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A frisbee into the long grass or a boomerang that will hit later?

I’m sticking with the theme of obesity, or population health resilience, as it continues to linger in the background of discussions about how to get out of lockdown safely, how to prevent future public health crises and the shape of that rapidly ageing term ‘the new normal’. 

I experienced a new sort of normal the other day when meeting a friend in London, the first time I’d been further than my local Tesco since late February. Half an hour before leaving home I prepared for battle: freshly-washed face mask, hand gel, contactless card, pre-paid parking. “Do I need gloves?”, I asked my wife. “Ah, good idea, she said, in case you have to touch anything on the train”. So there I go, in full body armour, in the middle of summer. “Wish me luck”, I said, sniggering at the madness of it all. I was going for a drink and a bite to eat with a mate….outside. 

My friend and I both had fish and chips and a gin and tonic. It was bliss, not because of the food and drink, but because of the great conversation and the fleeting feelings of normality. Zoom might have got us through the lockdown and will serve us well beyond, but it’s no permanent substitute for human interaction. The menu on offer – a choice between a burger and fish and chips – left me feeling a little guilty because the government wants me to watch what I eat to help me be more resilient to Covid-19 or another virus.

So far, the emerging population health resilience plan includes a ban on BOGOF (Buy-One-Get-One-Free) promotions of ‘junk food’ and end-of-aisle displays to discourage impulse purchase. Also, diet and exercise guru Joe Wicks has reportedly been discussing a planned fitness drive with the Number 10 Policy Unit. Rumours of an extension of the sugar tax beyond soft drinks triggered The Sun to relaunch its ‘Hands Off Our Grub’ campaign. The paper has rather prematurely claimed victory for the Prime Minister’s apparent decision to frisbee the idea into the long grass. The strategy is still in its formative stage, and campaigners have barely got going.

There is a remarkable amount of consensus on the need for and efficacy of sugar taxation. The UK itself, by introducing the Soft Drinks Industry Levy in 2015 was a trend-setter. Since then, 20 governments have followed, including Ireland, France, the UAE and Saudi Arabia. Past practice dictates that the EU will let Member States quietly introduce sugar taxes before declaring it is an area of the single market in urgent need of harmonisation. This then pulls the issue firmly within its remit and it can set about driving the issue from the centre. 

The World Health Organisation too is firmly behind sugar taxation and has published a handy guide to help governments structure the tax. It says that sugar taxes must be specific, i.e. levied per weight of product or amount of sugar contained. It can have single or multiple tiers, bands of sugar content each with a progressively larger tax rate. It also says that they need to be sufficiently high to drive fiscal revenue and/or behaviour change, either by making maligned products too expensive for (particularly poor) consumers or by encouraging manufacturers to remove sugar to decrease or eliminate the tax burden. 

The World Bank and International Monetary Fund are equally pro. They say that junk food, and particularly sugar, has negative externalities which are habitually compensated for via excise taxes. Incidentally, they also believe that best practice administration of excise taxes includes the mandatory use of track and trace technology to control supply chains and prevent tax avoidance.

For now, the measure may not be among the low-hanging fruit to be picked. This is more for political than ideological reasons. One of those is that the Labour Party has been calling for it and the Prime Minister won’t want to give the Opposition the pleasure of being able to claim it forced him into a u-turn. He gave footballer Marcus Rashford that pleasure recently on the issue of school meals, but would sooner cut off his right arm than concede to Sir Keir Starmer. The same goes for a ban on advertising junk food before the 9 p.m. watershed. Another reason is the obvious contradiction between subsidised dining under the ‘Eat Out to Help Out’ scheme and tax increases on food and beverages.

But the economy will recover, the population’s resilience will still need to be strengthened, and the powerful public health community will gradually dial up the volume of its campaign. I will therefore make the prudent assumption that the sugar tax issue is a boomerang that will return – but for now, affected parties have more time to prepare.

 

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