As we approach World Diabetes Day on November 14, civil society organisations warn that the cost of inaction on non-communicable diseases (NCDs) such as diabetes is already being paid for in lives, livelihoods, and lost potential. The Healthy Living Alliance (HEALA) is calling on the South African government to increase the Health Promotion Levy (HPL) on sugary drinks from 11% to 20%, to help curb sugary drinks consumption and reduce the financial burden on the health system from rising non-communicable diseases.
“Diabetes is now the second leading cause of death in South Africa, yet every year we allow preventable diseases to claim more lives,” says Nzama Mbalati, CEO of HEALA. “Raising the Health Promotion Levy is one of the simplest, most effective steps the government can take to protect people’s health, especially children, who are consuming sugar at dangerous levels.”
Since the introduction of the HPL in 2018, beverage companies have reduced the sugar content of their drinks, leading to cuts in average per-capita sugar consumption. But the gains have stalled. HEALA and its partners warn that without further cuts in consumption, the policy’s impact will fade, while rates of diabetes will continue to climb.
South Africa’s obesity rate is already twice the global average, and even one sugary drink a week raises a child’s risk of obesity and diabetes. One in four diabetes cases in the country is caused by sugary drink consumption. These numbers are not just statistics; they represent real people and families forced to navigate lifelong illness and financial hardship.
The economic toll is equally alarming. Treating obesity related conditions, such as diabetes, already costs South Africa more than R33 billion each year, or about 15% of total government health spending. Modelling by PRICELESS SA (University of the Witwatersrand) shows that increasing the levy to 20% could save approximately 72 000 lives and prevent 85 000 strokes over two decades while easing the fiscal pressure on a health system already stretched beyond capacity.
HEALA’s new national campaign, which launched in November, brings this message to the fore in two phases. The first calls for stronger health taxes across sugary drinks, alcohol, and tobacco, continuing South Africa’s proven track record of using taxation to advance public health. The second sharpens focus on raising the HPL, calling for its increase as part of a consistent, evidence-based approach to protecting lives.
Through personal stories of South Africans living with diabetes, the campaign reveals the real cost of inaction and unites civil society under the banner #OneVoice, calling on government to put public health before profit.
Alphinah Setumo, a 52-year-old mother from Mathibestad, lost both her legs and her eyesight after years of consuming sugary drinks without understanding the risks. “Back then, drinking two litres of a sugary drink a day was nothing,” she recalls. “If I had known what I know now, my life would be different.”
Mpho Thebe, a maths and science tutor from Kroonstad, tells a similar story. Once a daily consumer of fizzy drinks, he lost his left leg to diabetes at 45. Today, he walks with a prosthetic leg and teaches children about perseverance and prevention. “I thought sugar was harmless,” he says. “Now I know it can take everything from you.”
These stories mirror thousands of others across the country, where diabetes silently devastates families, especially in low-income communities where affordable, healthy food and clean water remain scarce.
The campaign, supported by actress and mother Samela Tyelbooi, urges the government to act. “As a parent, I worry about how sugar can make my kids sick,” says Tyelbooi. “We need government to increase the HPL, protect our children’s future, and stop putting profit before people.”
HEALA’s coalition partners, including health advocates, researchers, and civil society organisations, are speaking with one voice ahead of the Medium-Term Budget Policy Statement and the 2026 Budget Speech. Their collective message is clear: the HPL is not just another tax, it’s a health tax, like those on alcohol and tobacco, designed to save lives, prevent disease, and safeguard South Africa’s future.
“This is not about taking away people’s choices, it’s about giving South Africans the chance to make healthier, more informed choices,” adds Mbalati.
Diabetes and other NCDs already account for over 50% of deaths from preventable diseases in South Africa. Without decisive fiscal measures, the burden will continue to fall on the households least able to bear it.
Globally, countries from Mexico to the UK have proven that health taxes reduce sugar consumption and improve health outcomes.HEALA is urging citizens to join the call by signing the petition and demanding that the government increase the HPL to 20%. “We have the evidence, we have the stories, and we have the will,” concludes Tyelbooi. “Now we need action.”
The government must act now.
Increase the HPL on sugary drinks to 20%.
Sign the petition at www.heala.org.
