Imposition of tax on sugar-sweetened beverages (SSBs) is intended to curb non-communicable diseases (NCDs) and promote healthier population. However, years after its introduction, considerable amount has been generated as revenue but the impact has yet to be felt. Despite promises that the revenue would be used to support efforts at boosting public health, particularly, in tackling the growing burden of diabetes, obesity, and other NCDs in the country, there has been little or no evidence that the money is being used for the intended purpose. As the world marks World Diabetes Day on November 14, discussions around the Sugar-Sweetened Beverages (SSB) tax, have come to the forefront again with growing calls for stronger policy action to tackle the rising burden of diabetes and other non-communicable diseases (NCDs) writes MOYOSORE SALAMI.
In 2021, the Nigerian government introduced tax on sugar-sweetened beverages (SSBs) as part of its public health strategy to combat the surge in NCDs such as diabetes, obesity, and hypertension.
The tax was designed to serve two main purposes: reduce consumption of sugary drinks and generate revenue for health programmes promoting wellness and disease prevention.
However, more than four years later, stakeholders argue that the impact of the tax remains unclear. There is growing concern about the lack of transparency and accountability regarding how the revenues are being utilised.
Despite the commitment to channel the revenue into public health initiatives, reports revealed that there has been no visible investment in health campaigns, diabetes and obesity care as well as other programmes to prevent other chronic ailments.
Health advocacy groups have raised concerns about how the funds are being managed.
The Federal Ministry of Health has yet to release a detailed breakdown of how the sugar tax revenue is being utilised. Even more worrisome is the fact that some stakeholders, including local and international NGOs working on NCD prevention, have reported minimal communication or involvement in any programmatic use of the funds. Moreover, the biggest challenge is the fact that efforts to track how much has been generated through the tax in the last four years couldn’t yield results. Agencies that are believed to be responsible for collection, practically refused to release the data.
As the world celebrates World Diabetes Day on November 14, discussions around the Sugar-Sweetened Beverages (SSB) tax, have come to the forefront again with growing calls for stronger policy action to tackle the rising burden of diabetes and other non-communicable diseases (NCDs).
This year’s theme, ‘Diabetes and Well-being’, with a particular emphasis on “Diabetes and the Workplace,” reveals the everyday challenges faced by people living with diabetes from managing their health conditions to overcoming stigma and discrimination in work environments and the need to promote healthier lifestyles and create supportive workplaces must go hand-in-hand with policies that discourage unhealthy consumption habits, particularly excessive sugar intake.
This year’s theme also brings attention to how diabetes affects workplace productivity and employee’s well-being. People living with diabetes often face challenges balancing treatment with professional responsibilities, sometimes compounded by stigma or lack of workplace support.
According to the World Health Organisation, number of people living with diabetes rose from 200 million in 1990 to 830 million in 2022. “Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries,” the organisation said.
Since 2000, mortality rates from diabetes have been increasing. By contrast, the probability of dying from any one of the four main noncommunicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases or diabetes) between the ages of 30 and 70 decreased by 20 per cent globally between 2000 and 2019.
While noting that more than half of people living with diabetes did not take medication for their diabetes in 2022, it said diabetes treatment coverage was lowest in low and middle-income countries.
It stated that diabetes causes blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2021, diabetes was the direct cause of 1.6 million deaths and 47 per cent of all deaths due to diabetes occurred before the age of 70 years.
Another 530,000 kidney disease deaths were caused by diabetes, and high blood glucose causes around 11 per cent of cardiovascular deaths.
In 2022, 14 per cent of adults aged 18 years and older were living with diabetes, an increase from 7 per cent in 1990. More than half (59 per cent) of adults aged 30 years and over living with diabetes were not taking medication for their diabetes in 2022.
According to WHO Regional Director for Africa, Dr Mohamed Janabi, “Africa is facing an unprecedented rise in diabetes, driven by a complex interplay of changing lifestyles, rising overweight and obesity, and limited access to preventive and primary health services. The scale and speed of this trend demand urgent and sustained action.”
He said further: “Diabetes spares no one. It affects children, adolescents, adults and older people, with each life stage presenting distinct challenges that require tailored responses. The theme recognises that prevention and care must extend across the entire life course.
“In the WHO African Region, more than 24 million adults aged between 20 and 79 are living with diabetes. This number is projected to be more than double, to 60 million, by 2050. Nearly half remain undiagnosed, silently facing escalating risks of severe complications, disability and premature death. Over time, diabetes can damage the heart, kidneys, eyes and nerves, profoundly affecting individuals, families and communities.
“Unless reversed, this trajectory will overwhelm health systems, strain economies and erode hard-won development gains.
“Health systems must therefore be resilient, adequately resourced and organized to deliver continuous care: from prevention and early diagnosis to effective treatment and life-long support.”
In 2024, African member states endorsed the Framework for the Implementation of the Global Diabetes Compact in Africa, reaffirming their commitment to equitable and comprehensive care. Guided by this framework, countries such as Ghana and Uganda are integrating diabetes and cardiovascular services into primary health care.
“As I often say, we can prevent progression to full-blown diabetes, with vascular complications, if we detect it at insulin-resistance stage. We have a window of up to 15 years to control diabetes. Regular exercise, healthy eating and appropriate medication can slow progression, and make living with diabetes far more manageable.”
Recent data from the National Institute of Health (NIH) revealed that overall prevalence of diabetes mellitus (DM) in Nigeria stands at 5.77 per cent with significant regional variations from 3.0 per cent in the North-West to 9.8 per cent in the South-South, the highest in the country.
Key risk factors include urban living, 6.0 per cent; unhealthy diets, 8.0 per cent; physical inactivity, 4.8 per cent; obesity, 5.3 per cent; and family history diabetes, 4.6 per cent.
Similarly, a report by Our World in Data indicates Nigeria’s diabetes prevalence at 3.6 per cent ranking the nation 37th highest in Africa.
According to a report by the Centre for the Study of Economies of Africa (CSEA), Nigeria ranks fourth globally in sugar-sweetened beverage consumption, with beverage makers selling approximately 38.6 million litres annually.
The CSEA report also warned that further punitive measures, such as higher SSB taxes, could cause health risks and raise treatment costs.
Despite this, the Nigerian government has continued to justify the tax as a means to reduce sugary drink consumption and generate revenue to tackle the health-related consequences, especially chronic diseases.
But there is little evidence to show that the revenue generated from the tax is being used to fund public health programmes as originally designed.
Globally, there has been increasing recognition of the link between excessive sugar intake and poor health outcomes. Nigeria’s move is in line with global efforts to curtail these public health issues.
According to the WHO, the safe limit for sugar consumption is about 25 grams, approximately six teaspoons per day for an adult. But in Nigeria, per capita sugar consumption is roughly eight kilograms per year which translates to about 21 grams per day.
The Gross Domestic Product (GDP) is expected to generate N729 billion yearly from the SSB tax on carbonate drinks, representing an increase of 972 per cent based on the current price of N500 per litre bottle of such drinks in the country. The Corporate Accountability and Public Participation Africa (CAPPA) lamented that the revenue from the sugar tax is not being earmarked for its intended purpose, which is to combat NCDs.
Studies have shown that nearly 30 per cent of yearly deaths are due to NCDs, most of which are primarily linked to unhealthy diets resulting from SSB consumption.
Healthy Food policy manager, CAPPA, Abayomi Sarunmi, noted that there is a need for significant increase in the SSB tax, with the current structure falling short of its intended public health objectives.
According to him, the existing tax structure is inadequate and is being undermined by industry opposition.
He commended the introduction of the tax but said its current form falls short of international standards and domestic expectations. “Our organisation believes that the tax has not served the intended public health goals and this is why we have sustained our advocacy for an increase in the tax to meet global best practices. This advocacy is based on evidence around the world, with the WHO advising countries to have the tax rate at least 20 percent of retail prices or 50 per cent as advised by the Bloomberg advisory on health taxes,” Sarunmi said.
He identified one major challenge as the pressure from beverages manufacturers who are aggressively lobbying against the tax, claiming it could damage the economy.
“Beyond the tax structure, the tax has not achieved its public health objectives because of industry’s attack on it. We have seen that play out recently with manufacturers of these unhealthy products blackmailing and threatening the government with economic collapse while also advancing the aggressive promotion of the products.”
Sarunmi also noted that the legislation does not earmark tax revenues for health initiatives, which weakens the tax’s impact.
He pointed out that the current structures take the tax revenue directly to the government’s general purse, rather than allocating it for health purposes.
According to him, the CAPPA’s advocacy has been backed by extensive stakeholder’s engagement across the country, including regional meetings, community town halls and national conferences, which have addressed various interlinked policy gaps.
Sarunmi emphasised the need for the increase in tax to be complemented by government-led public sensitisation on the benefits of the policy. He called on the Nigerian Customs Service (NCS) to publicly disclose how much revenue has been generated and to provide details on tax compliance, exposing the defaulting companies.
According to him, CAPPA expects either the creation of a dedicated account for the revenue or the establishment of a legal framework to earmark the funds specifically for health purposes.
He also called for adoption of complementary policies such as marketing restrictions, ban on influencer endorsements of unhealthy products, and the implementation of mandatory front of pack warning labels.
The measures would help reduce the consumption of SSBs and other unhealthy diets, thereby contributing to better national health outcomes and increased productivity.
Sarunmi said raising the SSB tax to a minimum of 20 per cent of the retail price would ensure that the revenue is earmarked for tackling public health issues, especially non-communicable diseases.
He warned against the powerful influence of misleading advertisements, which present these products as luxurious or as having special powers especially when targeted at children, young adults and other vulnerable groups.
He expressed worry that while many Nigerians recognise that excessive intake of sugar is harmful, they often do not realise how much sugar they consume through sugary drinks or how these drinks are linked to serious health conditions.
He urged the government to intensify public awareness efforts and implement stronger public health policies to protect both the health of Nigerians and the country’s long term economic stability.
The Transparency Gap
A Co-Chair of the National Action on Sugar Reduction Coalition and Vice President of the Diabetes Association of Nigeria, Enyia Bernard, said there is no evidence that funds collected through the tax have been used to tackle non-communicable diseases as initially intended.
According to him, the N10 per litre tax approved under the Finance Act in December 2021 and implemented by the Nigeria Customs Service in June 2022 was expected to support medical interventions targeting diseases such as diabetes and hypertension.
Civil society organisations and health stakeholders have not received any official information about how much has been collected, in which account the funds are kept, and how they are being utilised.
Bernard revealed that in February 2023, the coalition received reports from the Federal Ministry of Finance, indicating that the tax deductions had been suspended to stabilise the economy.
He told The Guardian that he, alongside other members of the coalition, met with government officials in Abuja to verify the claims and was told that the suspension would last six months.
There has been no follow-up communication since the suspension period elapsed, leaving stakeholders in the dark.
Bernard also criticised what he described as the government’s lack of coordination, stating that despite the removal of tariffs and VAT on pharmaceutical ingredients to boost local drug production, prices of medicines have remained high.
He accused the government of failure to provide other necessary support such as consistent power supply, skilled manpower, and modern equipment for local manufacturers.
He pointed out that following lack of proper legislation directing the sugar tax revenue toward NCD interventions, some government agencies, including the National Health Insurance Authority (NHIA), have begun competing for control of the funds. He canvassed that the Federal Ministry of Health, as the lead health agency, should manage and allocate the money to lower the cost of caring for people living with NCDs.
To improve transparency and ensure the funds fulfill their original purpose, he recommended setting up of an independent monitoring and evaluation committee with representatives from civil society, non-state actors, and other relevant government ministries who would oversee the collection, remittance, and disbursement of the funds.
Bernard noted that a similar model was used in the national response to the HIV/AIDS, which led to the creation of the National Agency for the Control of AIDS (NACA).
He advised that a similar structure be put in place for NCDs without the need for major additional spending, since the required technical expertise and operational frameworks already exist within the Ministry of Health.
Bernard warned that unless reforms are implemented, the burden of NCDs will continue to grow, especially among vulnerable populations who cannot afford care. He called for urgent government action to ensure that revenue generated from the sugar tax genuinely benefits the health sector and those affected by lifestyle-related illnesses.
A Policy With No Impact
FOR Nigerians, the situation is becoming increasingly frustrating. While the tax on sugary drinks has resulted in higher prices at local stores, it has failed to deliver any noticeable improvement in health outcomes. In Lagos, the country’s commercial hub, consumption of sugary beverages remains high despite the increased cost, suggesting that the price hike is not enough to deter consumption. More concerning is the fact that there is no evidence of a corresponding drop in the cases of diabetes or obesity.
The consequences of failing to address NCDs in Nigeria are dire. The country’s healthcare facilities, already under significant pressure from diseases such as malaria and tuberculosis, are also ill-equipped to handle the growing burden of chronic diseases.
According to the WHO, NCDs are responsible for more than 30 per cent of deaths in Nigeria, a figure that is expected to rise in the coming years.
Diabetes, for example, has become a major health crisis, with millions of Nigerians at risk due to poor dietary habits, lack of awareness, and limited access to affordable treatment.
In rural areas, where health services are scarce, individuals with diabetes often go undiagnosed until their condition has worsened, leading to costly and preventable hospitalisation or even death.
The lack of investment in public health programmes with the revenue from the sugar tax is seen as a lost opportunity to reverse these trends, and without a clear funding for diabetes care, preventive screenings, and health education, the country risks worsening the health crisis caused by NCDs.
The Head of Corporate Affairs at Rite Foods, Ekuma Eze, said the company had taken steps to align with global health trends by offering zero-sugar alternatives.
Speaking on the conversation about the sugar tax and its impact on public health, he said blaming sugary drinks for Nigeria’s NCDs was misleading without considering broader dietary habits.
He noted that Nigeria’s per capita consumption of sugar as of 2023 was just 7.1 grams, significantly below the WHO’s recommended average of 9 grams.
This, he argued, challenges the narrative that sugary drinks are responsible for the country’s rising cases of obesity, diabetes and other NCDs. To him, the country tends to demonise sugar, which oversimplifies the problem.
Eze further argued that the claims linking carbonated soft drinks to non-communicable diseases (NCDs) are misleading, stating that it is inaccurate to isolate one product category as the root cause of any particular health issue. He rolled out data indicating that only 1.4 percent of household expenditure in Nigeria goes to carbonated soft drinks, compared to over 56 per cent spent on other food items, many of which are high in carbohydrates. Eze, who stressed that carbohydrates are also sugars, questioned why the focus remains solely on beverages.
While acknowledging the importance of addressing public health concerns, he explained that the food and beverage sector is one of Nigeria’s largest industries, accounting for over 33 per cent of the country’s entire manufacturing output. He said that policies which harm this sector could have unintended consequences on jobs and revenue.
“Look at Ireland. Between 2005 and 2020, the youth population reduced their sugar consumption from beverages by 60 per cent, yet obesity rates still rose from 18 per cent to 24 per cent.
“Similarly, in the United Kingdom, despite a 30 per cent drop in sugary drink sales between 2016 and 2021, sugar consumption and obesity rates continued to increase. These examples show that focusing on one product isn’t the solution.
“If you mislead people with wrong data and sentiments and cause this sector to collapse, how do you provide the jobs and revenue that the government relies on? The manufacturing sector, particularly food and beverage, creates millions of jobs directly and across the value chain. That is something we must consider,” Eze said.
He called for a more comprehensive approach to addressing NCDs, one that goes beyond targeting a single product, adding that policies should focus on the full range of dietary habits and lifestyle factors contributing to health outcomes. He commended the current administration led by President Bola Ahmed Tinubu for what he described as a balanced and listening approach to policy making.
On his part, a medical doctor with Spectre NG Healthcare, Edikan Ubak, told The Guardian that effectiveness of the proposed increase in SSB tax alone might not significantly reduce consumption or the growing burden of non-communicable diseases in Nigeria.
On the suggestion by CAPPA that the SSB tax be raised from N10 to N130 per litre, he said that while the move could generate more government revenue, its impact on reducing sugar intake among Nigerians remained doubtful.
“The increase in tax may not curb SSB intake. People are very resilient. A bottle of carbonated drink already costs around N400 to N500. If that goes up to N600, an average Nigerian may still choose a soft drink and bread, spending about N1,000 over a proper meal that could cost N2,000 or more. That’s a high-calorie diet, but many people don’t understand what a balanced meal or calorie intake really means,” Ubak said.
He noted that the average Nigerian lacks adequate knowledge of nutrition and calorie management, which is crucial in the fight against non-communicable diseases such as diabetes, hypertension, and obesity. Health education is paramount when we talk about disease management. Dr. Ubak also noted that while SSBs are a known risk factor for NCDs and can worsen disease progression, public awareness and preventive care strategies remain insufficient.
He called on beverage manufacturers to collaborate with healthcare professionals on public sensitisation campaigns. “These companies should work with health experts to educate the public on the risks of NCDs, healthy eating habits, and calorie management. Such collaborations could have a greater impact than taxation alone.”
On the issue of transparency, Ubak pointed out that the public has not seen clear evidence that revenue from the current SSB tax is being channeled into health programmes.
“These revenues usually go to the Federal Inland Revenue Service and are lumped into the national budget. We’ll only know if the tax is making a difference when we see a notable increase in the healthcare budget.”
