The absence of key components in the Bermuda Government’s “sugar tax” policy affected acceptance by the general public and limited potential health impacts.

This, from one of three published papers The Royal Gazette was referred to by a government spokeswoman, when asked about the outcome of the policy put in place in 2018. The studies were conducted in 2022.

A second paper noted that Bermuda implemented one of the highest import tariffs for sugary confection products, but non-sugar sweetened beverages remained just as expensive as the targeted SSB products.

And a related subsidy for fruits and vegetables was shown to be ineffective in turning Bermudians towards more healthy alternatives.

Not included in the three referred to by the Government was a Public Health England study published at the Imperial College Business School as part of PHE’s programme of public health support to the Overseas Territories.

Taxes on discretionary foods and sugar-sweetened beverages is a health promotion strategy.

Between 2018 and 2019, the Bermuda Government introduced a phased tax on imported sugar-sweetened beverages, confectionery, products containing cocoa and pure sugar, and eliminated import duties on select healthy food items.

Kim Wilson, the Minister of Health, was clear on the objective when she told MPs in June 2018 that Bermuda’s prevalence of obesity and diabetes is one of the highest among developed countries.

She said total 2017 spending for diabetes patients was $77.8 million. She added: “We also spent $24 million on dialysis due to chronic kidney disease, adding further preventable costs to our already strained system.”

Sixteen months after the institution of the measure, 2020 parliamentary questions from former opposition backbencher Michael Dunkley led to the revelation that $5.4 million had already been raised through the increased customs duties from the sugar tax.

That could mean that some $25 million has been raised in additional government revenue by now.

The 2018 Budget Statement opaquely promised: “A portion of the revenues from the sugar tax will be earmarked for educational programmes to improve health outcomes.”

The Royal Gazette last week asked the government about that promise and for the tracking efforts to determine their efficacy. We also asked about the report on a global anti-sugar tax campaign and if Bermuda was targeted.

As we waited, we noticed that all the above-mentioned external papers on Bermuda’s sugar tax programme were in some way critical of the way the policy was implemented.

One noted: “The lessons learnt in Bermuda can inform similar policies in other settings.”

The PHE study did find high awareness of the tax by Bermudians in a report they chose to entitle The sugar tax in Bermuda – does it work?.

Consumers reduced their purchases of beverages with added sugar in the same proportion as the price increase, ie, by about 26 per cent, which was similar to other countries.

But because beverages with no added sugar remained more expensive even after the tax was introduced, those who reduced their purchases of beverages with added sugar did not substitute towards sugar-free beverage options.

The PHE study also noted that stakeholders pointed out shortcomings with the tax and cited the need for clarity in the products taxed, clear price differentiation, accompanying health education campaigns and earmarking of tax revenue for health initiatives.

Concern was expressed that the tax may have increased food prices, disproportionately affecting lower income households.

The conclusions included the observation that more could be done to motivate people to improve their diet.

The report said: “The sugar tax was widely perceived to have been successful in generating new revenues,” as it noted: “But more could be done to motivate people to improve their diet.”

That requires “a wider range of health promotion efforts (eg, advertising, information to consumers, interventions to reduce price promotions on products and actions to reduce sugar levels), the lack of which was perceived as a missed opportunity.“

The report proposed a way forward for motivating diet improvement in Bermuda, noting that simple changes in the design of the tax could make it more targeted and ensure a greater impact on dietary behaviours.

And regulation of price promotions would contribute to the same goal.

It said: “Incentivising the consumption of fruit and vegetables through price incentives will require stronger measures than the recent tax reduction.

“Supporting the sugar tax with complementary regulatory policies aimed at creating healthy food environments in Bermuda could further improve dietary choices.

“For example, increasing the availability and promotion of affordable and healthy food and beverage options, especially for children and young people, restricting promotions on less healthy products covered by the tax, and restricting the availability of foods high in fat, salt and sugar in sensitive areas, such as near schools.

“The success of the sugar tax will increase with clear communication around the products that are taxed and those that are not, and around the use of the revenues generated by the tax, especially if the latter are directed towards supporting healthy food choices.”