A sweet deal for domestic industry: the political economy and framing of Vanuatu’s sugar-sweetened beverage tax

ABSTRACT
Introduction The Government of Vanuatu introduced an
excise tax on sugar-sweetened beverages (SSBs) in 2015.
While lauded for its alignment with the WHO’s Best Buys
recommendations for addressing non-communicable
diseases (NCDs), little is known about the tax’s adoption
process or whose interests it serves.
Methods Using case study methodology, this study
examined how and why Vanuatu’s SSB tax was introduced.
Policy documents, key informant interviews (n=33) and
direct observations were analysed using theories of policy
analysis, power analysis and postcolonial theory to map
the policy’s adoption, surrounding political economy and
the ideas, interests and institutions that shaped the tax and
its framing.
Results The SSB tax emerged during a politically and
economically unstable time in Vanuatu’s history. The tax’s
links to the national health agenda were tenuous despite
its ostensible framing as a way to combat NCDs. Rather,
the tax was designed to respond to tightening economic
and trade conditions. Spearheaded by several finance�focused bureaucrats, and with limited input from health
personnel, the tax targeted less frequently consumed
carbonated SSBs (which are mostly imported) without any
revenue reinvestments into health. Driven by the desire
to generate much-needed government revenue and instal
domestic protections via selective implementation and
carve-outs for local producers, the Vanuatu SSB tax did
meet national objectives, just not the dual health and
economic ‘win-win’ projected by the NCD Best Buys.
Conclusion Vanuatu’s SSB tax adoption process
reveals the limitations of decontextualised policy
recommendations, such as the NCD Best Buys, whose
framing may be overcome by local political realities. This
research highlights the need for further political economy
considerations in global health recommendations, since
contextual forces and power dynamics are key to shaping
both how and why policies are enacted and also whose
interest they serve