Ghana faces a critical public health challenge driven by the increasing consumption of Ultra-Processed Foods (UPFs). These industrially produced items are strongly linked to a surge in diet-related non-communicable diseases (NCDs), which now account for a staggering 45 percent of all deaths nationwide. Without decisive action, NCDs are projected to become the leading cause of mortality in Ghana by 2030.
This escalating health crisis demands bold government intervention. Experts are calling for measures like mandatory front-of-pack warning labels and, more urgently, the introduction of an excise tax, also known as a health promotional tax, on ultra-processed foods. This policy approach is not only evidence-based but also fiscally sound, offering the potential to significantly improve public health, curb the growing environmental and socio-economic burden of diet-related NCDs, and generate much-needed government revenue.
Understanding Ultra-Processed Foods (UPFs)
According to the World Health Organization (WHO)-endorsed NOVA classification system, Ultra-Processed Foods are industrial formulations typically containing five or more ingredients, often including additives rarely used in home cooking. These products are characterized by:
High levels of calories, free sugars, refined starches, saturated and trans fats, and sodium.
Extensive processing methods like extrusion, moulding, and pre-frying.
Hyper-palatability, achieved through additives and processing that make them highly appealing.
Low-cost ingredients and long shelf-lives.
Aggressive branding and marketing, often targeting vulnerable populations.
Common examples of UPFs in Ghana include sweetened beverages (already taxed), packaged snacks, instant noodles, highly processed meats like corned beef and canned meats, packaged baked goods, and ready-to-eat or ready-to-heat meals.
It’s crucial to differentiate these items from minimally processed foods like frozen meat, dried fish, or canned tomatoes with minimal additives. An effective tax policy must target the harmful UPFs contributing to conditions like hypertension and cardiovascular diseases while protecting healthier, culturally significant traditional foods.
The Soaring Health Burden in Ghana
The impact of UPF consumption on Ghana’s health statistics is clear and alarming. Data from the 2023 Ghana STEPS Survey reveals:
13.4 percent of adults are obese, and an additional 20.9 percent are overweight. This prevalence is notably higher among women and in urban areas.
High sodium intake is a significant issue, with over 22 percent of adults regularly consuming high-salt processed foods and more than 90 percent frequently adding salt during meal preparation.
Type 2 diabetes is on the rise, affecting 5.2 percent of adults aged 18-69 with elevated fasting blood glucose or on medication, and another 10.2 percent classified as having impaired fasting blood glucose (pre-diabetes).
International research further solidifies the link. Findings from the 2019 NutriNet-Santé prospective cohort study in France showed that a mere 10 percent increase in UPF consumption was associated with a 12 percent increased risk of cardiovascular disease and a 14 percent increase in all-cause mortality. This highlights the significant contribution of UPFs to cardiometabolic health risks, including type 2 diabetes.
The Economic Cost of Inaction
Beyond the human toll, diet-related NCDs impose a profound economic burden. While precise national estimates for Ghana are not readily available, international data indicate these conditions can cost low- and middle-income countries between 5 percent and 10 percent of their GDP annually through healthcare expenses and lost productivity.
Given Ghana’s changing dietary landscape and the surge in NCDs, the country is undoubtedly facing similar economic losses. The WHO estimated the annual cost of NCDs on Ghana’s healthcare system alone at US$351 million in 2018, with projected losses across low- and middle-income countries potentially reaching a staggering US$7 trillion by 2025. Ghana cannot afford inaction.
The growing dominance of UPFs also affects the agricultural sector, shifting demand towards monoculture farming to supply the processed food industry. A well-designed tax can serve as a corrective measure, discouraging reliance on nutrient-poor ingredients and promoting healthier food production and consumption patterns.
Addressing Aggressive Marketing and Industry Accountability
A significant concern is the aggressive and often misleading marketing of UPFs, particularly targeting children in urban and peri-urban settings. These tactics, using colourful characters, jingles, and tailored digital content, aim to create early brand loyalty and normalize the frequent consumption of unhealthy products, often subverting parental influence. This systematic exploitation of vulnerable populations demands a policy response that unequivocally prioritizes public welfare over corporate profits.
Excise taxes serve as a vital corrective mechanism, holding manufacturers accountable for the societal and environmental costs associated with their products. They can also incentivize industries to reformulate products to reduce harmful ingredients or diversify into healthier alternatives. While reformulation can mitigate some harms (like replacing sodium with potassium salt), it is important to note it doesn’t inherently make UPFs healthy.
Learning from Success: Ghana’s SSB Tax
Ghana is not starting from scratch in implementing such policies. The successful implementation of a 20 percent excise tax on sugar-sweetened beverages (SSBs) in 2023 offers a valuable template. Early assessments show reduced purchases, particularly among youth and low-income groups, demonstrating the behavioral impact and equity benefits of fiscal policies. Data from the Ghana Revenue Authority reported substantial revenue generated from excise taxes on SSBs, alcohol, and tobacco combined, illustrating the fiscal potential.
Internationally, over 50 countries have adopted similar health taxes. Notably, Colombia became the first nation to enact a comprehensive tax specifically targeting ultra-processed foods in November 2023, providing a global precedent.
Addressing Industry Concerns and Designing the Path Forward
Predictably, the food and beverage industry often opposes health taxes, raising concerns about regressivity and economic harm. However, evidence from around the world shows that health taxes tend to be progressive in outcome, delivering greater health gains among lower-income groups due who often have higher baseline consumption and vulnerability to NCDs. Furthermore, revenues can be earmarked to subsidize healthy foods, improve school meals, and expand public health campaigns, directly benefiting vulnerable populations.
Concerns about the impact on small businesses are largely unfounded, as most UPFs sold in Ghana are manufactured by large multinational firms. A carefully calibrated excise tax can exempt minimally processed or culturally significant foods and include transition support for smaller manufacturers.
Ghana must now build on the momentum of its SSB tax and take the next bold step: enacting a comprehensive excise tax on ultra-processed foods. This policy should adopt a tiered structure based on the nutritional profile of products, imposing higher rates on those with elevated levels of added sugars, sodium, and unhealthy fats. Tax revenues should be dedicated to health promotion initiatives, including the expansion of the Ghana School Feeding Programme and the National Health Insurance Scheme.
Implementing an excise tax on ultra-processed foods, potentially coupled with heavy advertising restrictions, is not just a policy option; it is a moral and fiscal imperative. Corporate practices fueling the public health crisis by exploiting dietary vulnerabilities and undermining traditional food systems must be addressed. With NCDs posing such a significant and unsustainable economic and human toll, Ghana cannot afford inaction.
Excise taxation on UPFs is an evidence-based tool to reclaim public health, restore food sovereignty, safeguard the country’s development trajectory, and ensure accountability for the true cost of these products. The tools and the evidence are robust; Ghana must take this crucial next step in food policy.
