Transcript: AMA President Professor Steve Robson on ABC Alice Springs

7 December, 2023

ABC Alice Springs

Topic: Sugar tax

Question: One other idea is a sugar tax. Now, the Australian Medical Association have been lobbying for this for a while. They say it'll make a difference. AMA president, Professor Stephen Robson, good morning to you.

STEVE ROBSON: Good morning.

Question: Let's just look at the picture. The rates we see in Central Australia. They are shocking, but they didn't come from anywhere, these rates of diabetes and then end stage renal failure. How important- and how much do we blame sugar in our diets for what we're seeing in Central Australia and right across the country, to be honest?

STEVE ROBSON: It’s a very good question. I think sugar, refined sugar plays an enormous role in all of these terrible health problems that we're seeing. I have to say, listening to what you've just said and reading over the weekend is truly heartbreaking. It's absolutely heartbreaking, and we as a country need to do everything we can to protect so many vulnerable people in your area.

Question: It is preventable. I mean, we know it's about diet amongst many things. We know it's carbohydrates, aka sugar. So is sugar the major culprit?

STEVE ROBSON: Sugar certainly is a major culprit because it's cheap and it's put in so many things. And I think one of the issues is people just don't have visibility of what they're actually drinking or eating. Sugar hides in a lot of the drinks and a lot of the foods that people eat, and they don't realise just the huge quantities of refined sugar that they're actually eating or drinking because it's not visible, and it's a huge, huge health problem.

Question: Now, what would you like to see? And the AMA has been- this isn't new. You've been talking about this for a while, but what would the AMA like to see in terms of a tax on sugar, a tax on cool drinks, for instance?

STEVE ROBSON: I think the real tragedy in all of this is that there's a completely free or cheap thing in just fresh water that people could drink. And we know these sugary drinks have literally no nutritional value of any kind whatsoever. And in hot environments like the one that you live in and your community is in, people drink a lot of sugary drinks. So there's very good evidence from around the world that making or putting a tax on sugary drinks tends to direct people away from sugary drinks to much healthier options that they could use. The World Health Organisation has called for this as a global strategy and there are 80 countries and jurisdictions around the world that have introduced sugar taxes, and they're strongly associated with people shifting their preference away from sugary drinks to healthier options.

And the other spinoff, the other real benefit is that the taxes raise money and allow governments to use this money for preventive programs. And we know that prevention is the key.

Question: Now, say a $0.40 on every hundred grams of sugar in a soft drink - how much would that raise, say, the cost of a 375 millilitres can of fizzy drink of some sort? What would be the increase, and does that have an impact?

STEVE ROBSON: The increase is a little bit variable depending on the way the volume metrics are done. But it's usually enough that it just over time directs people to cheaper options, and we know that that's really important. And the evidence from around the world is that it's actually really, really effective. And we've seen big drops in rates of consumption of these sugar sweetened drinks all over the world. That's why the World Health Organisation has backed this as a great strategy. It just kind of makes sense that people then say: wow, actually the cheaper option is the healthier option. Why don't I investigate that? It should really make no difference to retailers because they're still selling drinks at the normal profit margin. They're just selling healthier drinks.

Question: You mentioned 80 jurisdictions where this has been, is actually happening right now. How effective has it been? Has it reduced diabetes, and of course the cascading other forms of disease and illness which flow on from diabetes?

STEVE ROBSON: You're absolutely correct. And I think one of the big things that is always factored into these is the fact that you're not only preventing conditions like diabetes, but you're preventing all of the costs that are associated with treating diabetes and its complications in the community. So we're seeing drops, depending on the jurisdiction, the rate of the tax and where it's studied, of up to 20 per cent reductions in use or uptake of the sugary drinks, and that's translating into huge health benefits. We calculate, in Australia, it would prevent thousands and thousands of cases of diabetes. And prevention is the absolute key. We can't Band-Aid people once they've got it. We need to protect them, keep them healthy, and help people make these healthy choices before they get the disease. And the statistics where you are bear that out.

Question: And that would be my question. How important, how much of a difference would it make, do you think, in a place like Central Australia with the rates of diabetes we have, and as I said, the cascading flow on of different other conditions?

STEVE ROBSON: I would be hopeful it would make a huge difference. Now, it's not the only solution, it's not the only answer, but it's a great start and it's one of those starts that, as I said, not only helps people understand and make healthier choices to keep themselves diabetes-free, but it also, when they are consumed, it raises money that the government can then use to run these other programs. And the amount, the usage, for example, of dialysis in your community is absolutely staggering, and anything we can do to help people and their families avoid this, I think we should absolutely do.

Question: Our government is listening. And of course, the beverage industry is a very powerful lobby. So what are governments saying?

STEVE ROBSON: Look, we have brought this up again and again and again with the government, the Health Department and the Minister, and I think they get it. But I think they need to sense the community are behind this so that they're not so much influenced by the industry. And while I have sympathy for the industry, at the end of the day, it's all about keeping Australians healthy and more productive and reducing health costs in this time of cost-of-living crisis in the country. And I think we just need to balance the interests of industry, which are always going to be around profit, with the interests of our family, our loved ones, our friends who are suffering from these conditions and putting a huge strain on the health system when times are tight anyway.

Question: What about education? What role does that have? Can it turn things around? Say, if we didn't have a sugar tax, can education make a difference?

STEVE ROBSON: Education is really important. And I think these days, particularly with social media, there's a huge amount of disinformation. And I was reading some research on the weekend from Europe showing that, in fact, at the moment the amount of dis-and-misinformation that people are getting through news and social media and so on being shared is actually going up. People are becoming more and more confused about what's healthy and what's not. There's a lot of information that's misleading. So you are absolutely correct. Education is a key part of this and making sure people understand why drinking sugary drinks, making these choices in what you eat and drink, is such a problem. And it's very confusing and education is critical.

Question: What do you think will happen, say, if there isn't a sugar tax, if there isn't a change in how we're consuming sugars in sugary drinks? What's the endgame?

STEVE ROBSON: The endgame is continuing misery, health catastrophes for so many, so many people. And what we're doing at the moment is not working. It's absolutely time for a reboot. And when we look at the information that you were just telling your listeners earlier on about the scale of the problem, about the huge amount of misery and ill health resulting from these choices at the moment, it's clear that we can't just go on situation normal. We have to do something, and we think it's absolutely time for a reboot on multiple fronts.

Question: And where's the primary health budgets? Because that seems to be missing in this whole conversation. We're great at building renal dialysis facilities, the biggest in the southern hemisphere in Alice Springs. But where's the primary health reaction? That seems to be missing out of this.

STEVE ROBSON: I agree with you. And look, we're all proud of the massive effort that our healthcare workers put into dialysis and other treatments for diabetes, but at the end of the day, wouldn't it be great if that wasn't necessary in the first place? Australia has really one of the lowest preventive health spends in the developed world, and we need to have a look again. Only about a little over 2 per cent, $1 in every 50 in this country, is going to prevention. It needs to double or triple so that we can make sure that we prevent all of these illnesses happening in the first place. We protect people, keep them healthy, and that will just be such a massive benefit for so many families around the country, and particularly in your area where your listeners are.

Question: Yeah. Obviously, it seems like from the AMA's point of view, sugar is the new tobacco.

STEVE ROBSON: I think there are so many unhealthy choices that people don't realise are unhealthy, and I think one of the big problems. I think everybody gets that tobacco and vaping and all of those things are unhealthy, but often, sugar is hidden. You don't even know that you're using it and that's why it's such a problem. And we need to, exactly  as you said, shine a light on this.