Barbados has led the region in this regard as the first Caribbean country to implement a sugary drink tax in 2015 — a 10% ad valorem excise tax that was increased to 20% in 2022. Also in 2022, Barbados passed the National School Nutrition Policy to improve the school food environment for children. The policy includes measures related to food service, marketing in the school environment, physical activity, school health and nutrition services, curriculum, and community health promotion. Implementation has begun and will continue in a phased approach in 2023.

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• Randomized controlled trials using an experimental online shopping store, testing Brazil’s front-of-package warning labels using two different nutrient profiling models;
• Monitoring changes in the food supply following implementation of Brazil’s front-of-package warning labels; and
• Evaluation of Brazil’s innovative National School Feeding Program (PNAE). This includes:
  • Municipalities’ and states’ readiness to meet new PNAE dietary guidelines (based on updated Brazilian Dietary Guidelines);
  • Changes in procurement of ultra-processed foods, including regional differences;
  • PNAE’s impact on conventional and family farming-related employment and gross domestic product contribution;
  • Qualitative analysis of drivers and barriers to PNAE’s optimum program implementation; and
  • Changes in primary and secondary students’ consumption of healthy and unhealthy foods.

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Our evaluations to date: In collaboration with our research partners in Chile, we have evaluated the impacts of the Chilean sugary drink tax and Phase 1 and 2 of the Law of Nutritional Composition of Food and Advertising and its combined warning label, marketing restriction, and school sales policies. Data indicate that within the first and second year of implementation, these policies were already impacting the foods and drinks Chileans buy and consume as well as the public’s perceptions of junk foods targeted by the policies.

We will continue our work in Chile through 2023 in order to evaluate all three phases of the Law of Nutritional Composition of Food and Advertising.

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In July 2021, the Colombian government passed Ley Comida Chatarra (The Junk Food Law), which mandates front-of-package labeling. With our research partners in Colombia, we conducted experiments to inform the design of these labels. Our research found that octagonal-shaped labels (like those used in Chile, Peru, Mexico, and soon in Argentina and Venezuela) were the most effective, and that warning labels outperformed other label designs (Nutri-Score and Guideline Daily Amounts) among Colombians.

On December 13, 2022, the Colombian Ministry of Health issued Resolution 2492 detailing how the law will be regulated, including final label design (black octagonal warning labels) and the nutrient profiling model to identify which products will be subject to the regulation. Industry has six months to implement the labels.

Also in December, 2022, Colombia passed two fiscal policies: taxes on ultra-processed, sugary beverages and ultra-processed food products (details below). Colombia is the first country in the world to specifically target overconsumption of ultra-processed products with a fiscal policy.

Our future evaluations: In collaboration with our research partners in Colombia, we plan to evaluate the adoption and impact of the world’s first tax on both sugar-sweetened beverages and ultra-processed foods.

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In January 2014 Ghana’s government implemented Excise Duty Act 2014 (ACT 878), which imposed a 17.5% ad valorem excise tax on bottled water and other non-alcoholic beverages. In May 2023, this tax rate increased to 20% via the Excise Duty Amendment Bill 2023 (ACT 1093), which also expanded the range of taxed products to include fruit and vegetable juices.

Ghana’s excise tax is structured with a main objective to increase revenue, but could also potentially discourage excess consumption of sweetened beverages as observed elsewhere (as in Chile and South Africa, for example) due to any price increases faced by consumers. Because the tax base includes plain bottled water, however, it remains to be seen whether this may discourage bottle water purchases or consumption as well as potential substitution towards other water source such as sachet waters and non-potable waters.

The main aims of our work with research partners in Ghana are to:

1. Analyze price changes of products subject to the original and amended taxes and their untaxed alternatives;
2. Investigate the factors influencing water and other beverage purchases among low-income households; and
3. Design and pilot a survey to collect dietary and anthropometric data among preschool children in preparation for a future evaluation of nutrient profile modeling and front-of-package warning labeling in Ghana.

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Our evaluations: We are assessing school food environments in Jamaican and Bajan schools in order to determine whether schools are abiding by Jamaica’s beverage guidelines and if other aspects of the school food environment are changing.

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Evaluations: The sugary drink tax and nonessential food tax evaluations include studies that examined the impact of the taxes on prices, food and beverage purchases, dietary intake, and employment. The front-of-package warning label evaluations will combine food purchase impact with studies on the impact on children and their diets, knowledge and attitudes, food and beverage reformulations, and food purchase patterns.

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Our evaluation work began before the law was implemented and will continue for 3 years. Our evaluation work has five components to examine:

1. Implementation of the FOP warning labels law in Peru. We will use qualitative interviews with key stakeholders to highlight the key facilitators and barriers of the FOP law implementation;
2. Changes in the healthfulness of the food supply following introduction of FOP warning labels;
3. Changes in mothers’ attitudes towards, knowledge about, and perceptions of unhealthy and healthy foods along with their awareness and usage of FOP warning labels in urban and rural areas;
4. Changes in household food purchases of regulated (ie, with warning labels on packages) and unregulated foods and beverages after introduction of the FOP warning labels law, overall and by socio-economic status; and
5. Changes in taxed and untaxed beverage purchases after the SSB tax, overall and by socio-economic status. This evaluation will look at both the 2018-19 SSB tax shift and the additional changes implemented in 2019.

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