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HEALA – tackling SA's obesity crisis

World Obesity Day will be observed on Tuesday 4th March this year.

How health taxes can generate much-needed revenue for social protection?

The Chew on This series finale, titled ‘How Can the Health Promotion Levy Support and Expand Social Protection?’ is now available on Healthy Living Alliance’s (HEALA) YouTube channel. 

Released ahead of South Africa’s 2025 Budget Speech, it brings into sharp focus the Health Promotion Levy (HPL) and its potential to drive social change. Evidence shows a reduction in the consumption of sugary drinks and calorie intake since the HPL’s introduction in 2018.

South Africa faces a dual burden of malnutrition, with high rates of obesity alongside stunting in children, making the Health Promotion Levy a critical tool for addressing these challenges. The episode features a panel of experts, including Professor Corné van Walbeek from the University of Cape Town, Angelika Grimbeek from HEALA, Khanyisa Mapipa from Section 27, and Baone Twala from Wits PRICELESS SA. Together, they explore how health taxes like the HPL can generate much-needed revenue to fund social protection interventions like the National School Nutrition Programme (NSNP).

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Our country faces a tsunami of health and social challenges : “South Africa has the highest prevalence of obesity in sub-Saharan Africa, yet millions of children live below the poverty line,” says ‘Chew on This’ host, Crystal Orderson. “The HPL, introduced in 2018, has already generated over R8 billion. It’s time to explore how these funds can directly impact social protection.”

One in four children in South Africa is stunted. “The NSNP provides critical support to nearly 10 million children, but this isn’t enough,” says Baone Twala from PRICELESS SA. “We must consider how the HPL can be used to improve the nutritional quality of school meals and expand the programme to early childhood centres (ECDs).”

One of the mothers interviewed for the finale said her children’s school was lucky to have a nutrition programme. “Kids get proper meals. For example, on Thursdays, they get rice, chicken, cabbage, and carrots – a real full meal. The meal servers are actually parents of some of the kids, which is great. Their salaries, the food and fuel costs, are covered by money from the Department of Education. Learning and teaching have improved so much since it started. Kids aren’t skipping school anymore because they know they’ll get a meal. It has made a huge difference for everyone.”

Another mother said feeding her children is a constant battle. “Sometimes there’s no milk, and even basics feel like luxuries. The grant money I get just doesn’t stretch far enough. My husband does piecemeal jobs, but it’s still not enough. I skip meals to make sure the kids can eat. Right now, I can’t think about what’s healthy or not. If I try to buy healthy food, we wouldn’t have enough to eat. Things like fruits and vegetables? Those are a luxury.”

What is government doing with the Health Promotion Levy?

Expanding the scope of the HPL
HEALA’s Angelika Grimbeek says that while SARS doesn’t ring-fence taxes, it should consider this approach because it guarantees funding for essential health and social services and increases public confidence in the government’s commitment to enhancing public health.

In this episode, the panel also discusses how public buy-in for the HPL could be bolstered by funds for visible and impactful programmes. In addition, the pilot expansion of the NSNP to Early Childhood Development Centres could include breakfast meals as a critical step in addressing malnutrition in younger children.

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The case for urgent action

With nearly five million children living below the poverty line, the consequences of inaction are far-reaching. These children face long-term challenges that affect every part of their lives, including slower cognitive development, poor academic performance, and fewer economic opportunities as they grow up. 

 “Increasing the levy to 20% or more and ensuring annual adjustments to counter inflation are non-negotiable steps,” says Grimbeek. “Without these measures, the levy’s effectiveness will diminish over time.” She adds that by including ultra-processed products like sugary fruit juices, often wrongly seen as healthy, the government can reduce unhealthy consumption and raise more funds for essential programmes like the NSNP.

“The health and well-being of our children are at stake,” adds Grimbeek. “With the right policies, we can build a healthier, more equitable society.”

WHAT YOU CAN DO :

 Sign the petition to protect and expand the Health Promotion Levy at Heala.org.

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