Sugar Tax Policy Briefing for Singapore's Minister of Health

This briefing note, prepared for the Minister of Health of Singapore, examines the implementation of a sugar tax in Mexico as a potential model to reduce sugar consumption and combat rising obesity rates in Singapore. The report highlights the current situation in Singapore, where high sugar intake from sugar-sweetened beverages contributes to increasing rates of obesity and related noncommunicable diseases. It delves into Mexico's experience, detailing the background, challenges, and outcomes of their sugar tax policy, including the industry's resistance and the importance of clear communication. The briefing note identifies key lessons from Mexico's experience, such as the need for clear scientific language, proper allocation of tax revenue, and government leadership, and provides precautionary measures. The author reflects on the policymaking process, emphasizing the influence of political factors and the need for stakeholder engagement. The briefing concludes with a call to action for Singapore to consider implementing similar policies to improve public health outcomes. The assignment is based on the framework of Shiffman and Smith and adapted by W and G.

Sugar Tax
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Author Note
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BRIEFING NOTE FOR THE MINISTER OF HEALTH OF SINGAPORE
Lessons from the implementation of sugar tax policy in Mexico
Purpose:
The main purpose of presenting this briefing note is the implementation initiative undertaken
by Mexico for the sugar tax and thereby, reducing the consumption of sugar for people. The policies
that have been implemented by them are one form of a learning experience and are required to be
implemented in Singapore such that the prevalence rate of obesity is reduced among the people. For
the appropriate implementation, health care services in middle and low-income countries are a huge
challenge; less appreciation is given to the threat of politics in the process of policymaking.
Current situation:
The extent of children in Singapore who are obese or overweight rose from 11 per cent in
2011 to 13 per cent in 2017i. Like most nations in the Asia-Pacific locale, a quick-paced way of life
and the reasonableness of beverages and foods which are processed has incited rising quantities of
Singaporeans to devour more sugar. This, thus, has prompted them putting on weight, and more
instances of noncommunicable illnesses, for example, cardiovascular diseases, diabetes and cancerii.
As per an overview a year ago by Singapore's Health Promotion Board, Singaporeans on normal
expend 60 grams of sugar a day - higher than the 25 grams prescribed by the World Health
Organization. The greater part of this admission is from sugar-sweetened beveragesiii. The board said
drinking an extra 250 milliliters of sugar-sweetened refreshments consistently builds the danger of
diabetes by up to 26 per cent. A milestone ban in Singapore on promoting drinks with high sugar
content has at long last tended to one of the key purposes for the rising incidence rate of obesity in
childhood - the unregulated advertising of food itemsiv. By applying this ban to just the most
unfortunate items, the industry is given a solid impetus to re-evaluate. The drink fabricating
organizations are given the message to make just healthy food items with the end goal that they get
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an opportunity of publicizing their items and produce an income for them and the nationv. In any
case, decreasing their presentation to luring advertisements is not enough because those different
roads are utilized to pull in clients to sugary beverages, including retail and cheap food outlets.
Background:
It is alarming to realize that, in Mexico, 70% of children living in rustic networks have sodas
with breakfast. Be that as it may, this issue is not observed to be exclusive to the rural and provincial
territories; it influences most by far of this nation where more soda drinks are expended than
anyplace else on the planet. The downsides of high utilization of soda drinks, sugar-sweetened
drinks, and vitality rich nourishments are not restricted to the effectively significant worry over the
morbidity related with these propensities, yet in addition to their effect on family units and national
economiesvi. It has been determined that 10% of family earnings in Mexico are spent on these items
and that the expense of clinic care for health complications of diabetes and hypertension came to
MXN 68 000 million in 2008, an incredibly high and disturbing figure when one thinks about that
the whole spending plan of a province of Mexico for that year, e.g., Jalisco, was MXN 79 000
million. Considering these conditions, different CSOs recommended that the Federal Government of
Mexico should require a 20% tax on sugar-sweetened drinks. Children who routinely devour sugar-
sweetened refreshments between suppers were 2.4 times bound to be overweight as contrasted and
youngsters who did not expend such drinks. A connection between intake of soft-drink and the
metabolic disorder has been found in Mexico. Insights show that people who drink at least two
sugar-sweetened refreshments per day are at a twofold danger of building up the metabolic disorder,
a sickness related to expanded triglycerides and diminished high-density lipoprotein cholesterol
levels. Besides, a positive relationship has been affirmed between the admission of sugar-sweetened
refreshments and the rate of hypertension.
Among the endeavours embraced in Mexico, in 2010, the Government—through the Ministry
of Health—advanced the National Agreement for Healthy Nutrition: A Strategy to Reduce
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Overweight and Obesity, which, notwithstanding joining a multisectoral approach, energized private-
area contribution by methods for self-guideline. Be that as it may, this strategy accomplished not
many advances and rehashed the circumstance of the European nations, where self-guideline did not
create normal outcomes. On 23 August 2010, the Agreement was distributed in the Official Journal
of the Federation to build up general rules concerning the deal and conveyance of nourishment and
refreshments for utilization at fundamental instruction offices.
The proposition of a Special Tax on Production and Services (IEPS) that is required to be
levied on sugar-sweetened beverages and sodas emerged from the joint exertion of different national
foundations, including the government, Congress, the scholarly community, CSOs, and worldwide
associations, which structure intersectoral representatives that speak to the greater part of the areas
intrigued by utilization of financial arrangements as a method for improving the strength of the
Mexican populace. The proposition depends on the logical evidence that shows the connection
between sugar-sweetened beverage intake, overweight, and obesity, and on epidemiological
information that exhibits the major issue brought about by this affiliation, which implies that the two
key parts of the proposition comprised of demoralizing utilization of sugar-sweetened refreshments,
through a 20% tax, and to gather assets for the execution of obesity avoidance programs, especially
one that advances better, increasing access to drinking water in schools, open spaces, and country
regions. The proposition of administrative activity to charge sugar-sweetened refreshments and soda
drinks started to accumulate energy in the second semester of 2012, inside the system of a
conversation on the monetary bundle, when a gathering of legislators and agents, headed by
representative Marcela Torres Peimbert, revived the proposition and broke down its significance and
reason. The assessments of different administrators, for and against the proposition, were heard. It
was clear that the individuals who contradicted the proposition communicated similar contentions
progressed by the soda drinks industry.
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The PAHO/WHO Representative Office in Mexico attempted to build up vital associations
with a few divisions, for example, the official and authoritative branches, CSOs focused on the battle
against obesity in Mexico, portrayals of the United Nations framework, and scholarly and explore
establishments. Also, it went to specialized gatherings at the Senate of the Republic close by
researchers, scientists, and CSO individuals so as to audit the Initiative and bolster the advancement
of a technique to make it evidence-based. PAHO/WHO reacted to data demands—giving specialized
data, logical proof, and global experience to the legislators engaged with the bill—by getting ready
reality sheets. These included key messages and national and universal logical proof for imparting to
writers, supposition creators, and officials uninvolved with the new Initiative that was remembered
for the Treasury Reform proposition made by the Executive. The Senate of the Republic, with
specialized help from the PAHO/WHO Representative Office in Mexico, gathered a discussion with
assessment pioneers and individuals from the correspondences media, titled "Soda drink duties:
health financial strategy", with the target of demonstrating the significance of monetary measures as
devices to lessen request and debilitate utilization of these items. This technique speaks to a suitable
reaction to the developing social and money related expenses brought about by obesity in the nation.
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Five key lessons from the Mexican experience:
1. Perhaps the greatest challenges faced by the Government of Mexico were the reaction of
the soda drinks industry, which acted much as other intrigued organizations did. The
whole business included introduced an assembled front against the tax, with noteworthy
activism in the media—TV, radio, press and promoting efforts. One of its systems was to
introduce opinion producers and clinical and nourishment experts to propel their
contentions against the tax and convince the general supposition in support of it.
Consequently, it tends to be discovered that giving very much looked into realities about
the nourishing substance of the soda drinks will empower the producers to get familiar
with their error and redress them.
2. The second challenge was the means by which to "interpret" the data produced by logical
research and national and worldwide evidence to a vocabulary justifiable to everybody
and the chiefs of the Executive and Legislative Branches. The agents were not masters in
the general wellbeing of the public, economy, or statistics; in any case, the powerfully
bolstered specialized contentions assumed a significant job in the reception of the duty.
Thus, the use of clear logical language is required to be utilized to cause the delegates to
comprehend about the issue and take aggregate measures.
3. Another challenge confronted was the means by which to legitimately reserve the
resources gathered through the tax toward explicit projects, for example, the
establishment of water fountains in schools and open spaces or the anticipation of
overweight and obesity, as Mexican financial approach generally does not accommodate
reserving of gathered assets. Subsequently, if a comparable expense is collected on us, we
would need to assign the assets to great purposes like taking care of poor people or
building homes for the destitute.

4. From the first, no government leadership was observed, which made it difficult for the
Senate to understand the requirement of the sugar tax law in the country. Hence, it could
be learned that leadership in the government is required such that it is easier for the
people to make them understand the requirement of the sugar tax.
5. It is required to deduce a budget plan that is required for the implementation of the policy
on sugar tax to be introduced for the citizens in the court of law. However, Mexico failed
to do in the initial days. Hence, it can be learned that a budget plan should be structured
such that the revenue generated after the implementation and the cost of the development
of the policy is outlined.
Three precautionary measures:
1. One of the measures to be undertaken by the government for the implementation of
the policy is the cost of the implementation for the citizens of the country.
2. The second measure required is the collective information regarding the resources that
are required for the appropriate implementation of the policy in the nation.
3. Public health and food safety are the crucial measures that are a concern of the
government for the healthy wellbeing of the nationals.
Personal reflections on the assignment experience
It is with the experience of the real-life policymaking process that has helped me in
gaining an understanding of the usage of a theoretical framework in the development of
policy intricately and its implementation procedure. As it is was proposed by Shiffman and
Smith and was adapted by W and G, the presence of various elements involved in the
policymaking procedure have been enlightening and also made me understand the
relationship among the elements with each other. In addition, it also helped me in
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understanding the application of all the various elements in the procedure of policymaking.
Hence, it is because of this that it is easier for me to identify the issues that are related to the
procedure of policymaking and also able to construct appropriate lessons for their
improvement. The political influence in the making of a policy is determined to be huge and
the rising complexities in the procedure are immense. Hence, it requires officials to ensure
that the tasks are withheld with importance with no question of risk failure. It is required of
the stakeholders to ensure that the challenges of the development procedure of policy are
needed to be carried out such that handy solutions are present. However, the influence of
formal constitutions in the decision-making process is one of the arenas which is not very
clear to me and will require collective emphasis and teaching. It was important for me to
acknowledge the factors or teachings that were a factor to influence the optimum
understanding of the policymaking and developing procedures.
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i Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2015).
Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2
diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. Bmj, 351, h3576.
https://doi.org/10.1136/bmj.h3576
ii Dong, D., Bilger, M., van Dam, R. M., & Finkelstein, E. A. (2015). Consumption of specific foods and beverages and
excess weight gain among children and adolescents. Health Affairs, 34(11), 1940-1948.
https://doi.org/10.1377/hlthaff.2015.0434
iii Keller, A., & Bucher Della Torre, S. (2015). Sugar-sweetened beverages and obesity among children and adolescents:
a review of systematic literature reviews. Childhood Obesity, 11(4), 338-346.
https://dx.doi.org/10.1089%2Fchi.2014.0117
iv Amarra, M. S. V., Khor, G. L., & Chan, P. (2016). Intake of added sugar in Malaysia: a review. Asia Pacific journal
of clinical nutrition, 25(2), 227-240. https://doi.org/10.6133/apjcn.2016.25.2.13
v Narain, A., Kwok, C. S., & Mamas, M. A. (2016). Soft drinks and sweetened beverages and the risk of cardiovascular
disease and mortality: a systematic review and meta‐analysis. International journal of clinical practice, 70(10), 791-
805. https://doi.org/10.1111/ijcp.12841
vi Pan American Health Organization. (2019). Taxes on Sugar-sweetened Beverages as a Public Health Strategy: The
Experience of Mexico [Ebook] (pp. 31-47). Retrieved 3 April 2020, from https://iris.paho.org/handle/10665.2/18391.