logotype

Contacts

Bird Rock, St Kitts, St Kitts and Nevis, West Indies

info@lakehealthandwellbeing.com

+1 869 765 8702

Category: You’re Sweet Enough

ReportCoverImage
Health PolicyYou're Sweet Enough

Health Policy Forum

On Thursday 28th July 2022, we hosted a Health Policy Forum for Civil Servants in St. Kitts and Nevis at the St. Kitts Marriott Resort.

The objective of this forum was to bring together civil servants from various government ministries and departments to engage them in an in-depth discussion about the multi-sectoral implications of implementing sugar-sweetened beverage (SSB) taxes, SSB sale and marketing restrictions and front-of-pack warning labels as policies to support the prevention and control of non-communicable diseases (NCDs). 

There were twenty participants representing ten government departments in St. Kitts and the departments represented included:

      • St. Kitts Ministry of Health
      • Nevis Health Promotion Unit
      • Nevis Mental Health Unit
      • Nevis Trade and Consumer Affairs
      • Nevis Ministry of Education
      • St. Kitts and Nevis Legal Department
      • St. Kitts Dept. of Gender Affairs
      • St. Kitts Dept. of Labour
      • St. Kitts Bureau of Standards
      • St. Kitts Drug Council

The Forum agenda was split into two parts. During part one, attendees received information from presenters about the impetus behind advocacy for health policies on NCD prevention and control. Presentations provided key information about current NCD rates and health challenges faced locally and regionally, the recommended evidence-based policies being championed by WHO/PAHO, and case study analyses and reports on the effectiveness of health taxes in similar jurisdictions. The presentation agenda went as follows (click each to view slides or listen to a clip from presentations):

For part two of the forum, attendees were divided into three breakout groups to discuss the implications of implementing each policy recommendation being considered. Each group was asked to consider the following questions:

  • How does the ___ sector play a part/consider their role in the prevention and control of NCDs in St. Kitts and Nevis?
  • What are the implications of implementing an SSB tax on each respective sector?
  • What are the sector-specific or general considerations for restricting the sale and marketing of SSBs in schools?
  • What are the sector-specific or general considerations for implementing front-of-pack warning labels (FOPWL)?

Attendees had a robust discussion on each of these questions and provided some useful insight on how each policy area might affect each government department and how each department can support the implementation of these policies.  

This was a very enjoyable and informative day and we would like to thank all our speakers (PAHO, the World Bank, the St. Kitts and Nevis Ministry of Health the Bermuda Department of Health)  who provided some excellent background information which helped set the scene for the discussion session.

For more detailed information on the points raised during the discussion session, you can download the forum report below.

GMSKN
DietYou're Sweet Enough

We Were on GMSKN

On the 4th July 2022, we were delighted to join the Essence of Hope Breast Cancer Foundation and SIS Inc on Good Morning SKN to discuss the work that our charities are doing in St Kitts and Nevis. 

This interview was part of efforts by Change for Charity, a new fundraising initiative in the Federation, to highlight the work of NGOs and encourage the public to support these worthy causes. 

During the interview, we explored holistic health, and some of our projects, including You’re Sweet Enough, our work on fibroids, My Healthy Heroes and our COVID-19 and NCDs project.  If you missed this episode of Good Morning SKN, you can watch the recording below.

SodaPicture
SSB TaxYou're Sweet Enough

Dispelling myths about SSB Taxes

While SSB taxes are found to be effective at reducing purchases and consumption of SSBs and producing better public health outcomes in the long run, different counter-arguments are made in resistance to this tax-based health policy. One common argument made by industry stakeholders against SSB taxes is that they will lead to considerable job losses among businesses that produce, distribute and sell the taxed beverages; however, these claims are unfounded.

To date, peer-reviewed SSB tax evaluation studies have estimated labour market impacts in taxing jurisdictions of the United States and these studies consistently found no net negative impacts on employment and unemployment outcomes. No evidence of net job losses or job losses in industries that produce or sell SSBs has been found (UIC, 2022). Rather, SSB taxation may influence market development by sparking the growth of a healthy drink and food industry. By increasing awareness of the harms of high-sugar diets and utilizing SSB tax revenues to subsidise local fruits and vegetables, the local fruit juice market stands to benefit from expansion and sustainability. Small businesses and street vendors who sell SSBs can make and sell local unsweetened fruit juices and healthy snacks where the demand for healthier and cheaper drink alternatives increases as a result of SSB taxation.

Conclusion

Now more than ever, civil society organisations (CSOs) across the world are advocating for effective health policies, like SSB taxation, that help to improve health outcomes and cultivate healthy environments for all. SSB taxes are demonstrably effective at reducing SSB purchases and improving obesity rates in the long term. To achieve the greatest impact in NCD prevention and control, taxation ought to be coupled with other policies that help to reduce socioeconomic inequalities in diet-related health.

Interventions such as including front-of-pack warning labels, cultivating healthy school environments through nutrition education, implementing sale restrictions on sugary foods and drinks in schools and at hospitals, and providing subsidies on locally grown healthy foods are all valuable and necessary for the most equitable impact on consumer behaviour and health outcomes. To combat the threat that NCDs pose on our people, productivity and livelihoods, government, civil society, industry, individuals and communities must work together. Together we can strengthen calls to action for local government to prioritise proper health, nutrition and wellbeing by implementing health policies that lead to better health and sustainability for all.

sugar-258113_640
SSB TaxYou're Sweet Enough

An Introduction to SSB Taxation

Sugar-sweetened beverage (SSB) taxation is a common effective policy adopted by governments to deter the purchase and consumption of SSBs. In the last decade, more than 50 countries worldwide have introduced a tax on SSBs. The World Health Organization (WHO) recommends SSB taxes as a best buy[1] option for governments, noting that “just as taxing tobacco helped to reduce tobacco use, taxing sugary drinks can reduce consumption of sugar” (2017). Evidence of SSB tax effectiveness is published in a World Bank 2020 report that details the results of SSB taxes in jurisdictions across the globe. Overall, trends indicate that where taxes are enforced, purchases of SSBs decline. Furthermore, the higher the tax rate the greater the impact on consumer behaviour.

In the Caribbean, Barbados, Bermuda and Dominica have implemented SSB taxes. According to the World Bank report, Barbados implemented a 10% tax on SSBs in 2015 and in the first year, average weekly sales of SSBs overall and carbonated SSBs specifically decreased by 4.3% and 3.6%, respectively. Additionally, sales of non-SSBs increased 5.2%, with bottled water increasing 7.5%. In 2022, the Barbados government decided to increase the SSB tax to 20% after researchers found that some consumers shifted to purchasing cheaper SSB options instead of reducing consumption altogether. According to the WHO, to maximise the desired impact of SSB taxation, a minimal tax rate of 20% is recommended.

In Mexico, where SSB taxes higher than 10% were introduced in 2014, data show that three years after implementation, the excise tax on SSBs helped to increase the proportion of people who do not consume SSBs. A 2020 research study found that before implementation, more than 50% of research participants were medium and high consumers of SSBs and less than 10% were non-consumers. After tax implementation, 43% of the population was categorised as medium and high consumers and the prevalence of non-consumers increased to 14% (BMJ, 2020). Notably, the reduction in SSB consumption after tax implementation also led to recorded health improvements among adolescents in Mexico. For every 10% increase in the city’s average price of an SSB, there was a significant 1.3% absolute decrease in both overweight or obesity prevalence for girls within two years of the SSB price change (JAMA Pediatrics, 2021).

SSB taxation is a win-win solution. Evidence shows that taxation not only helps to reduce consumption which contributes to improved health over time, but it also generates additional government revenue which can be used to fund other necessary health promotion programmes. In Bermuda, SSB tax revenue was reinvested into making healthy foods more accessible by subsidising fruits and vegetables to increase consumption. In addition to healthy food subsidies, SSB tax jurisdictions in the United States report using revenue to invest into early childhood programmes and community infrastructure improvements like recreation centres and public gym parks to promote physical activity (PMR, 2021).

Public support for SSB taxes varies widely by jurisdiction, although when governments commit to designating tax revenue to reinvest into improving public health, general support for taxation increases. For instance, in St. Kitts and Nevis, public opinion polls completed in 2021 reveal that support for implementing SSB taxes across the federation increases if tax revenue is earmarked for investment in health-focused initiatives like improving public water drinking infrastructure. As an evidence-based policy solution SSB taxation is strongly recommended to reduce the consumption of sugary drinks and ultimately help to reduce the prevalence of non-communicable diseases (NCDs). Government is not only being called to act but is encouraged to consider how SSB tax revenue can be designated to increase healthcare resources and improve public health outcomes.

[1] NCD Best-Buys are evidence-based public health interventions for tackling NCDs, according to the World Health Organization

SodaPicture
SSB TaxYou're Sweet Enough

Tackling NCDs through SSB Taxation

Facing the NCD Epidemic in St Kitts and Nevis

In St. Kitts and Nevis, non-communicable diseases (NCDs) are the leading cause of death among residents. According to the latest data published by the St. Kitts and Nevis Ministry of Health, 63% of all deaths are prematurely caused by a preventable chronic illness such as stroke, cancer, diabetes and cardiovascular and respiratory diseases.

The prevalence of NCDs in the federation is a major concern for individuals, families, civil society and government because NCDs threaten quality of life, productivity and sustainable development. In fact, the World Health Organization (WHO) and the Global NCD Alliance recognise non-communicable diseases as the world’s number one killer.

Globally, St. Kitts and Nevis has one of the highest prevalence rates of diabetes per capita (24%). Poor diet, physical inactivity, overweight and obesity are some of the risk factors for NCDs that are prevalent among our adults and children. Health data indicate that 1 in 2 adults and 1 in 3 children in St. Kitts and Nevis are overweight or obese, and the consumption of unhealthy products like sugar-sweetened beverages (SSBs) is at an all-time high with 62% of school-aged children drinking at least one SSB every day (Global High School Survey, 2011).

.

The Dangers of SSB Consumption

The consumption of sugar-sweetened beverages is of particular concern since some have no nutritional value and exceed recommended daily amounts of sugar for proper health and wellbeing.  Regular consumption of SSBs is a major contributor to the development of obesity, type 2 diabetes, tooth decay and cardiovascular illnesses. Research conducted by Harvard Medical School experts reveals an association between a high-sugar diet and a greater risk of dying from heart disease since consuming too much added sugar can raise blood pressure and increase chronic inflammation, both of which are pathological pathways to heart disease.

The scientific and medical evidence on the dangers of sugar for individuals’ health and wellness is alarming. Consuming too much sugar, especially from SSBs, can be deadly and must be better monitored and controlled. Curtailing SSB consumption and promoting water as the healthy alternative is a primary approach to improving food culture and combatting the NCD epidemic.  

The Solution: Government Policy Interventions

Across the world, individuals, civil society organisations (CSOs), medical professionals and governments have been advocating for and implementing solutions that help to reduce the risk factors associated with NCDs. Public education on healthy food and nutrition, accessible health screening programmes and the promotion of increased physical activity are all necessary inputs for combatting the global NCD problem.

However, addressing the problem also requires that governments take responsibility by using public policy to create healthy food environments and to help consumers make healthier choices. The WHO recommends implementing a suite of health policies that include SSB taxation and octagonal front-of-pack warning labels as evidence-based interventions that reduce the purchase and consumption of SSBs. Health advocates also call on government to implement school nutrition policies that restrict the sale and marketing of SSBs in and around schools to create and promote healthy school environments for our children. Public support for health policies like these is important for inciting government action; as data show, there is need for change in our food consumption and nutrition environments and the time to act is now more than ever.

MeetTheWillbutsCover
BlogYou're Sweet Enough

Our SSB Animation Gets a Special Mention from WHO

On Friday 13th May 2022, the World Health Organisation (WHO), hosted its award ceremony for its third Health for All Film Festival.

The WHO Health for All Film Festival is held annually to demonstrate how creative media is being mobilised for health promotion and education. The festival invites submissions from patients, health workers, health activists, NGOs, public institutions and professional filmmakers of short films on a wide range of health-related topics. This year, films covered a range of topics including the trauma of war, living with COVID-19, women’s health and non-communicable diseases.

We entered our short animation, Meet the Willbuts, into the film festival and in March it was announced that we were shortlisted under the very short film category for conveying messages about NCDs and the need for families to improve their diets for better health outcomes. We were beyond excited and in the run-up to the awards ceremony to announce the winners, we launched a mini social media campaign highlighting the key messages of the animation.

Then, on 13th May we settled down to watch the awards ceremony and were so delighted to have received a special mention during the ceremony which you can watch below. We would like to thank WHO for their recognition of our short film and hope that this exposure will lead to the animation’s important health message reaching more people.

We would also like to congratulate the winner in our category, “Glamming my Wounds” by Terry Adhiambo Ombaka (Kenya) which focused on gender-based violence.

Other winners included:

Universal Health Coverage “GRAND PRIX”:
“Pre-eclampsia: Predict Earlier, Prevent Earlier”  – Indonesia / Maternal health / Documentary – Duration 7’53’’ / Submitted and directed by Indonesian Prenatal Institute

Health Emergencies “GRAND PRIX”:
“Intensive” – United Kingdom / COVID-19 severe case / Animation – Duration 7’26’’ / Submitted and directed by Oliver John Pratt (United Kingdom)

Better Health and Well-being “GRAND PRIX”:
“Euphoric”  – India / Female Genital Mutilation / Artistic creation based on testimony – Duration 4’35’’ / Submitted and directed by Nirmala Choudhary and Roopali Ramesh Kumar (India)

SPECIAL PRIZE Rehabilitation Film:
“Sim-Patia” – Spain – Italy / Brain injury / Animation – Duration 2’42’’ / Submitted and directed by Carlos Gómez-Mira Sagrado and Rossana Giacomelli

SPECIAL PRIZE Health Innovation film:
“For Every Girl, a Forest”  – India / Gender equity / Documentary – Duration 6’24’’ / Submitted and directed by Jose Corbella (Argentina)

STUDENT FILM PRIZE:
“Improving Lives in Three Dimensions: 3D-Printed Prostheses” – Sierra Leone / Disability / Documentary – Duration 5’03’’
Submitted and directed by Merel van der Stelt (The Netherlands)

Films receiving a special mention included:

UHC Special Mention:
“The 5% : A Family’s Perspective on Complex Clubfoot”  – Brazil / Disability / Documentary – Duration 5’40’’ / Submitted by MiracleFeet and directed by Rachel Vianna (Brazil)

Health Emergencies Special Mention: 

“I was just a child”  – Philippines / Natural disasters / Animation – Duration 5’06’’ / Submitted and directed by Breech Asher Harani (Philippines)

Better Health and Well-being Special Mention:
“Autism in China: The Challenges Parents Face Raising Children of the Stars”  – China / Documentary – Duration 8’28’’  / Submitted and directed by Andersen Weicong Xia (China)

Rehabilitation Special Mention:
“Move, Dance, Feel”  – United Kingdom / Cancer and artistic dancing to support treatment / Documentary – Duration 4’58’’  / Submitted and directed by Emily Jenkins and Move Dance Feel (United Kingdom)

Health Innovation Special Mention

“Malakit”  – Brazil, French Guiana, Suriname / Malaria – Access to diagnosis and care in remote areas / Documentary – Duration 8’54’’ / Submitted and directed by Maylis Douine (French Guiana)

 Very Short Films Special Mention:

“Meet the Willbuts”  – Saint Kitts and Nevis / NCDs prevention / Animation – Duration 1’23’’ / Submitted and directed by Oyehmi Begho and Lake Health and Wellbeing (Saint Kitts and Nevis)

SodaPicture
DietNewsSugarYou're Sweet Enough

The Impact of Sweetened Drinks

In April 2022, the Healthy Caribbean Coalition hosted an excellent symposium on food policy in the Caribbean and during this event we were delighted to hear about work conducted in Trinidad and Tobago to evaluate the link between sugar-sweetened beverages (SSBs) and the development of non-communicable diseases (NCDs). This work was part of a project conducted by the Institute for Clinical Effectiveness and Health Policy entitled “Empowering healthcare decision-makers to achieve regional needs in sugar-sweetened beverages policies in Latin America and the Caribbean: building a framework to evaluate the disease burden and the cost-effectiveness of available interventions; and estimating the disease burden in Argentina, Brazil, El Salvador and Trinidad and Tobago.”

As part of this project researchers aimed to determine the burden of disease that is attributable to the consumption of SSBs and also the cost of the illnesses that are related to SSBs.  

The team behind this project have very helpfully put together an infographic to share their findings and this can be downloaded from their website here, but in summary, here are some of the key findings:

The Impact of SSBs on the Health of Persons in Trinidad and Tobago

Their study found that in Trinidad and Tobago, the overconsumption of SSB is linked to  15,000 cases of
overweight and obesity in adults and 11,700 cases in children and adolescents as well as 44,100 cases of diabetes, 2000 cardiac disease cases and 1500 renal failure cases. 

Excerpt from the IECS Infographic
The Economic Impact of SSBs

The study also determined that Trinidad and Tobago spends 156 million TT Dollars per year to treat diseases associated with excessive consumption of SSBs.

Page 5 of the IECS infographic
Conclusion

This work is very significant as it adds to the growing evidence highlighting the negative impact that SSBs have on the health of the public.  This work is useful in that it quantifies both the health and economic impact of SSBs and thus gives policymakers an idea of the magnitude of the impact of SSBs and how many lives can be saved and improved if we can reduce SSB consumption.

Reference

Instituto de Efectividad Clínica y Sanitaria. The hidden side of sugary beverages in Trinidad and Tobago.
Alcaraz A, Gittens-Baynes K, La Foucade A, Balan D, Perelli L, Cairoli F, Beharry V, Gabriel S, Laptiste C, Espinola N, Palacios A, Comolli M, Augustovski F, Bardach A, Metivier C, Pichon-Riviere A. Dec 2020, Buenos Aires, Argentina.
Available at: www.iecs.org.ar/sugar and https://sta.uwi.edu/fss/heu/fiscal-policy-taxation-sin-taxes

GMSKN
NewsYou're Sweet Enough

We Were on GMSKN

On Tuesday 5th April,  our Creative Director, Oyehmi Begho, and our Advocacy and Research Officer, Isalean Phillip, joined the hosts of Good Morning St. Kitts and Nevis to discuss our animation, Meet the Willbuts.

Meet the Willbuts was recently shortlisted for the WHO Health for All Film Festival in the very short film category for conveying messages about NCDs and the need for families to improve their diets for better health outcomes.

Our submission was recognised out of over 1000 submissions from 110 countries and we are just so proud of this achievement. So, we were very happy to join the Good Morning St. Kitts and Nevis team to discuss the animation, its message and the future of our You’re Sweet Enough campaign. 

CSO Health Advocacy Workshop Flyer 2022
BlogYou're Sweet Enough

Strengthening Civil Society’s Role in Health Advocacy

The World Bank describes civil society as “the wide array of non-governmental and not for profit organizations that have a presence in public life, express the interests and values of their members and others, based on ethical, cultural, political, scientific, religious or philanthropic considerations.”

The Role and Impact of Civil Society

Based on this definition, civil society organisations (CSOs) play an important role in ensuring that Governments and the private sector act in the best interest of the public and this involves advocating for policies and actions that benefit society.

In public health, civil society organisations from across the world have a long history of successfully advocating on behalf of patients for better care and treatment, and to reduce health inequalities. For example, Cancer Research UK and other cancer charities in the UK have consistently advocated for improvements to the cancer diagnosis pathway leading to a more streamlined and structured pathway that aims to reduce delays in diagnosis and thus reduce cancer mortality.

Additionally, CSOs have fought for the introduction of policies that have improved the health of the public and prevented and controlled diseases.  For example, the tobacco control policies that have been implemented throughout the world leading to a reduction in the public’s exposure to tobacco and second-hand smoke leading to reduced rates of tobacco-related illnesses. 

Civil Society in Small Island Developing States

In countries such as the UK and US, the CSO environment is a very strong and cohesive one with a variety of organisations advocating for change, having a positive influence on the development and implementation of effective health policies, forming strategic alliances to bring about change and implementing effective advocacy campaigns.  Conversely, in many countries, such as here in the Caribbean region, CSOs, because of the small size of our countries and lack of resources, face many challenges when advocating for change and this leaves the public, patients and vulnerable communities without organisations who can effectively advocate on their behalf or hold Governments and the private sector accountable.

Building a Strong Civil Society Sector

With this in mind, we have started a series of capacity-building webinars aimed at CSOs in St Kitts and Nevis with the aim of strengthening the sector. Our overall goal is to build up this sector, empower organisations and thus create an environment where organisations can work collaboratively to advocate for the changes that are required to tackle the major public health challenges that our country faces.

Our first capacity-building event was an online workshop on strengthening civil society’s role in health advocacy and this event was held over two days – on 25th February and 25th March 2022. The first session focused on how to develop and implement successful health-related advocacy campaigns and featured the following speakers and presentations:

In the second session, we explored how to monitor and evaluate advocacy campaigns and looked at the successes of advocates from across the world using sugar-sweetened beverages as a case study. During this session attendees heard from:

  • Dr Shelly Trim, Development Coordination Officer, Data Management & Results Monitoring/Reporting, Office of the UN Resident Coordinator – Measuring Success: The Importance of Monitoring and Evaluation
  • Maisha Hutton, Executive Director, Healthy Caribbean Coalition – The Need for Action on SSBs in the Caribbean
  • Shirley Ewang, Advocacy & External Engagement Specialist, Gatefield Impact– Lessons Learnt: The Role of Civil Society in the Introduction of an SSB Tax in Nigeria
  • Dr Marissa Carty, NCD Coordinator,  Kitts and Nevis Ministry of Health – Developing a Federal SSB Policy for St. Kitts and Nevis

.

Through this first two-part workshop, we were able to bring civil society organisations together  to build their capacity so that together we can more effectively advocate for the evidence-based policies that St Kitts and Nevis needs to improve the public’s health. 

Conclusion

Capacity-building is a useful first step in building a strong civil society sector, but we recognize that strengthening this sector requires more than just capacity-building; it requires a commitment from decision-makers to transform the sector from an informal, voluntary sector to a dynamic, sustainable sector that becomes a viable career option for those wanting to make a difference in society. To support this transition requires an investment of time, funding and resources; these investments are more than worth it because of the many benefits that CSOs can bring to the health, development and economy of a country.

MeetTheWillbutsCover
NewsYou're Sweet Enough

Our Animation in the News

We were absolutely delighted that our recent achievement of being shortlisted for the World Health Organisation Health for All Film Festival was featured on the ZIZ News on 1st April 2022. 

We’d like to say a big thank you to ZIZ for this feature and if you missed it, you can watch it in the clip below.