes palatable in sub-Saharan Africa: Lessons from Ghana. BMJ Glob. Health 2023, 8, e012154. [Google Scholar] [CrossRef]
  73. Thow, A.M.; Karim, S.A.; Mukanu, M.M.; Ahaibwe, G.; Wanjohi, M.; Gaogane, L.; Amukugo, H.J.; Ruhara, C.M.; Ngoma, T.; Asiki, G.; et al. The political economy of sugar-sweetened beverage taxation: An analysis from seven countries in sub-Saharan Africa. Glob. Health Action 2021, 14, 1909267. [Google Scholar] [CrossRef]
  74. Weihrauch-Blüher, S.; Kromeyer-Hauschild, K.; Graf, C.; Grünewald-Funk, D.; Widhalm, K.; Korsten-Reck, U.; Markert, J.; Güssfeld, C.; Müller, M.J.; Moss, A.; et al. Current guidelines for obesity prevention in childhood and adolescence. Obes. Facts 2018, 11, 263–276. [Google Scholar] [CrossRef]
  75. Hoogstoel, F.; Samadoulougou, S.; Diouf, A.; Savoye, I.; Donnen, P.; Van der Heyden, J.; Kirakoya-Samadoulougou, F. Adherence to ‘5-2-1-0’ guidelines and multiple risky behaviours among adolescents in nine sub-Saharan African countries: Evidence from Global School-based Student Health Survey 2012–2017. BMJ Nutr. Prev. Health 2022, 6, e000488. [Google Scholar] [CrossRef]
  76. Laar, A. The role of food environment policies in making unhealthy foods unattractive and healthy foods available in Africa. EClinicalMedicine 2021, 36, 100908. [Google Scholar] [CrossRef]
  77. Walls, H.; Nisbett, N.; Laar, A.; Drimie, S.; Zaidi, S.; Jody Harris, J. Addressing malnutrition: The importance of political economy analysis of power. Int. J. Health Policy Manag. 2021, 10, 809–816. [Google Scholar] [CrossRef]
  78. Sholey, O.O.; Animasahun, V.J.; Salako, A.A.; Oduwole, A.D. Snacking and sweetened beverage consumption among adolescents in Sagamu, Southwest Nigeria. Nutr. Food Sci. 2018, 48, 5. [Google Scholar] [CrossRef]
  79. Omuemu, V.O.; Okoh-Oboh, A.G. Meal pattern and soft drink consumption among school adolescents in Benin City, Edo State, Nigeria. J. Med. Biomed. Res. 2015, 14, 1. [Google Scholar]
  80. Audain, K.; Levy, L.; Ellahi, B. Sugar-sweetened beverage consumption in the early years and implications for type-2 diabetes: A sub-Saharan Africa context. Proc. Nutr. Soc. 2019, 78, 547–553. [Google Scholar] [CrossRef] [PubMed]
  81. Amukugo, H.J.; Abdool Karim, S.; Thow, A.M.; Erzse, A.; Kruger, P.; Karera, A.; Hofman, K. Barriers to, and facilitators of, the adoption of a sugar-sweetened beverage tax to prevent non-communicable diseases in Namibia: A policy landscape analysis. Glob. Health Action 2021, 14, 1903213. [Google Scholar] [CrossRef] [PubMed]
  82. Wang, Y.C.; Coxson, P.; Shen, Y.; Golman, L.; Bibbins-Domingo, K. A penny-per-ounce tax on sugar-sweetened beverages would cut the health and cost burdens of diabetes. Health Affairs 2014, 31, 199–207. [Google Scholar] [CrossRef]
  83. European Union. Egypt-Market Handbook. In The Food and Beverage Market Entry Handbook. A Practical Guide to the Market in Egypt for European Agri-food Products and Products with Geographical Indications; European Union: London, UK, 2019. [Google Scholar]
  84. Global Agricultural Information Networks. South African Sugar Production Forecast to Grow Despite Revenue Pressures. GAIN Report Number: SA1912; Global Agricultural Information Networks: Toronto, Canada, 2019. [Google Scholar]
  85. Obeid, O.; Al Jawaldeh, A.; El Mallah, C. Regional Policies on Sugar Intake Reduction at Population Levels to Address Obesity in the Eastern Mediterranean. JSM Nutr. Disord. 2018, 2, 1006. [Google Scholar]
  86. Nucifora, A.; Doemeland, D.; Rijkers, B. The Unfinished Revolution: Bringing Opportunity, Good Jobs and Greater Wealth to All Tunisians; World Bank Development Policy Revie: Washington, DC, USA, 2014. [Google Scholar] [CrossRef]
  87. Hagenaars, L.L.; Jeurissen, P.P.; Klazinga, N.S. The taxation of unhealthy energy-dense foods (EDFs) and sugar-sweetened beverages (SSBs): An overview of patterns observed in the policy content and policy context of 13 case studies. Health Policy 2017, 121, 887–894. [Google Scholar] [CrossRef]
  88. Kadungure, A.; Loewenson, R. Taxing for Health: Taxes on Sugar-Sweetened Beverages in East and Southern African Countries; EQUINET Discussion Paper; TARSC: Harare, South Africa; EQUINET: Brussels, Belgium, 2023. [Google Scholar]
  89. Bridge, G.; Lomazzi, M.; Bedi, R. Implementation of a sugar-sweetened beverage tax in low- and middle-income countries: Recommendations for policymakers. J. Public Health Policy 2020, 41, 84–97. [Google Scholar] [CrossRef]
  90. Lehner, M.; Mont, O.; Heiskanen, E. Nudging–A promising tool for sustainable consumption behaviour? J. Clean. Prod. 2016, 134, 166–177. [Google Scholar] [CrossRef]
  91. Hansen, P.G.; Jespersen, A.M. Nudge and the manipulation of choice: A framework for the responsible use of the nudge approach to behaviour change in public policy. Eur. J. Risk Regul. 2013, 4, 3–28. [Google Scholar] [CrossRef]
  92. Jensen, J.D.; Smed, S.; Aarup, L.; Nielsen, E. Effects of the Danish saturated fat tax on the demand for meat and dairy products. Public Health Nutr. 2015, 19, 3085–3094. [Google Scholar] [CrossRef] [PubMed]
  93. White, A.; Lockyer, S. Removing plastic packaging from fresh produce–what’s the impact? Br. Nutr. Found. Nutr. Bull. 2020, 45, 35–50. [Google Scholar] [CrossRef]
  94. Xanthos, D.; Walker, T.R. International policies to reduce plastic marine pollution from single-use plastics (plastic bags and microbeads): A review. Mar. Pollut. Bull. 2017, 118, 17–26. [Google Scholar] [CrossRef] [PubMed]
  95. World Health Organization. Rio Political Declaration on Social Determinants of Health. In Proceedings of the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19–21 October 2011. [Google Scholar]
  96. Bosch-Capblanch, X.; Lavis, J.N.; Lewin, S.; Atun, R.; Rottingen, J.A. Guidance for evidence-informed policies about health systems: Rationale for and challenges of guidance development. PLoS Med. 2012, 9, e1001185. [Google Scholar] [CrossRef]
  97. Enowkenwa, R.O. Developing a framework for the adoption of an effective sugar tax in South Africa. unpublished Ph.D. Thesis, North-West University, South Africa, June 2025. [Google Scholar]
  98. Carter, H.E.; Schofield, D.J.; Shrestha, R.; Veerman, L. The productivity gains associated with a junk food tax and their impact on cost-effectiveness. PLoS ONE 2019, 14, e0220209. [Google Scholar] [CrossRef]
  99. Colchero, M.A.; Rivera-Dommarco, J.; Popkin, B.; Ng, S.W. In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax. Health Affairs 2017, 36, 564–571. [Google Scholar] [CrossRef] [PubMed]
  100. Amoutzopoulos, B.; Steer, T.; Roberts, C.; Collins, D.; Page, P. Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16). Nutrients 2020, 2, 393. [Google Scholar] [CrossRef]
  101. Csákvári, T.; Elmer, D.; Németh, N.; Komáromy, M.; Mihály-Vajda, R.; Boncz, I. Assessing the Impact Of Hungary’s Public Health Product Tax: An Interrupted Time Series Analysis. Cent. Eur. J. Public Health 2023, 31, 43–49. [Google Scholar] [CrossRef]
  102. Royo-Bordonada, M.A.; Fernández-Escobar, C.; Simón, L.; Sanz-Barbero, B.; Padilla, J. Impact of an excise tax on the consumption of sugar-sweetened beverages in young people living in poorer neighborhoods of Catalonia, Spain: A difference in differences study. BMC Public Health 2019, 19, 1553. [Google Scholar] [CrossRef]
  103. Zhuang, X.; Liu, Y.; Gittelsohn, J.; Lewis, E.; Song, S.; Ma, Y.; Wen, D. Sugar-Sweetened Beverages Consumption and Associated Factors among Northeastern Chinese Children. Nutrients 2021, 13, 2233. [Google Scholar] [CrossRef]
  104. Bipasha, M.S.; Raisa, T.S.; Goon, S. Sugar-Sweetened Beverages Consumption among University Students of Bangladesh. Int. J. Public Health Sci. 2017, 6, 2. [Google Scholar] [CrossRef]
  105. Kao, K.E.; Jones, A.C.; Ohinmaaa, A.; Pauldena, M. The health and financial impacts of a sugary drink tax across different income groups in Canada. Econ. Hum. Biol. 2020, 38, 100869. [Google Scholar] [CrossRef] [PubMed]
  106. Roache, S.A.; Gostin, L.O. The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behaviour. Int. J. Health Policy Manag. 2017, 6, 489–493. [Google Scholar] [CrossRef] [PubMed]
  107. Allcott, H.; Lockwood, B.B.; Taubinsky, D. Regressive sin taxes, with an application to the optimal soda tax. Q. J. Econ. 2019, 134, 1557–1626. [Google Scholar] [CrossRef]
  108. Colchero, M.A.; Guerrero-López, C.M.; Molina, M.; Rivera, J.A. Beverages Sales in Mexico before and after Implementation of a Sugar Sweetened Beverage Tax. PLoS ONE 2016, 11, e0163463. [Google Scholar] [CrossRef]
  109. Fernandes, L.; Mokwena, K.; Ntuli, B. Case report on energy drink consumption among Health Sciences University students in Gauteng Province, South Africa. Public Health Rev. 2020, 41, 9. [Google Scholar] [CrossRef]
  110. Ukegbu, P.O.; Uwaegbutea, A.C.; Echendua, C.A. Obesity and associated factors in young adults attending tertiary institutions in South-Eastern Nigeria. S. Afr. J. Clin. Nutr. 2017, 30, 2. [Google Scholar] [CrossRef]
  111. Gissing, S.C.; Pradeilles, R.; Osei-Kwasi, H.A.; Cohen, E.; Holdsworth, M. Drivers of dietary behaviours in women living in urban Africa: A systematic mapping review. Public Health Nutr. 2017, 20, 2104–2113. [Google Scholar] [CrossRef]
  112. Cawley, J.; Daly, M.R.; Thornton, R. The Effect of Beverage Taxes on Youth Consumption and BMI: Evidence from Mauritius; National Bureau of Economic Research: Cambridge, MA, USA, 2021. [Google Scholar]
  113. Allen, W.M.K.; Allen, K.J. Should Australia tax sugar-sweetened beverages? J. Paediatr. Child Health 2020, 56, 8–15. [Google Scholar] [CrossRef]
  114. Vandevijvere, S.; Soupen, A.; Swinburn, B. Unhealthy food advertising directed to children on New Zealand television: Extent, nature, impact and policy implications. Public Health Nutr. 2017, 20, 3029–3040. [Google Scholar] [CrossRef] [PubMed]
  115. Bandy, L.K.; Scarborough, P.; Harrington, R.A.; Rayner, M.; Jebb, S.A. Reductions in sugar sales from soft drinks in the UK from 2015 to 2018. BMC Med. 2020, 18, 20. [Google Scholar] [CrossRef] [PubMed]
  116. Essman, M.; Stoltze, F.M.; Carpentier, F.D.; Swart, E.C.; Taillie, L.S. Examining the news media reaction to a national sugary beverage tax in South Africa: A quantitative content analysis. BMC Public Health 2021, 21, 454. [Google Scholar] [CrossRef] [PubMed]
  117. Stacey, N.; Mudara, C.; Ng, S.W.; van Walbeek, C.; Hofman, K.; Edoka, I. Sugar-based beverage taxes and beverage prices: Evidence from South Africa’s Health Promotion Levy. Soc. Sci. Med. 2019, 238, 112465. [Google Scholar] [CrossRef]
  118. Subaiea, G.M.; Altebainawi, A.F.; Alshammari, T.M. Energy drinks and population health: Consumption patterns and adverse effects among the Saudi population. BMC Public Health 2019, 19, 1539. [Google Scholar] [CrossRef]
  119. Acton, R.B.; Vanderlee, L.; Hobin, E.P.; Hammond, D. Added sugar in the packaged foods and beverages available at a major Canadian retailer in 2015: A descriptive analysis. Can. Med. Assoc. Open Access J. 2017, 5, E1–E6. [Google Scholar] [CrossRef]
  120. Coetzee, A.; Beukes, A.; Dreyer, R.; Solomon, S.; van Wyk, L.; Mistry, R.; Conradie, M.; van de Vyver, M. The prevalence and risk factors for diabetes mellitus in healthcare workers at Tygerberg hospital. Cape Town, South Africa. A retrospective study. J. Endocrinol. Metab. Diabetes S. Afr. 2019, 24, 77–82. [Google Scholar] [CrossRef]
  121. Fungai, M. Factors Influencing Customer Repurchase Intention in The Fast Food Industry. A Case Study of Innscor Mutare, Zimbabwe. Bus. Soc. Sci. J. BSSJ 2017, 2, 113–133. [Google Scholar]
  122. Yamoah, D.A.; De Man, J.; Onagbiye, S.O.; Mchiza, Z.J. Exposure of Children to Unhealthy Food and Beverage Advertisements in South Africa. Int. J. Environ. Res. Public Health 2021, 18, 3856. [Google Scholar]
  123. World Health Organization. Report on Fiscal Policies to Reduce Consumption of Sugar-Sweetened Beverages and Other Regulatory Measures to Promote Healthy Diets in the Republic of Maldives; WHO: Geneva, Switzerland, 2017; Available online: http://www.searo.who.int/maldives/documents/report-on-fiscal-policies-reduce-consumption-sugar.pdf?ua=1 (accessed on 1 July 2025).
  124. Kamin-Friedman, S.; Davidovitch, N.; Yang, Y.T. Israel’s repeal of a sweet beverages tax harms public health. Front. Public Health 2023, 11, 1231709. [Google Scholar] [CrossRef]
  125. Troen, A.M.; Martins, A.P.B.; Aguado, I.H.; Popkin, B.; Mozaffarian, D.; Caraher, M. Israel decides to cancel sweetened beverage tax in setback to public health. Lancet 2023, 401, 10376. [Google Scholar] [CrossRef] [PubMed]
  126. Hangoma, P.; Bulawayo, M.; Chewe, M.; Stacey, N.; Downey, L.; Chalkidou, K.; Hofman, K.; Kamanga, M.; Kaluba, A.; Surgey, G. The potential health and revenue effects of a tax on sugar sweetened beverages in Zambia. BMJ Glob. Health 2020, 5, e001968. [Google Scholar] [CrossRef] [PubMed]
  127. Mmbaya, F.K.; Waudo, J.; Mwangi, S.M.; Ngetich, E. Nutrition knowledge and consumption of sugar-sweetened beverages among high school students in Kenya. J. Public Health Nutri. 2020, 3, 212–216. [Google Scholar]
  128. Sassi, F.; Belloni, A.; Mirelman, A.J.; Suhrcke, M.; Thomas, A.; Salti, N. Equity impacts of price policies to promote healthy behaviour. Lancet 2018, 391, 2059–2070. [Google Scholar] [CrossRef]
  129. Van Wyk, R.B.; Dlamini, C.S. The impact of food prices on the welfare of households in South Africa. S. Afr. J. Econ. Manag. Sci. 2018, 21, a1979. [Google Scholar] [CrossRef]
  130. Saxena, A.; Stacey, N.; Puech, P.D.R.; Mudara, C.; Hofman, K.; Verguet, S. The distributional impact of taxing sugar-sweetened beverages: Findings from an extended cost-effectiveness analysis in South Africa. BMJ Glob. Health 2019, 4, e001317. [Google Scholar] [CrossRef]
  131. Canada’s First ‘Sugar Tax’ shows Signs of Effectiveness, but Repeal Already Set. CTV News, 17 June 2025.
  132. Crosbie, E.; Davis, F. Expanding our understanding of industry opposition to help implement sugar-sweetened beverage taxation. Public Health Nutr. 2022, 25, 180–182. [Google Scholar] [CrossRef]
  133. Lauber, K.; Rippin, H.; Wickramasinghe, K.; Gilmore, A.B. Corporate political activity in the context of sugar-sweetened beverage tax policy in the WHO European Region. Eur. J. Public Health 2022, 32, 5. [Google Scholar] [CrossRef]
  134. Zhai, T.; Wang, J.; Li, L.; Si, W. Taxing sugar-sweetened beverages in China: By volume or sugar content? A consumer welfare approach. J. Integr. Agric. 2024, 23, 4237–4249. [Google Scholar] [CrossRef]
  135. Fan, S.; Gao, H. Rethinking the global food system under COVID–19. J. Huazhong Agric. Univ. 2020, 5, 168. [Google Scholar]
  136. Fan, S.; Headey, D.; Rue, C.; Thomas, T. Food systems for human and planetary health: Economic perspectives and challenges. Annu. Rev. Resour. Econ. 2021, 13, 131–156. [Google Scholar] [CrossRef]
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