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FEATURE STORY December 9, 2021

Taxes to Tackle Obesity in Tonga

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STORY HIGHLIGHTS

  • Tonga has some of the highest rates of death from non-communicable diseases in the Pacific, and the world.
  • New modelling, supported by the World Bank, is helping the Government of Tonga better understand the amount of fat, sugar and salt being consumed across the country.
  • Using this modelling, Tonga is now implementing taxes on many of these products, with increased prices for unhealthy foods now driving down consumption of unhealthy foods, while generating additional revenue for Tonga.

Fat. Salt. Sugar. They are loved ingredients in countless meals served across the Pacific, every day. They enhance flavours and provide energy. But excess consumption is hurting Pacific islanders, their families, and their communities. High consumption of fat, salt, and sugar are major causes of non-communicable diseases (NCDs) – including heart disease, stroke, diabetes and cancer; which are affecting Pacific people at alarming rates. In fact, NCDs are the main cause of premature disability and death in the Pacific, with the region’s Leaders declaring an ‘NCD crisis’.

NCDs place a huge burden on Pacific health care systems that struggle to provide adequate services. There is also a significant economic burden with NCD-related chronic sickness and disability impacting the economies of many countries. In response, governments have been promoting policies designed to address major risk factors including unhealthy diets.

NCDs in Tonga

NCDs account for 83% of all deaths in Tonga[1], with the Tongan Government now implementing its NCD Strategy and Action Plan that aim to make healthier options like fish more available, while applying diet-related taxes to reduce the consumption of particularly unhealthy products like mutton flaps, turkey tails, and sugary drinks. Building on the findings of a World Bank report the taxes have proved successful in driving product prices higher, helping to reduce their consumption while also delivering an increase in government revenue.

Keen to build on this initiative, the Tongan Government were however challenged by a shortage of information about the nutrients; particularly the levels of fat, salt and sugar found in everyday foods, making it difficult to decide on a new range of food and drinks to target. To tackle the problem, the government sought the World Bank’s support to develop ‘nutrient profile models’ that could guide the design and implementation of a new tax policy.

“Nutrient profile models classify foods according to their nutritional composition, and provide thresholds on the unhealthy levels of fat, salt, and sugar in different food groups,” says Sutayut Osornprasop, World Bank Senior Health Specialist who co-authored the Nutrient Profile Model report. “Using the models, it’s possible to work out what which foods represent healthier options, and which are unhealthy.”

 


"Our analysis confirmed that, per capita, Tongans are consuming unhealthy levels of fat, salt, and sugar, with salt and sugar being of most concern."
Sutayut Osornprasop
World Bank Senior Health Specialist

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To keep within national and international guidelines for healthy eating, the report recommends a reduction of total fat intake of 15 percent per day, a reduction of salt intake of 63 percent per day, and a reduction of sugar intake of 40 percent per day. The report also recommends targeting discretionary food and drinks with stricter thresholds (for example; ultra-processed snack foods and ice cream), given how much these foods are currently being eaten.

 

Applying big lessons to save lives

The nutrient profiling is already being applied to the Tongan Government’s tax policy. It is also helping to inform front-of-pack labelling for packaged foods, and providing the evidence needed to inform Tonga’s action plans for changing behaviors to reduce obesity.

Tonga’s government sees the potential for this work to go even further; with profiling providing an opportunity for schools to prepare guidelines for healthy eating, and for placing restrictions on the availability of unhealthy foods being marketed towards children.

“Tackling NCDs is a complex problem that requires innovative solutions from all corners of the community. The Nutrient Profile Model report has been very useful for us and helped us apply scientifically-verified nutritional evidence to our taxation policy and beyond,” acknowledges Kelemete Vahe, Chief Executive Officer of Tonga’s Ministry of Revenue and Customs. “It is informing an effective way of promoting healthier eating habits for all Tongans.”

This work was supported by the Government of Japan, through the Japan Trust Fund for Scaling Up Nutrition, the Australian Government (DFAT), New Zealand Government (MFAT), together with the Food & Agriculture Organisation (FAO) and World Health Organization (WHO).

 

[1] World Health Organisation (WHO) Progress Monitor 2020 Report


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