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The Philadelphia soda tax experiment

They were rudimentary props but ones which made his point far more emphatically than any amount of sermonising about the need to eat your vegetables and curb your sugar intake ever could.

When former Philadelphia mayor Mike Nutter first floated the idea of a tax on sugar-rich soft drinks in America’s “City of Brotherly Love”, he kept a single bottle of soda on his office desk. Sitting right next to it was a plastic container holding 17 teaspoons of sugar — the amount to be found in a popular and not unrepresentative brand of sweetened drink.

As Nutter once told The New York Times: “Who in their right mind would ever put this much sugar into something you’re going to drink?”

Who indeed?

Yet the reality is all too many of us unthinkingly consume multiple amounts of that quantity each and every day in the form of just two or three sugar-saturated drinks.

Nutter referred to the soda bottle and the sugar container displayed side-by-side in his office as “conversation pieces”. Taking them along with him to public talks and town hall meetings on the subject of a tax on sweetened drinks, they did indeed help to stimulate a citywide conversation in Philadelphia. It was, unavoidably, a dialogue focused on childhood obesity and the growing epidemic of diabetes and diabetes-related complications faced by Western societies, which are attributable, in no small measure, to sugar-rich carbonated sodas, sports drinks and juices.

After almost six years, two failed attempts and vociferous opposition from the free-spending sugar industry and what might be termed the “Big Soda” lobby, Nutter’s successor as mayor recently guided a measure to tax sweetened drinks through Philadelphia’s city council.

The new tax of 1.5 cents an ounce applies to all sugar-saturated drinks sold in the city. This legislation is expected to both reduce sales of sweetened beverages in that Pennsylvania city while raising an estimated $91 million a year in additional revenue. Some of those funds are already earmarked for Philadelphia’s overburdened health system.

The California cities of San Francisco and Oakland, and Boulder, Colorado, will likely approve similar taxes this year.

Many other American and Canadian cities are expected to follow suit in 2017 and beyond. There has also been movement on this front in Europe and Asia. Britain, for instance, has said it would like to establish a soft drink tax in 2018, and India and Indonesia are now considering introducing one as well.

The passage of the Philadelphia law is likely to represent a defining moment in how these drinks are viewed from now on — both as a public health risk and as a potential new revenue source — by all manner of local and national legislatures. (Mexico actually established a national tax on both sugary drinks as well as junk foods in January 2014 and its almost immediate success in curbing consumption and raising revenues gave renewed momentum to the stalled Philadelphian measure.)

If replicated on enough of a widespread basis, the Philadelphia law’s impact could eventually be similar to that of the now-standard “sin taxes” on cigarettes and alcohol: both discourage harmful overindulgence in smoking and drinking while also raising much needed monies to help combat the long-term health effects of such excesses. The Philadelphia experiment in soda taxation could well end up being the bellwether of things to come in all manner of other jurisdictions.

Critics of the Philadelphia measure have branded the soft drink tax as an example of overzealous “nanny state” intrusiveness. The legislation’s defenders, an otherwise entirely unlikely alliance of left-of-centre political activists and voters as well as healthcare advocates, and providers and insurance companies, have counterpunched by pointing out that diabetes-related illnesses are emerging as the dominant healthcare crisis in the Western world.

Linked to everything from blindness to strokes to heart and kidney failure to limb amputations, diabetes is cutting a grim swath through societies where sugar-rich drinks and foods, and sedentary lifestyles, increasingly go hand in hand.

The collective impact of such diabetes-related complications is also placing an unsustainable burden on health systems, including Bermuda’s.

Studies in recent years have consistently demonstrated that Bermuda has one of the highest rates of diabetes in the world.

When it comes to Type 2 diabetes, brought on by lifestyle and behavioural factors rather than genetic ones, Bermuda now sits perilously close to the very top of the international rankings.

Among the many unhappy consequences of this heavy concentration of the chronic condition is that Bermuda now has the highest rate of diabetes-related amputations among women, and the second-highest for men, in the entire world.

Despite boasting first-rate diabetes prevention and control programmes, despite running powerful public awareness campaigns and despite increasing consumer awareness of the health problems associated with sugar-sweetened beverages and foods, the crisis in Bermuda shows no signs of abating.

Bermuda has already adopted some of the most stringent tobacco control regulations in the world to make smoking less attractive, less accessible and less affordable to locals because of the health risks and costs involved.

The island may now want to consider following Philadelphia’s lead when it comes to taxing sugar-loaded drinks for precisely the same reasons.

As many supporters of the Pennsylvania measure point out, this really isn’t an example of “nanny state” overreach into the area of personal choice at all. Rather it’s a pressing financial imperative given the increasing — and near-crippling — costs of treating diabetes. And, to borrow a line from Mike Nutter, who in their right mind could argue with that?