Introduction by Croakey: As new research underscores the many health benefits of taxing sugar-sweetened beverages, health policy analyst Charles Maskell-Knight PSM takes a journey down the long and frustrating road of related policy inaction.
After so many years, so many reviews and so many recommendations, the Australian Government needs to act on the evidence about the merits of this public health intervention, he writes below.
Maskell-Knight notes that more than 100 countries, including the UK, France, Portugal, South Africa and Mexico, have now introduced such a tax.
Charles Maskell-Knight writes:
In 2015, the World Health Organization (WHO) published a report, Fiscal Policies for Diet and Prevention of Noncommunicable Diseases, which concluded that a tax of 20 percent or more on sugar-sweetened beverages (SSBs) would “lead to more than proportional reductions in SSB consumption and net reductions in caloric intake, and thus contribute to improving nutrition and reducing overweight, obesity and Non-Communicable Diseases”.
Three years later, in December 2018 a Senate inquiry into the obesity epidemic recommended “the Australian Government introduce a tax on SSBs, with the objectives of reducing consumption, improving public health and accelerating the reformulation of products”.
The then Morrison Government did not respond to the report. Nor did the Albanese Government, until September 2024 when it tabled a response “given the passage of time since this report was tabled, in December 2018, a substantive Government response is no longer appropriate”.
As none of the recommendations were time-critical, this response is evasive, if not disingenuous.
In June 2024, a House of Representatives inquiry into diabetes mellitus recommended “the Australian Government implement a levy on SSBs, such that the price is modelled on international best practice and the anticipated improvement of health outcomes”.
“The levy should be graduated according to the sugar content,” it recommended.
The (comparatively rapid) Government response tabled in March 2026 “noted” the recommendation – a euphemism for masterly inactivity.
The response went on to say “the Government supports the objective of reducing consumption of sugar and is committed to reviewing all evidence and considering approaches, including non-regulatory approaches, to meet this objective”.
Over the last decade, a number of Australian health groups led by the Australian Medical Association have argued for the introduction of a sugar tax.
Government response
Every time the issue is put to the Government, the response is along the lines of Health Minister Mark Butler’s comments in 2025.
He said: “There is no plan in our Government for a sugar tax. We’re instead focusing on education and also working with food manufacturers to reduce the amount of sugar that they put into their products.”
“Working with food manufacturers” is a reference to the Partnership Reformulation Program, which operates as part of the Healthy Food Partnership.
The reformulation program began in 2020, covering sodium reduction targets for 28 food categories and saturated fat reduction targets for five food categories. It was expanded in 2021, with sugar reduction targets for nine food categories, and sodium reduction targets for a further five food categories.
The Australian Bureau of Statistics report on the reformulation process for sugar found that after two years “the reformulation of participating products resulted in a 1.3 percent decrease in total sugars between June 2021 and June 2023”.
“In per capita terms this amounted to a decrease of less than 0.1 gram per day from the estimated total sugar consumption of 109 grams per capita, per day.”
Guidance on healthy sugar consumption varies across different authorities, but 100 grams per day is the maximum any source suggests.
On the current rate of progress, the reformulation program will lead to sugar consumption falling to 100 grams per day by about the year 2200.
Accumulating evidence
The AMA released a report on its modelling of the impact of a sugar tax in 2021, and the Grattan Institute released a report in 2024.
A team from Griffith University and other institutions, led by Adjunct Research Fellow Dr Mishel Shahid, has now published a study in BMJ Public Health modelling the impact of a 20 percent tax on sugar-sweetened beverages on health outcomes, including dental caries, periodontitis and edentulism (loss of teeth), which have not been included in earlier studies.
Croakey has published an article by Shahid and colleagues on their research and its implications.
The results of the modelling suggested a tax would:
- add 511,000 (95% uncertainty interval (UI) 425,000 to 602,000) health-adjusted life-years (HALYs) for the 2019 Australian population over their lifetime
- avoid a total of 3.7 million (95% UI 2.3 to 5.2 million) incident cases of dental caries and 191,000 (95% UI 147,000 to 237,000) incident cases of periodontitis
- reduce the incidence of edentulism via dental caries by 76,000 (95% UI 48,000 to 106,000) and edentulism via periodontitis by 39,000 (95% UI 30,000 to 48,000) total cases.
As the Grattan Institute says, “there are now sugary drink taxes in 117 countries, including the UK, France, Portugal, South Africa and Mexico”.
“And the taxes are working. There is strong evidence that they slash sales, and get manufacturers to put less sugar in their drinks,” says the Grattan Institute.
“In the UK, one in three products had more than eight grams of sugar per 100ml before a sugary drinks tax was announced. Four years later, only one in 12 had that much sugar.”
And as Shahid et al report, “an interrupted time series analysis of the UK’s Soft Drinks Industry Levy found fewer hospital admissions for carious tooth extractions in children after the levy was introduced”.
“In the United States, an analysis of the Philadelphia beverage tax found reductions in tooth decay measures among lower-income adults and children, who often carry a higher burden of oral disease,” the researchers reported.
The evidence is clear – a tax on sugar-sweetened beverages works to reduce consumption and improve health outcomes.
The Government’s preferred approach of “working with industry” is barely achieving any progress in harm reduction.
If the Government is serious about “reviewing all evidence and considering approaches” to reducing consumption of sugar in general and sugar-sweetened beverages in particular, it needs to join the majority of the international community and introduce a tax on sugar-sweetened beverages.
To do anything less is simply pusillanimous.
Author details
Charles Maskell-Knight PSM was a senior public servant in the Commonwealth Department of Health for over 25 years before retiring in 2021. He worked as a senior adviser to the Aged Care Royal Commission in 2019-20. He is a member of Croakey Health Media, and author of Croakey’s weekly column, The Zap. Follow on X/Twitter at @CharlesAndrewMK, and on Bluesky at: @charlesmk.bsky.social.
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