How to Approach ‘Fat-Tax’ on Food to Tackle Non-Communicable Diseases in India:A Review

Non-communicable diseases (NCDs) contributed to an estimated 61% (5.8 million) total deaths and 55% disability-adjusted life years in India in 2015. These diseases not only affect the health status of the population, but they also have social and economic implications, such as-prolonged disability and increased health-related expenditures by health systems, households, and individuals. As per recent disease burden study in India, unhealthy diet was found to be an important risk factor for NCD related mortality. Unhealthy diets, particularly those rich in fat are associated with overweight and obesity, which are an important metabolic risk factor for NCDs. Fiscal policies, such as taxation on unhealthy (fat and sugars) and subsidies on healthy (fruits and vegetables) food itemsare key population-based interventions to reduce the consumption of calorie-dense foods and address diet-related NCDs. These policies can offer both economic and health benefits. Many high-income countries, such as Hungry (packaged products with high sugar, saturated fat, and salt), Denmark (saturated fat), Finland (sweets), France (drinks with added sugar or sweeteners) and Mexico (high calorie packaged foods) have implemented health-related food taxes. Evidence from these countries suggests taxes and subsidies are effective in reducing consumption of sugary drinks and increasing the consumptions of vegetables and fruits. However, with fat taxes, a smaller effect is observed. Therefore, prior to designing a fat tax policy for India, evidence and lessons learned from other countries’ experiences must be considered. Also, the direct and indirect impact of the tax on both consumers and the food industry should be anticipated. While planning the taxation policy on fat, consumer responsiveness to the change in the price of the products that are being considered for taxation, and food industryinterests and tactics must be considered in local context. It is recommended to first have a clearly defined objective for the tax- is it for public health or economic benefits. Next step is to define the tax type and structure, followed by selecting the products to be taxed. To offset the influence of industry and to increase public and political support, earmarking the revenue from health taxes for healthcare financing or health promotion is recommended. Lastly, to tackle NCDs in India, the fat tax must be considered as one of the policy interventions and must be accompanied by other public health interventions.