The WHO is lying about food and drink taxes

The WHO's excrucitaing decline continued yesterday when it published a document calling for fiscal measures in the food supply, ie. taxes and subsidies. Written anonymously, as is their style, its report - Fiscal Policies for Diet and Prevention of Noncommunicable Diseases - makes a number of unsupported claims, such as this...

There is increasingly clear evidence that taxes and subsidies influence purchasing behaviour, notably when applied to sugar-sweetened beverages and this contributes significantly towards addressing the obesity and diabetes epidemic, especially when part of comprehensive multisectoral population-based interventions.

It is a statement of the bleeding obvious that price influences consumption and it is equally obvious that taxes and subsidies affect price. But where does the belief that taxing sugary drinks 'contributes significantly towards addressing the obesity and diabetes epidemic' come from? No country has ever reduced the prevalence of these health conditions with taxation. There is not a jot of real world evidence to support this claim, and the WHO does not offer any.

The authors continue...

Estimates from recent economic research show that the prices of foods and beverages effect [sic] purchase and consumption significantly.

Well, duh.

As taxes increase, the purchase price of certain foods increases and consumers thus reduce their purchases. As a consequence, industry may produce less of the food in question.

I love the use of the word 'may' here. In fact, it's safe to say that if people buy less of a product, the industry will produce less of it.

The fundamentals to the effect of fiscal policies on diet and the basics of price elasticities include:

a) demand for SSBs [sugar-sweetened beverages] is generally elastic, with price elasticities around -0.9 to -1.3

No, demand for sugary drinks is generally inelastic.

Growing evidence shows that appropriately designed fiscal policies, when implemented with other policy actions, have considerable potential for promoting healthier diets.

Really? And where is this growing evidence?

These will improve weight outcomes and other diet-related risk factors, and will contribute, ultimately, both to the prevention of NCDs and to the reduction of the NCD health and economic burden.

Note the switch from talking about the 'potential' of these policies to the certainty that they 'will' work.

A meta-review of 11 recent systematic reviews on the effectiveness of fiscal policy interventions for improving diets and preventing NCDs (6) showed that the evidence was strongest and most consistent for the effectiveness of SSB taxes in the range of 20–50% in reducing consumption, and of fruit and vegetable subsidies in the range of 10–30% in increasing consumption.

Finally, some evidence! Let's have a look at reference (6) shall we?

(6) Fiscal policy options with potential for improving diets for the prevention of noncommunicable diseases (NCDs) (draft). Geneva: World Health Organization; 2015.

The report is citing itself! I've never seen that before.

Whatever evidence the FIFA of Health claims to have in mind can only be based on theoretical models. No country taxes sugary drinks at 20-50% (excluding sales taxes such as VAT). Even Mexico and Berkeley only tax them at 10%. Nor do any countries subsidise fruit and vegetables at 10-30%. It is simply dishonest to pretend that these policies have been shown to work. They haven't even been tried - and with good reason.

There is also growing evidence for the likely effectiveness of combinations of taxes and subsidies, particularly as a mechanism to reduce potential substitution with unhealthy foods.

Sheer bullshit again. No one has tried this.

The WHO goes on to discuss eleven countries that have dabbled with policies of this kind. Perhaps this is the 'meta-review of 11 systematic reviews on the effectiveness of fiscal policy interventions' that they mention when referencing themselves. It must be because it's the nearest thing to evidence that appears in the report. If so, it is mendacious.

Denmark’s tax on saturated fat – implemented on 1 October 2011 and abolished on 1 January 2013 – proved to be efficient in reducing the intake of saturated fat as well as in improving other dietary measures and reducing mortality from NCDs.

Unevidenced, unmitigated tripe. There is no evidence - none - that a short-lived tax on saturated fat reduced mortality from non-communicable diseases.

The WHO then mentions Ecuador where a tax on soft drinks and some food 'faced challenges which made the tax difficult to implement'. It mentions Egypt where 'the government has not adopted taxes on unhealthy food as a tool to reduce consumption. On the contrary, it has imposed low tax rates on some unhealthy foods, such as sugar'. Great success!

Then there is Finland which 'has a long history of using price policies to influence food consumption'. Has it reduced obesity or improved health? We don't know because it 'has not been formally evaluated'.

And so it goes on. A soda tax in Mauritius 'has not been assessed'. A bill to introduce a soft drink tax in the Philippines (a despotic country admired by the WHO) has not been passed but a computer model reckons that 'a tax that would increase the price of SSBs by 20% would reduce overall consumption by 24%'. Hungary has lots of food and drink taxes but there's no evidence of any improvements in health. France has a small tax on fizzy drinks, but it applies to sugary and non-sugary drinks alike. Thailand taxes sugary drinks at a lower rate than non-sugary drinks but gets a mention anyway. Mexico saw soda sales drop after a tax was introduced if you compare it to a 'public health' counterfactual but sales didn't actually drop. Finally, the USA gets a mention because most of its states have a soda tax of some sort but the WHO neglects to mention all the studies showing that they have had no impact on obesity because of substitution effects.

That, apparently, is the 'growing evidence' for taxing food and soft drinks. This unelected, secretive agency is pushing governments to introduce regressive taxes that it does not understand and willfully misrepresents.

In most cases, however, the demand for foods and beverages is typically inelastic (i.e. consumers are not very responsive to price changes). This should not be viewed, per se, as hindering the pursuit of public health goals. It simply means that the tax rate will have to be high enough to reduce the consumption of the taxed products to an extent that will generate meaningful health effects.

Be afraid.