What is government doing with the health promotion levy?

South Africa faces a dual burden of malnutrition, with high rates of obesity alongside stunting in children. An increase in health taxes could fund social protection interventions like the national school nutrition programme
3 mins read

The finale of the Chew on This series, titled “How Can the Health Promotion Levy Support and Expand Social Protection?”, premiered on the Healthy Living Alliance’s (HEALA) YouTube channel on January 30 2025.

This discussion, released ahead of South Africa’s 2025 budget speech in late February, brings into sharp focus the health promotion levy (HPL) and its potential to drive social change. Evidence shows a reduction in the consumption of sugary drinks and calorie intake since the HPL’s introduction in 2018.

South Africa faces a dual burden of malnutrition, with high rates of obesity alongside stunting in children, making the HPL a critical tool for addressing these challenges.

The episode features a panel of experts, including Professor Corné van Walbeek from the University of Cape Town, Angelika Grimbeek from HEALA, Khanyisa Mapipa from Section 27, and Baone Twala from the Wits PRICELESS SA. Together, they explore how health taxes like the HPL can generate much-needed revenue to fund social protection interventions like the national school nutrition programme (NSNP).

A tsunami of health and social challenges

“South Africa has the highest prevalence of obesity in Sub-Saharan Africa, yet millions of children live below the poverty line,” says Chew on This host Crystal Orderson. “The HPL, introduced in 2018, has already generated over R8bn. It’s time to explore how these funds can directly impact social protection.”

One in four children in South Africa is stunted. “The NSNP provides critical support to nearly 10-million children, but this isn’t enough,” says Twala. “We must consider how the HPL can be used to improve the nutritional quality of school meals and expand the programme to early childhood [development (ECD)] centres.”

One of the mothers interviewed for the finale said her children’s school was lucky to have a nutrition programme. “Kids get proper meals. For example, on Thursdays, they get rice, chicken, cabbage, and carrots – a real, full meal. The meal servers are actually parents of some of the kids, which is great. Their salaries, the food and fuel costs are covered by money from the department of education. Learning and teaching have improved so much since it started. Kids aren’t skipping school anymore because they know they’ll get a meal. It’s made a huge difference for everyone.”

Another said feeding her children is a constant battle. “Sometimes there’s no milk, and even basics feel like luxuries. The grant money I get just doesn’t stretch far enough. My husband does piecemeal jobs, but it’s still not enough. I skip meals to make sure the kids can eat. Right now, I can’t think about what’s healthy or not. If I try to buy healthy food, we wouldn’t have enough to eat. Things like fruits and vegetables? Those are a luxury.”

Expanding the scope of the HPL

HEALA’s Grimbeek says that while the National Treasury doesn’t ringfence taxes, it should still prioritise increasing the HPL to the recommended 20% to increase the revenue it collects. This additional money could be used for essential health and social services, and increase public confidence in government’s commitment to enhancing public health.

In this episode, the panel also discusses how public buy-in for the HPL could be bolstered by funds for visible and impactful programmes. In addition, the pilot expansion of the NSNP to ECD centres could include breakfast meals as a critical step to address malnutrition in younger children.

With nearly 5-million children living below the poverty line, the consequences of inaction are far-reaching. These children face long-term challenges that affect every part of their lives, including slower cognitive development, poor academic performance, and fewer economic opportunities as they grow up.

“Increasing the levy to 20% or more and ensuring annual adjustments to counter inflation are non-negotiable steps,” says Grimbeek. “Without these measures, the levy’s effectiveness will diminish over time.”

She adds that by including sugary fruit juices, often wrongly seen as healthy, the government can reduce unhealthy consumption and raise more funds for essential programmes like the NSNP.

“The health and wellbeing of our children are at stake,” she says. “With the right policies, we can build a healthier, more equitable society.”

Catch the conversation

As finance minister Enoch Godongwana prepares for the budget speech, Chew on This episode 5 is a call to action for him, policymakers and the public alike to advocate for stronger HPL.

Sign the petition to protect and expand the health promotion Levy levy at Heala.org.

Visit the HEALA website to view all episodes in the series and follow #chewonthis on social media to join the conversation.

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HEALA

HEALA is a coalition of civil society organisations advocating for equitable access to affordable, nutritious food in South Africa by building a more just food system.

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