Business Lobby Letter

1 BuReducing Obesity and Improving Public Health: The Case for a Tax on Sugar- Sweetened Beverages" By (Name) Course Professor Affiliation City\State Date

2 Name and background of your client: The Australian Medical Association (AMA) In Australia, physicians are represented primarily by the Australian Medical Association (AMA). Fishbein (2019) highlights that AMA's vital role is advancing the interests of both medical practitioners and communities. The American Medical Association (AMA) began as a collection of meetings in 1858. According to Fishbein (2019), the Association was formed after adopting a code of ethics based on the America Medical Association. Despite a positive beginning, the Association was ultimately wound up in 1868 due to declining numbers. In 1912, the BMA's agreement led to the formation of the Australian branch. Establishing an Australian Council in 1933, it marked a significant development. Having been entrusted with such authority, this Council could effectively act on behalf of state groups. State groups retained partial control, hindering the Council's autonomy. In England, BMA approval delays processes, requiring some decisions to be pre-authorized. 1937 saw the decision to form an independent national organization, and thus the investigation began. After years of effort, the AMA registration came through in 1962 and AMA was finally registered. The issue(s) you are addressing To combat growing obesity rates in Australia, the Australian Medical Association (AMA) is pushing for a tax on sugar-sweetened drinks. To combat growing obesity rates in Australia, the Australian Medical Association (AMA) is pushing for a tax on sugar-sweetened drinks. There are already taxes on sweetened beverages in 45 different nations, towns, and areas throughout the world. The American Medical Association suggests a tax of 40 cents per 100 grams of sugar added to beverages. This would produce up to $814 million per year, which could be used for health promotion initiatives (Butler, 2021). The WHO (2017) found that a 20% price increase for sugary drinks result to a decrease in consumption. Mexico, the United Kingdom, Spain, France, South Africa, India, and Morocco are just some of the at least 54 nations that have implemented a levy on sugary beverages. A tax on these drinks could result in substantial gains in revenue, public health, income, and long-term healthcare costs. The historical background of the issue:

4 health and well-being of our community depend on your support for this policy, and we respectfully request your involvement. B. The Effectiveness of a Sugar-Sweetened Beverage Tax The success of taxes in reducing consumption and enhancing public health has been evident in countries that have adopted these measures. By implementing the tax on sugary drinks, a healthier lifestyle was proactively promoted. The tax implementation in Mexico led to a considerable decrease in sugary drink sales, with an estimated volume decrease of 7.6%, according to Andreyeva et al. (2022). In 2018, a tax on sugary drinks was implemented in the United Kingdom. A study published in 2022 found that the tax resulted in a remarkable reduction in both the sugar content and individual consumption of sugar-sweetened beverages (Andreyeva et al.). Furthermore, the tax encouraged beverage manufacturers to reformulate their products to lessen their sugar content Evidence from foreign countries, like France, Spain, and the Philippines, underscores the success of sugar-sweetened beverage taxes. Following a review of studies in different income categories, we found that taxes on sugary drinks are connected to lower intake and lower rates of overweight and obesity. According to the World Health Organization (2022), at least 85 countries have implemented taxes on sugary drinks. The findings underscore the effectiveness of taxation in reducing consumption and promoting public health through sugary drinks. The data suggests that these taxes reduce the demand for sugary beverages, prompting manufacturers to lower the sugar content of their goods, and increase interest in healthy options. C. The Economic Benefits of a Sugar-Sweetened Beverage Tax We continue to advocate for a tax on SSBs as a means of reducing Australia's alarmingly high obesity rate, and we believe it is important to highlight the substantial economic advantages that such a tax may offer. Due to their high consumption rates, sugar-sweetened beverage taxes have the potential to produce substantial sums of money in Australia. At a rate of 4 cents per 100 grams of sugar added to beverages, the proposed tax has the potential to generate substantial yearly income. There is statistical evidence to suggest that levying a tax on sugary drinks might provide substantial revenues that could be utilized to support public health programs. In the United States, for instance, municipal excise taxes on sugary drinks brought in an annual income of $133.9 million (Krieger et al., 2021). If sugary drinks were taxed at a rate of 1 cent per ounce across the nation, the government would generate $14.9 billion in the first year (Brownell 2019). (Brownell 2019). Revenue generated from sugary beverage taxes can be used to support programs aimed at improving child nutrition or combating obesity, as well as providing healthcare for the uninsured or bolstering overall budgetary needs. Moreover, the revenue could be directed towards programs that improve access to nutritious food and foster healthy growth in young children. As reported by Andreyeva et al. (2022), countries like Mexico, the UK, and South Africa have seen

5 revenue for public health initiatives through taxes on sugary beverages. The WHO (2022) reports a significant revenue increase of approximately US$1.4 trillion through a 50% tax hike on SSBs. By levying a tax on sugar-sweetened beverages, a substantial amount of revenue can be generated, which can then be used to support public health efforts and enhance the general well- being of the populace. then be used to support public health efforts and enhance the general well- being of the populace. III. Counter-Arguments and Rebuttals A. The Beverage Industry's Opposition to a Sugar-Sweetened Beverage Tax We are aware that the proposed tax on SSBs has caused some alarm, especially in the beverage sector. These issues must be addressed, and a balanced view of the situation must be presented. The sector claims that this tax would disproportionately affect those with lower incomes. However, empirical evidence and data disprove these statements. According to one research based on Nielsen consumption data, for every 1% rise in income, consumers spend 0.01 % less on sugary beverages, indicating a regressive spending trend (Ross and Lozano, 2018). Another study examined the effects of the tax in Tonga and found that people bought less soft drinks and more bottled water as a result of the tax, with lower income households seeing even greater reductions in soft drink spending (Teng et al., 2021). Low-income customers are an important group for whom to evaluate the SSB tax's potential revenue. As previously discussed a significant amount of the money made may go toward funding health education and awareness initiatives, lowering the cost of nutritious food, and bolstering healthcare systems. These initiatives can help alleviate the tax's regressive effects by offering targeted support to those who require it most. To tackle regressivity, we must investigate alternative revenue streams, such as taxing beverages according to their sugar content through a tiered system (Ross & Lozano, 2018). This approach ensures the tax burden correlates with the health risks of each beverage. While the beverage sector presents a convincing argument regarding the tax's regressive nature, it is crucial to assess the policy's long-term effects on public health and its potential to alleviate the unequal health burden on low-income populations. B. The Effectiveness of a Sugar-Sweetened Beverage Tax Some have questioned whether the planned tax on SSBs would really be helpful in lowering sugar intake. There are many who believe the levy will not achieve its stated goal because customers would just absorb the higher prices or go elsewhere for their sugary needs. Despite the validity of these worries, an abundance of data suggests that SSB levies are an excellent method for reducing sugar intake and enhancing public health. The compelling evidence supporting the efficacy of sugar-sweetened beverage (SSB) taxes stems from the successful implementation and outcomes seen in several nations. As an example,

7 suggests that SSBs play a crucial role in this global crisis by contributing to widespread health concerns due to their high sugar content. Furthermore, we have demonstrated how the proposed SSB tax might fundamentally alter both our economy and public health. It has the potential to provide a sizeable yearly income, up to $814 million, which might be wisely spent in public health programmes. These programmes may include advertisements promoting healthier foods, financial assistance for physical exercise programmes, and easier access to healthcare services. Such expenditures would address health inequities, boost low-income areas, and lessen the economic and health impact of obesity. We strongly encourage the Australian government to act swiftly and decisively in light of the overwhelming evidence and the effectiveness of SSB taxes in other nations. It is time to put the health of our people first and take decisive action to reduce excessive sugar intake. We urge the government to adopt the recommendations in our submission and impose a tax on drinks with added sugar in Australia. This programme is a crucial and effective step that may promote public health, lower obesity rates, and improve the standard of living for all Australians Our country's health and future are at stake. References Fishbein, M., 2019. History of the American Medical Association. Journal of the American Medical Association , 133 (12), pp.836-849. Jin, C., Tooth, L.R., Xu, X. and Mishra, G.D., 2023. Is being childless associated with a woman’s risk of overweight and obesity? Results from a national longitudinal study. International Journal of Obesity , pp.1-7. Falbe, J., 2020. The ethics of excise taxes on sugar-sweetened beverages. Physiology & behavior , 225 , p.113105. Josh Butler., 2021. Doctors warn Australia risks being ‘odd one out’ if it resists sugar tax on soft drinks. The Guardian https://www.theguardian.com/australia-news/2023/jan/20/doctors-warn- australia-risks-being-odd-one-out-if-it-resists-sugar-tax-on-soft-drinks World Health Organisation (WHO)., 2017. Taxes on sugary drinks: Why do it? https://apps.who.int/iris/bitstream/handle/10665/260253/WHO-NMH-PND-16.5Rev.1-eng.pdf Dineen-Griffin, S., Garcia-Cardenas, V., Rogers, K., Williams, K., & Benrimoj, S. I. 2019. Evaluation of a Collaborative Protocolized Approach by Community Pharmacists and General Medical Practitioners for an Australian Minor Ailments Scheme: Protocol for a Cluster Randomized Controlled Trial. JMIR research protocols , 8 (8), e13973. https://doi.org/10.2196/13973

8 Lewin, A. M., Naylor, J. M., Sheridan, M., & Harris, I. A. 2023. Audit of surgeon billing in workers compensation-insured elective spinal surgery in New South Wales, Australia from 2010 to 2018. ANZ journal of surgery , 10.1111/ans.18647. Advance online publication. https://doi.org/10.1111/ans.18647 McLean, M., Tepper, C., Maheshwari, N., Brazil, V., & Moro, C. 2020. Developing future medical educators in an Australian medical program: supervisors' reflections on the first four years of MD Professional Project implementation. Medical education online , 25 (1), 1819113. https://doi.org/10.1080/10872981.2020.1819113 Ekholm, E.M. and Ford, D.J., 2018. Rhetorical Strategies Implemented By The American Medical Association To Identify Roles Within The Interprofessional Healthcare Team. https://kuscholarworks.ku.edu/handle/2271/1335 Andreyeva, T., Marple, K., Marinello, S., Moore, T. E., & Powell, L. M. 2022. Outcomes Following Taxation of Sugar-Sweetened Beverages: A Systematic Review and Meta- analysis. JAMA network open , 5 (6), e2215276. https://doi.org/10.1001/jamanetworkopen.2022.15276 World Health Organization (WHO). 2022. WHO calls on countries to tax sugar-sweetened beverages to save lives? https://www.who.int/news/item/13-12-2022-who-calls-on-countries-to- tax-sugar-sweetened-beverages-to-save-lives Andreyeva, T., Marple, K., Marinello, S., Moore, T.E. and Powell, L.M., 2022. Outcomes following taxation of sugar-sweetened beverages: a systematic review and meta-analysis. JAMA Network Open , 5 (6), pp.e2215276-e2215276. doi:10.1001/jamanetworkopen.2022.15276 Krieger, J., Magee, K., Hennings, T., Schoof, J., & Madsen, K. A. (2021). How sugar-sweetened beverage tax revenues are being used in the United States. Preventive medicine reports , 23 , 101388. https://doi.org/10.1016/j.pmedr.2021.101388 Brownell, K. D., Farley, T., Willett, W. C., Popkin, B. M., Chaloupka, F. J., Thompson, J. W., & Ludwig, D. S. (2019). The public health and economic benefits of taxing sugar-sweetened beverages. The New England journal of medicine , 361 (16), 1599–1605. https://doi.org/10.1056/NEJMhpr0905723 Ross, J. and Lozano-Rojas, F., 2018. Are Sugar-Sweetened Beverage Taxes Regressive? Evidence from Household Retail Purchases. Washington, DC: Tax Foundation . https://taxfoundation.org/research/all/federal/soda-taxes-regressive/ Teng, A., Buffière, B., Genç, M., Latavao, T., Puloka, V., Signal, L. and Wilson, N., 2021. Equity of expenditure changes associated with a sweetened-beverage tax in Tonga: repeated cross- sectional household surveys. BMC public health , 21 , pp.1-13. https://doi.org/10.1186/s12889- 020-10139-z