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South Africa faces interrelated burdens of disease resulting from a mixture of communicable diseases such as HIV/AIDS and tuberculosis as well as non-communicable diseases such as type 2 diabetes, obesity, hypertension, cardiovascular diseases and cancers. Prevalence rates of obesity and type 2 diabetes are especially high among women. In 2010, approximately 9% of men and 11.8% of women in South Africa had diabetes, a nearly twofold increase since 1980. Approximately 90% of this group suffers from type 2 diabetes mellitus, of which 60.1% is estimated to be unscreened and undiagnosed.

Implemented Policies

Health Promotion Levy | Implemented April 1, 2018

Tax on sugary drinks | Implemented October, 2014

For all non-alcoholic beverages and beverage concentrates, manufacturers & distributors taxed:

  • R0.021 ($0.0014 USD) per gram sugar in excess of 4 g/100 mL.
  • If sugar is not labeled, product taxed at default rate based on containing 20 g sugar/100mL (R0.336/100 mL or $0.023 USD).

Exempt: 100% juice, dairy beverages

Developing Policies

Front-of-package warning label

Developing policy: after conducting focus groups to test and determine the most effect shape, color, and style for the proposed warning labels, the research team in South Africa is conducting a randomized controlled trial to test the warning label alongside a traffic light label and Guideline Daily Amounts label. This experiment is being led by Rina Stewart as part of a Department of Health task force.

Research Partners

PRICELESS SA (Priority Cost Effective Lessons for System Strengthening South Africa)

Wits School of Public Health, University of the Witwatersrand, Johannesburg

Community and Health Sciences, University of the Western Cape

Research Team

Priceless SAPRICELESS team

Karen Hofman, MD
Susan Goldstein
Ijeoma Edoka
Nicholas Stacey
UWC South Africa

UWC team

Rina Swart, PhD
Tamryn Jenkings


Our Evaluations

We are evaluating whether and to what extent the HPL might be associated with changes in:

  • Knowledge of the health outcomes associated with sugary drinks and attitudes and perceptions of sugary drinks among young adults in Langa township (Western Cape)
  • Beverage intake among young adults in Langa township (Western Cape)
  • Prices of taxable beverages before and after HPL implementation
  • Purchases of taxable beverages before and after HPL implementation
  • Media coverage and framing of the HPL
  • Sugar and energy content of beverages available before and after HPL implementation
  • Employment trends before and after HPL evaluation


Stacey N, C Mudara, SW Ng; C van Walbeek, K Hofman, I Edoka. 2019. Sugar-Based Beverage Taxes and Beverage Prices: Evidence from South Africa’s Health Promotion Levy. Social Science and Medicine 238: 112465