Summary of a case study published in 2019
In 2017, a national tax on sugar-sweetened beverages was approved by the Government of South Africa. The Mayor of Cape Town, Patricia de Lille, wanted their city to support efforts to reduce sugar consumption in line with the tax’s health aims. In 2018 they launched a city-wide healthy living campaign to increase public awareness about the importance of a healthy diet, including the risks associated with sugar-sweetened beverages.
The campaign started by running a survey in the local community to understand people’s opinions and knowledge about healthy behaviours. This revealed low public awareness of the links between consuming sugar-sweetened beverages and developing diabetes, or other noncommunicable diseases. It also justified the city’s decision to focus on awareness raising.
In 2018, a city-wide campaign was launched, timed to build on implementation of the national sugar tax in April 2018. It was based on learnings from the baseline survey, aiming to build public understanding that weight gain from these drinks was a health threat. It also directly addressed messages heard from the community, such as the idea that sugar-sweetened beverages were a good thing because they “gave you energy”. Billboards, community newspapers, social media and advertisements in transport hubs were used with messages warning against the dangers of sugar-sweetened beverages and promoting a healthy diet. The national media buzz generated by the new tax provided a good lead-up for the city’s own campaign.
The Mayor and city health authorities made additional efforts to protect people by removing sugar-sweetened beverages from view at point-of-sale in all buildings controlled by municipal authorities. They also removed machines selling soft drinks from the main government building and worked with vendors to reduce the availability of these drinks for staff and visitors in other municipal buildings. Coherence between public messaging and their own actions made it clear that the consumption of these drinks was actively discouraged. In July, free screening for diabetes was also offered at the Civic Centre and at municipal health facilities for members of the public.
Local political support was key to progress and also made it easier for ideas to become actions. The Mayor of Cape Town herself hosted a healthy lunch in August and ran a live streaming video of the event, during which she spoke about the importance of healthy eating and discussed its implications with medical professionals. This high-level political support gave the work impetus to move away from a strategic debate on whether sugar reduction should be promoted and towards concrete actions to improve the diets of city residents and protect their health.