Can taxes fix India’s junk food crisis?

India faces a growing health crisis, driven by the alarming rise in unhealthy food consumption, demanding urgent strategic interventions. The National Institute of Nutrition (NIN) – led “Let’s Fix Our Food” (LFOF) consortium, has recently recommended health taxes and advertising restrictions to combat this menace.

For example, the daily per capita sugar intake, a key component of ultra-processed foods (UPFs), has surged from 22 grams in 2000 to an estimated 68 grams in 2021, with similar increases in salt and fat. This directly contributes to the rising incidence of diabetes and non-alcoholic fatty liver disease (NAFLD) among younger populations. The average urban Indian consumes at least 100 grams of packaged foods daily, providing approximately 500 kilocalories. This excessive intake, coupled with sedentary lifestyles, leads to energy imbalance, resulting in weight gain and increased risk of NAFLD, diabetes, and cardiovascular diseases at younger ages, with higher mortality rates than global averages, significantly burdening India’s healthcare infrastructure.

This trend is substantiated by the National Family Health Survey (NFHS)-5 (2019-21), which highlights a concerning rise in overweight and obesity across India. Overall, 24% of women and 23% of men are affected. Specifically, 6.4% of women and 4% of men aged 15-49 are obese. Additionally, overweight children under 5 have increased from 2.1% (NFHS-4) to 3.4% (NFHS-5) nationwide. These rising obesity rates directly correlate with an increased strain on India’s healthcare system, driven by the
higher incidence of cardiovascular diseases, type 2 diabetes, certain cancers, and musculoskeletal disorders.

Recognising the severity of these health implications, the LFOF consortium has proposed a 32% health tax on Sugar-Sweetened Beverages (SSBs) and High Fat, Sugar, and Salt (HFSS) products, alongside a 20 to 30% tax on sweets and confectioneries. This aligns with the World Health Organisation’s recommendations and evidence from over 70 countries, suggesting that a 20% price tax increase can lead to a 20% reduction in SSB consumption. The UK and Mexico have demonstrated the effectiveness of SSB taxes in reducing consumption and prompting product reformulation. While the US and Europe show varied implementation and effectiveness, we can adapt these strategies to our context.

Specifically, a projected 20% increase in SSB prices in India may reduce overweight and obesity by 3% and type-2 diabetes by 1.6%, mirroring trends in countries with similar taxes.

Studies indicate these taxes reduce sugary drink consumption, with a potentially greater impact on low-income populations. Revenue can subsidise healthy food options, enhancing accessibility. Furthermore, generated revenue can fund community-based nutrition programmes, food distribution initiatives in underserved areas, and educational campaigns tailored to specific socioeconomic groups.

Beyond consumption reduction, health taxes may incentivise food and beverage manufacturers to reformulate products, contributing to a healthier food environment. Additionally, generated revenue can fund public health initiatives, such as subsidising healthy food options, public awareness campaigns, and improved healthcare infrastructure. These initiatives should be tailored to address the specific needs of low-income communities, where the impact of unhealthy food consumption is most pronounced.

Curbs on marketing

Marketing strategies often exploit vulnerabilities in low-income populations. Therefore, complementing taxation, reasonable restrictions on food advertising to children are essential. For example, targeted advertising of cheap, high-calorie processed foods in low-income neighbourhoods, the use of celebrity endorsements or cartoon characters to appeal to children from vulnerable backgrounds, and the placement
of unhealthy snacks at eye level in small local stores are common marketing tactics that need addressing.

However, even with these measures, comprehensive public awareness campaigns are essential, informing the population about health risks and promoting healthier lifestyles, especially among children. Collaboration with schools, community centres, and healthcare providers is also vital. These campaigns must be culturally sensitive, addressing specific dietary habits and challenges faced by different socioeconomic groups. For instance, campaigns utilising local languages, addressing food preparation challenges in resource-limited settings, and working with
community leaders can enhance effectiveness.

To maximise the effectiveness of these interventions, robust monitoring and evaluation are needed to track indicators and adjust strategies. Authorities must proactively engage with industry stakeholders, providing evidence-based information and exploring product reformulation for healthier alternatives. Ultimately, to safeguard children’s food choices and public health, clear food labelling and measures against surreptitious advertisements, such as product placement and influencer marketing merit consideration.

A comprehensive approach, encompassing unhealthy food taxation, healthy option subsidies, active lifestyle promotion, workplace stress mitigation, improved food labelling, and behaviour change, is crucial. To complement these systemic changes, families can drive change by adopting healthier food habits. The time for decisive action is now, to safeguard the health of future generations and build a more equitable India.

(The author is an independent writer)

Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.