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Prevalence of type 2 diabetes mellitus, (adult) obesity and (child) overweight Source: Diabetes (The World Bank, 2021a); Overweight and obesity (The Global Health Observatory, 2021a,b).
Source publication
Taxes on sugar-sweetened beverage (SSBs) are recommended as part of comprehensive policy action to prevent diet-related non-communicable diseases (NCDs), but have been adopted by only one quarter of World Health Organization (WHO) Member States. This paper presents a comparative policy analysis of recent SSB taxes (2016-2019) in 16 countries. This...
Contexts in source publication
Context 1
... were 10 high-income countries (HICs) and six MICs ( Table 2). All countries had a documented burden of diet-related NCDs, including type 2 diabetes, overweight and obesity ( Figure 2). The prevalence varied across the countries, with the Eastern Mediterranean region countries having the highest prevalence of diet-related NCDs ( Figure 2). ...
Context 2
... countries had a documented burden of diet-related NCDs, including type 2 diabetes, overweight and obesity ( Figure 2). The prevalence varied across the countries, with the Eastern Mediterranean region countries having the highest prevalence of diet-related NCDs ( Figure 2). Consumption of SSBs prior to adoption of the taxes (2015) ranged from around 80 g/capita/day in Malaysia to over 400 g/capita/day in Seychelles (Figure 3). ...
Context 3
... most common mechanisms for engagement with the policy process used by government policy actors to support the taxes were information and messaging (n = 10) and constituencybuilding (n = 7) ( Table 3). There was no evident association between evidence of active government support for the tax and the proportion of health expenditure borne by government in these countries or the prevalence of related health conditions (Table 2, Figure 2). In five countries, opposition to the tax from government actors was also evident in the media. ...
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Policies to require front-of-package labels (FOPLs) on packaged foods may help Indian consumers to better identify foods high in nutrients of concern, including sugar, saturated fat, and sodium, and discourage their consumption, which are outcomes that are critical for preventing rises in diet-related non-communicable disease. The objective was to...
Citations
... It is worth mentioning that health authorities and nutrition experts often advise limiting the consumption of beverages with added sugars, including fruit juices, as they are linked to obesity, diabetes, and dental cavities (Micha et al., 2017;Pepin et al., 2019;Wan et al., 2021). Since 2017, Saudi Arabia and many countries such as Mexico, the United Kingdom, France, and Chile have implemented or considered implementing sugar taxes on sugary beverages, including fruit drinks, to address public health (Mulcahy et al., 2022). ...
Ready‐to‐drink (RTD) mango beverage enriched with short‐chain fructooligosaccharides (scFOS) was developed to reduce added sugar and incorporate a soluble prebiotic fiber. The impact of pulsed light (PL) technology on microbial inactivation, enzyme activity, and quality attributes in scFOS‐enriched mango RTD beverages was investigated. Effective PL fluence of 0.12–1.2 J/cm² was employed on mango beverage in order to maximize the retention of nutritional properties along with inactivation of microbial and enzymatic activity. There is complete inactivation of microbial load and enzymatic activity with 72.45, 84.17, 88, 78.79, and 77.63% retention of ascorbic acid, antioxidants, total phenolics, total flavonoids, and total carotenoids in 6% scFOS mango beverage at an effective fluence of 1.2 J/cm². There is no wide change in TSS, pH, and TA in all the PL treatments. The scFOS increased viscosity, and it also protected bioactives, namely, carotenoids, ascorbic acid, and phenolics, from photoxidation caused by PL. Results showed that scFOS allowed a substantial reduction in added sugar and increased soluble fiber content in the beverage. Sensory score of 3 and 6% scFOS‐enriched beverages were closely comparable with control. The study showcases the potential of scFOS to enhance the nutritional profile of beverages. It also highlights the effectiveness of PL processing in pasteurization fruit beverages, meeting stakeholders' demands for microbial safety, enzymatic stability, and nutrient retention.
Practical applications
The practical applications of this research hold significant promise for the food and beverage industry. The innovative formulations of ready‐to‐drink (RTD) mango beverages not only reduce added sugar by up to 52% but also increase fiber content from 0.6 to 6%, meeting consumer demands for healthier options. The integration of pulsed light technology effectively targets microbial and enzyme inactivation, complying with Food and Drug Administration standards and offering a viable processing method. The incorporation of short‐chain fructooligosaccharides enhances the protection of bioactive compounds during pulsed light treatment, ensuring higher retention of antioxidants, vitamins, and other valuable components. This advancement contributes to improved nutritional profiles while maintaining sensory appeal. These findings have the potential to revolutionize RTD beverage production, addressing health‐conscious consumer preferences, and enhancing product quality.
... Health policy analysis entails the examination of legislation that exerts influence, whether directly or indirectly, upon health and its multifaceted dimensions. The implementation of health policy can be undertaken within both the public and private sectors, as documented in Mulcahy et al. (2022). Policy analysis is a multidisciplinary endeavor aimed at scrutinizing the interplay among institutions, concepts, and their contributions within a political process (Browne et al., 2019). ...
Preventive policies have been devised with the aim of curbing health-related violence, and their efficacy is believed to furnish evidence for their continued implementation, thereby enhancing their effectiveness. This study undertakes a retrospective analysis of these policies in the context of Türkiye. A comprehensive examination involved the review of 26 documents, employing a progressive scanning approach for data collection. This methodology encompassed the utilization of gray literature databases (OECD iLibrary and WHO Iris), extensive Google searches, thorough website scans, and consultations with subject-matter experts. Data analysis was meticulously conducted within the framework of the Health Policy Triangle. The findings reveal active participation from diverse stakeholders, including governmental bodies, political entities, professional organizations, and trade unions, in various preventive initiatives aimed at mitigating health-related violence. Notably, the adoption of legislation for health violence prevention, perceived as a paramount achievement, can be attributed to persistent efforts by both the media and other influential actors and stakeholders. These endeavors have sustained the topic's prominence on the policy agenda, positioning it as a promising source for the development of novel violence prevention and management strategies. This study underscores the necessity for a comprehensive investigation into the working conditions, personal rights, and wage policies of healthcare workers, in light of documented factors that frequently precipitate violence. Concomitantly, it advocates for the development of effective mechanisms to address these issues.
... The results of the review analysis also identified 3 publications that used comparative studies in conducting research related to the implementation of transfers in Indonesia (Mulcahy et al., 2022;Yuda & Qomariyah, 2022). This method is carried out to analyze the comparison of the implementation of transfers between different loci but applying the same policy transfer practices. ...
... Of the 31 publications identified by the author as implementing policy transfer or policy learning, there are several publications that analyzed the implementation of The ASEAN Smart Cities Network (ASCN)which is adopted by Indonesia in the field of urban planning, Taxes on sugar-sweetened beverages (SSBs) program (Mulcahy, 2022) adopted by Indonesia through WHO and the Prime Health Program adopted from JICA (Aslinda & Guntur, 2020) in the health sector, as well as learning policies related to the Covid Task Force adopted from WHO during the last pandemic. Then the author also identified policy learning in the field of Education related to multicultural-based education adopted from the United States (Ngalimun, et al), then in the maritime field, related to policy learning regarding the management of the Exclusive Economic Zone (EEZ) from the Norwegian government, as well as related policy learning Policy Brokers in the Indonesian Biodiesel Policy Network in the energy sector (Howlett et al., 2017). ...
... In addition to several cities in Indonesia being loci for policy transfer/learning, 3 provinces are also loci for policy transfers, including Central Kalimantan (Larsen et al., 2012). Of the thirty one selected publications analyzed by the author, there are sixteen publications, where the policy transfer products are implemented in Indonesia, such as the Program Keluarga Harapan (PKH) (Larasati & Jannah, 2022), The CIM Returning Experts program (Arinda & Fathurrahman, n.d.), Bureaucratic Reform (Arwanto & Anggraini, 2020), Incentivized Policy Transfer (IPT) on asylum policy (Nethery & Gordyn, 2014), E-Voting (Tambunan., 2016), Academic Administrative Entrepreneurs (A. A. , Covid Task Force (Agustino, 2016), Management of EEZ (Asmara, 2019), policy brokers in the Indonesian biodiesel policy network (Howlett et al., 2017), Documentary Film Making Program related to Culture (Irawanto, 2017), Program integration of visas and residence permits (Maulana, 2021), Taxes on sugar-sweetened beverages (SSBs) program (Mulcahy et al., 2022), The National Economic Recovery (NER), Reducing Emissions from Deforestation and Forest Degradation (REDD+) program, and the ASEAN Smart Cities Network (ASCN) (Tan, et al, 2021). An interesting finding from the research conducted is that there are 2 publications that analyze the transfer process originating from Indonesia and then being adopted by several countries. ...
The practice of policy transfer has been known since 315 BC, but conceptually it has been increasingly discussed by policy experts in the world in the last 30 years. In the Indonesian context, the application of policy transfers has been increasingly adopted by policymakers in the last ten years or so. In practice, policy transfer is an alternative that makes it easier for policymakers to make new policies. Policy transfer facilitates learning of good policy practices from various initiating countries so as to minimize failure. The transfer process is easier to build when a network or relationship is established between the actors acting as the source of the transfer, the recipient of the transfer, or other related parties. This study analyzes the implementation of policy transfers that have occurred in Indonesia in the last ten years (2012-2022) through 4 stages of Systematic Literature Review, namely 1) Pre-SLR; 2) Identification, 3) Screening, and 4) Eligibility. There were 31 selected publications which were further analyzed based on three criteria: 1) Fields/areas where policy transfer was applied, 2) Research methods conducted, and 3) Policy transfer analysis. Topics related to the analysis of policy transfers produce 5 sub-topics that can be studied further, namely: Transfer products, Transfer Loci, Policy Actors, Forms of Transfers, and Transfer Processes
... Unlike other political processes in other countries where interministerial support was an important factor, 68-70 the MoEF is, therefore, a leading actor for health taxes in Peru. 71 In contrast, other ministries such as the MoH played a marginal role due to institutional weaknesses. Civil society engagement and reference to BMJ Global Health international agencies were also crucial in Peru, which is congruent with the literature. ...
... 68 More research on these processes could deepen whether, in these cases, we could be talking about policy transfer or policy diffusion networks. 71 75 76 The use of trade association to represent companies in the alcohol, SSBs and tobacco industries was also noted in other studies. 68 72 77 This showed the unity and strength of these sectors and made their positions readily accessible to the media and the government. ...
... 68 79 The argument advocating for health taxes as a source of revenue in Peru differs from that found in other studies. 71 Trade associations mentioned that health taxes would increase job losses, prices and informality, among other economic concerns, an argument also found elsewhere. 62 The industries also argued against health taxes for their alleged regressivity, highlighting that those most affected were actors in the supply chain, an argument also found in other countries but not backed up by scientific evidence. ...
Background
In 2016 and 2018, the Peruvian Ministry of Economy and Finance (MoEF) significantly reformulated taxes on tobacco products, alcohol and sugar-sweetened beverages (SSBs). During these processes, different actors advanced arguments supporting or opposing the taxes. This study examines Peru’s political and socioeconomic factors, the role of other actors and framing strategies, shaping health taxes introduction.
Methods
We conducted qualitative analysis by collecting information from three sources, such as: (1) media material (n=343 documents), (2) government documents (n=34) and (3) semistructured interviews (n=11). That data allowed us to identify and characterise the actors involved in implementing health taxes in Peru. We combined the data from these sources, synthesised our findings and conducted a stakeholder analysis.
Results
Key actors supporting taxes were the MoEF and civil society organisations, while trade associations and the alcohol, SSBs and tobacco industries opposed them using economic, trade-related arguments and criticised the policy process. The supporting group used arguments related to the economy and health to legitimate its narrative. The framing strategies employed by these stakeholders shaped and determined the outcome of the policy process.
Conclusion
Peruvian stakeholders against health taxes demonstrated a strong capacity to convey their messages to the media and high-level policy-makers. Despite these efforts, attempts to interfere with health taxes were unsuccessful in 2016 and 2018 and failed to overcome state institutions, particularly the MoEF. Strong institutions and individual decision-makers in Peru also contributed to the successful implementation of health taxes in Peru in 2016 and 2018.
... Addressing gap 1: intervention and system coevolution over time Many SSB tax evaluations have considered factors leading to the introduction of a tax. [13][14][15][16][17] However, SSB taxes may continue to be contested after introduction, with important consequences for health impacts. For example, promising efforts to increase the SSB tax rate in South Africa were stalled, while in the UK the SSB tax has faced repeated calls for repeal. ...
... 5 Existing research on SSB tax adoption focuses on either drivers and barriers of the adoption within countries (thereby single cases), [13][14][15] or analyses the policy failure of this tax, 16 or its legal and administrative feasibility 17 or conducts comparative analyses across countries with a view on specific drivers and barriers, such as narratives and policy learning. 18 This leaves the need for a systematic comparison of governments' decisions to adopt an SSB tax. ...
Background:
Studies confirm the positive effect of sugar-sweetened beverage (SSB) taxation on public health. However, only a few countries in Europe adopt SSB taxes. From a public policy perspective, we investigate the conditions under which countries do or do not follow this evidence.
Methods:
Crisp-set Qualitative Comparative Analysis (QCA) of 26 European Organization of Economic Cooperation and Development countries with and without an SSB tax. We test which configurations of conditions (problem pressure, governmental composition, strategic planning, health care system, public health policies, inclusion of expert advice in policymaking) emerge as relevant in determining adoption and non-adoption between the years 1981 and 2021. Pathways that lead to the presence and absence of SSB taxes are identified separately.
Results:
At least one of the following configurations of conditions is present in countries that introduced taxation: (i) high financial problem pressure, low regulatory impact assessment activity; (ii) high public health problem pressure, a contribution-financed health care system, no holistic strategy for combatting non-communicable diseases (NCDs); (iii) a tax-financed health care system, a holistic NCD strategy, high strategic and executive planning capacity. In countries that did not adopt SSB taxes, we find (i) high regulatory impact assessment activity, high levels of sugar export; (ii) no holistic NCD strategy, high spending on preventive care; (iii and iv) a lack of strategic planning capacity and either a high share of spending on preventive care or inclusion of expert advice.
Discussion:
Evidence inclusion requires clear policy priorities in terms of strategy and resources to promote public health.
... The preparation of the policy timeline uses a secondary data analysis method by identifying policies in Indonesia that regulate, in general, the excise duty on beverages containing alcohol. increasing revenue and support taxing off-premises sales (Ramirez, 2017). The rise of alcohol also reduces consumption. ...
... The rise of alcohol also reduces consumption. However, there are opponent arguments such as the increase would cost the state jobs, cross-border shopping, and substitution to cheaper forms of alcohol (Ramirez, 2017;Fogarty & Chapman, 2011 of the alcohol excise tariff policy. Therefore, an increase in excise tariff is reasonable. ...
One of WHO's recommended strategies for controlling NCDs and their risk factors is to impose health taxes. Health taxes are a successful measure in many developing countries. In Mexico, during the first two years of the implementation of the SSB tax, per capita sales of SSB dropped by 7.3%, followed by an increase in per capita sales of plain water by 5.2% (Guerrero-Romero et al., 2016). The more recent study by Vall Castelló and Lopez Casasnovas (2020) in Catalonia also found that the SSB tax has successfully reduced SSB purchases by 7.7%, with a stronger effect in areas with higher obesity incidents. Similarly, the sin tax for tobacco and alcohol has been widely proven successful in various countries. The study by Javadinasab et al. (2019) comparing the implementation of sin tax in six different countries found that sin tax could provide sustainable health financing for the respective countries. one recent survey by the Center for Social Security Studies, Universitas Indonesia (PKJS-UI) in 2018 found that as much as 66% and 74% of smokers will quit at the price of IDR 60,000 (US$ 4.2) /pack and IDR 70,000 (US$ 4.9)/pack, respectively. All these studies agreed on the importance of price as a control instrument for commodities with adverse health effects. However, Indonesia is still yet to fully adopt this recommendation.
Obesity or excessive weight gain is identified as the most important and significant risk factor in the development and progression of type 2 diabetes mellitus (DM) in all age groups. It has reached pandemic dimensions, making the treatment of obesity crucial in the prevention and management of type 2 DM worldwide. Multiple clinical studies have demonstrated that moderate and sustained weight loss can improve blood glucose levels, insulin action and reduce the need for diabetic medications. A combined approach of diet, exercise and lifestyle modifications can successfully reduce obesity and subsequently ameliorate the ill effects and deadly complications of DM. This approach also helps largely in the prevention, control and remission of DM. Obesity and DM are chronic diseases that are increasing globally, requiring new approaches to manage and prevent diabetes in obese individuals. Therefore, it is essential to understand the mechanistic link between the two and design a comprehensive approach to increase life expectancy and improve the quality of life in patients with type 2 DM and obesity. This literature review provides explicit information on the clinical definitions of obesity and type 2 DM, the incidence and prevalence of type 2 DM in obese individuals, the indispensable role of obesity in the pathophysiology of type 2 DM and their mechanistic link. It also discusses clinical studies and outlines the recent management approaches for the treatment of these associated conditions. Additionally, in vivo studies on obesity and type 2 DM are discussed here as they pave the way for more rigorous development of therapeutic approaches.
Purpose
California’s failed attempts to enact a statewide sugary beverage tax presents an opportunity to advance understanding of advocacy coalition behavior. We investigate the participation of advocacy coalitions in California’s statewide sugar-sweetened beverage (SSB) tax policy debate.
Design
Document analysis of legislative bills and newspaper articles collected in 2019.
Setting
California.
Method
A total of 11 SSB tax-related bills were introduced in California’s legislature between 2001-2018 according to the state’s legislative website. Data sources include legislative bill documents (n = 94) and newspaper articles (n = 138). Guided by the Advocacy Coalition Framework (ACF), we identify advocacy coalitions involved in California’s SSB tax debate and explore strategies and arguments used to advance each coalitions’ position.
Results
Two coalitions (public health, food/beverage industry) were involved in California’s statewide SSB tax policy debate. The public health coalition had higher member participation and referred to scientific research evidence while the industry coalition used preemption and financial resources as primary advocacy strategies. The public health coalition frequently presented messaging on the health consequences and financial benefits of SSB taxes. The industry coalition responded by focusing on the potential negative economic impact of a tax.
Conclusion
Multiple attempts to enact a statewide SSB tax in California have failed. Our findings add insight into the challenges of enacting an SSB tax considering industry interference. Results can inform future efforts to pass evidence-based nutrition policies.
Berdasarkan tantangan utama di atas, buku ini mencoba untuk menciptakan analisis
dengan beberapa tujuan, yaitu:
1. Membuat analisis kebijakan dan menarik atensi terkait kebijakan pajak kesehatan di
Indonesia
2. Mendukung dan membangun kapasitas nasional dalam hal analisis kebijakan pajak
kesehatan
3. Menciptakan kerangka, tools, dan pendekatan yang sesuai untuk analisis kebijakan
pajak kesehatan.
