‘Sweet’ is not always sweet

Despite all the headlines—and hysteria—over diseases like dengue and the threat of a recurring polio epidemic, there is one illness that has long been identified as a “silent killer”—diabetes. Indeed, with a current population of over 100 million, the Philippines now counts more than 5 million people diagnosed with diabetes, with some 50,000 dying in 2017 due to diabetes-related complications like heart attack, stroke, and kidney and heart failure.

Dr. Joven Cuanang, a member of the board of trustees of the University of the East Ramon Magsaysay Medical Center Inc., says he would consider diabetes as “an epidemic,” emphasizing the need for a public information and education program regarding the disease.

And yet, even as the country observed World Diabetes Day last Nov. 14, the majority of Filipinos still seem blissfully unaware of the consequences of a diabetes diagnosis. This is mainly because, many suspect, diabetes may not directly cause death; but left untreated, it can lead to fatal consequences. These are not just limited to the common cardiovascular and renal diseases, but also include blindness (diabetes is the No. 1 cause of blindness in the country) and amputations.

Even as health authorities mount public information campaigns on diabetes treatment, prevention and awareness, the government has been trying other modes to limit the number of Filipinos vulnerable to the disease—by way of constricting access to sugary drinks, for instance, sugar consumption being one of the major reasons for the onset of diabetes.

Last year, finance officials imposed additional taxes on sugar-sweetened beverages, which could, say researchers with the World Health Organization (WHO), “cut consumption and avoid nearly 6,000 deaths related to diabetes.”

Quoting the WHO study, Reuters reported that “the new sugar-sweetened beverage tax may help reduce obesity-related premature deaths and improve financial well-being in the Philippines.” This is because, the researchers said, the high consumption of colas is the main driver of obesity, “swelling the burden of noncommunicable diseases.”

As a consequence of the new taxes, retail prices of sugar-sweetened beverages (aside from colas, these include bottled and powdered fruit drinks, instant coffee, instant tea) have risen by as much as 13 percent. And soon enough, consumption of sweetened beverages fell by an average of 6.5 percent, with powdered concentrates registering the highest decline at 25 percent.

This has not gone unnoticed by the rest of the world. Indeed, Association of Southeast Asian Nations (Asean) member nations, according to a finance official, “have hailed the Philippines’ excise tax on sugar-sweetened beverages under the tax reform program” of the current dispensation as a “successful fiscal policy intervention that aims to attain the group’s goal of nurturing a healthier society in the region.” During a recent meeting in Indonesia, officials from Malaysia and Singapore were said to have expressed interest in replicating the program in their countries.

There are many ways by which we, as a society, can address the proliferation of a “silent” disease like diabetes, which is now threatening the health and well-being of a younger cohort who are being raised on a diet heavy on sugar and carbohydrates. One is to encourage more physical activity among youngsters, who are increasingly confined to a sedentary lifestyle thanks to their devotion to electronic and digital devices. Another is to look into the planning and purchasing of ingredients used in family meals, with purchases of fresh vegetables and fruits encouraged. Another is to educate both parents and children on the importance of awareness about diet and consumption, about the caloric value and the sugar content of snacks that may not necessarily be sweet.

Having proved the value of using taxation to dampen demand for harmful ingredients like sugar and sweeteners (and also tobacco), the Philippines would do well to add to this measure other social amelioration programs, such as promoting better and healthier food options, modifying young people’s taste for sweet products and prioritizing public health and social services in the national budget, to enable more institutional help to reach families burdened with the costly illness, especially those from the poorest sectors.

In the case of diabetes, “sweet” may not always be sweet.