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SA Canegrowers believe improving health requires holistic approach

Andrew Russell

This article appeared in the Daily Maverick on November 8, 2022

https://www.dailymaverick.co.za/opinionista/2022-11-08-sa-canegrowers-believe-improving-health-requires-holistic-approach/

Improving health outcomes in South Africa requires a holistic approach to the causes of obesity including the overconsumption of calories, food poverty, high-carbohydrate diets, physical inactivity, psychological factors, and underlying medical conditions.

On 22 September 2022, Daily Maverick published a response to my opinion on the Health Promotion Levy (HPL) that was authored by Mikateko Mafuyeka and Petronell Kruger.

Given what is at stake in this policy debate, namely the survival of one million livelihoods dependent on the sugar industry, some of the more problematic arguments contained in their reply cannot go unanswered. 

It’s worth reminding ourselves of government’s stated purpose for introducing the HPL, which is to reduce obesity and its related diseases. SA Canegrowers does not dispute the assertion that the HPL could well have led to a reduction in the consumption of sugar-sweetened beverages.

But the unanswered question is, has that led to a decrease in obesity levels? Even the research linked by the authors notes that only focusing on the consumption of certain products cannot provide an accurate picture overall: “…for the population studied, targeting individual components of the diet in isolation may not be enough to improve overall diet quality and associated health outcomes such as obesity”. 

This is the heart of SA Canegrowers’ argument against the HPL. Improving health outcomes in South Africa – and elsewhere – requires a holistic approach to the causes of obesity including the overconsumption of calories, food poverty, high-carbohydrate diets, physical inactivity, psychological factors, and underlying medical conditions.

Contrary to the sugar industry scapegoating the HPL, it is proponents of the HPL that have used sugar as a scapegoat for the many social problems, including poverty and inequality, that limit South Africans’ access to a well-rounded, nutritious diet.

Increasing the tax and extending it to fruit juice and other sugar products is a lazy and destructive approach to a complex problem.

In response to this argument, the authors point to the tactics of the tobacco industry using deceptive commissioned studies. But this is not applicable in this situation for two reasons.  

First, SA Canegrowers has primarily pointed to research of the economic impact of the HPL. The Bureau for Food and Agricultural Policy is a well-respected institution that has, in its modelling for SA Canegrowers, made no medical or health claims about the HPL. What they have provided is an analysis of its profoundly negative economic impact, and this has been confirmed by separate research commissioned by the National Economic Development and Labour Council. 

More importantly, we can understand the authors’ distrust of industry-funded research as much as we would be sceptical of the biases of pro-HPL researchers. This is why SA Canegrowers has continuously called for government, as a neutral arbiter, to conduct research into the effectiveness of the HPL. We have also called on the Department of Health to conduct a national dietary intake study to gain a holistic picture of the causes of obesity in South Africa instead of unreasonably singling out sugar-sweetened beverages. 

The Health Promotion Levy has been in place since 2018. Valuable time has been lost in which we should have been doing this vital work. Moreover, the Sugarcane Value Chain Master Plan includes a tax policy review based on which we have repeatedly called for the necessary research to be conducted. Sadly, this has still not been forthcoming. But, if we suspend the HPL, we can buy ourselves the time to do this crucial groundwork. 

There may well be “few policies that are good for business, good for health and good for government”, as stated by the authors.  

However, SA Canegrowers believes that we can craft precisely such a policy if there is the will to work together. The association has worked successfully with government and industry stakeholders to craft and implement the Sugarcane Value Chain Master Plan, and we can do it again in order to tackle the country’s health challenges. Industry in fact has a vital role to play since earning a living is central to wellbeing, and the sugar industry supports one million livelihoods, which are currently at risk because of the HPL. 

The authors level two more charges at the industry that cannot go unchallenged. 

The idea that the sugar industry is “subsidising its internal fraud” is outrageous and an insult to the growers, farmworkers, and other industry participants throughout the industry value chain who work hard daily to put food on the table and create opportunities for other South Africans. Citing one example of suspected fraud implicating people associated with one miller cannot justify incriminating the entire industry and shows no regard for the real people who are faced with the devastating consequences of this policy. 

It is also important to note that the failure to pivot to biofuels cannot be laid at the door of South Africa’s canegrowers. SA Canegrowers in particular has been very active in pushing for progress in this regard, working with international organisations to demonstrate the viability of this exciting opportunity for the country and is also convenor of the Master Plan task team charged with driving this issue.

To grow this industry sustainably, we cannot take shortcuts.

We must lay the groundwork including the completion of rigorous feasibility studies. This work is under way, and few stakeholders are more committed than the industry to seeing it through to completion. 

In the meantime, we are faced with the current reality of a low-growth South African economy with a high unemployment rate during a tumultuous period in the global economy. Pro-HPL lobbyists can ignore the research if they please, but that doesn’t change the fact the HPL if maintained, will cost more than 21,000 jobs over the next 10 years – in addition to the 16,000 already lost. Increasing the HPL will have even greater catastrophic consequences for South African workers in rural economies that can least afford to shed jobs.  

The tragedy of this conflict is compounded by the knowledge that health advocates and the industry do not have to be opponents. SA Canegrowers, for its part, maintains the call it has always advanced: for all the stakeholders affected by the HPL to work together to craft a holistic, economically viable, evidence-based approach to ensuring the health of all South Africans. DM

ANDREW RUSSELL – CHAIRMAN SA CANEGROWERS
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