By Labram M. MUSAH
Ghana is confronting an escalating public health emergency driven by the widespread consumption of Ultra-Processed Foods (UPFs).
These industrially manufactured products are linked to a surge in diet-related non-communicable diseases (NCDs), which now account for 45 percent of all deaths nationwide and are projected to become the leading cause of mortality by 2030.
This nutrition-driven health crisis demands decisive and bold government intervention through measures such as mandatory front-of-pack warning labels, introduction of excise taxes, otherwise known as health promotional taxes on ultra-processed foods.
Such a policy is both evidence-based and fiscally sound, with the potential to improve public health, curb the growing environmental and socio-economic burden of diet-related NCDs and generate essential revenue.
Ultra-processed foods, as categorised by the NOVA classification system endorsed by the World Health Organization (WHO), are defined as industrial formulations typically containing five or more ingredients, including additives rarely used in traditional cooking.
UPFs are often high in calories, free sugars, refined starches, saturated and trans fats and sodium.
The production of UPFs involves extensive processing methods such as extrusion, moulding and pre-frying, which transform raw ingredients into hyper-palatable products that bear little resemblance to their original food sources with additives that heighten their appeal and durability.
The UPFs contain low-cost ingredients, have long shelf-lives, are hyper-palatable and are highly branded and aggressively marketed to consumers.
In Ghana, UPFs include sweetened beverages, packaged snacks, instant noodles, highly processed meats (e.g., corned beef/canned meats), packaged baked goods and ready-to-eat or ready-to-heat meals.
These products have increasingly supplanted traditional diets in both urban and rural settings, facilitated by aggressive marketing strategies and affordability.
It is crucial to delineate ultra-processed foods – such as corned beef, sausages and instant noodles containing additives like sodium nitrite and flavour enhancers – from minimally processed foods like the frozen meat, dried fish or canned tomatoes with minimal salt to formulate effective tax policies. This will ensure culturally significant and healthier traditional foods are protected while targeting health-damaging UPFs that contribute to NCDs like hypertension and other cardiovascular diseases.
Data from the 2023 Ghana STEPS Survey show that 13.4 percent of adults are obese, and an additional 20.9 percent are overweight, with prevalence notably higher among women and urban populations. High sodium intake is another dietary challenge, with over 22 percent of adults regularly consuming processed foods high in salt while more than 90 percent frequently add salt during meal preparation.
Furthermore, type two diabetes incidence is rising in Ghana, with 5.2 percent of adults aged 18-69 years having elevated fasting blood glucose or currently on medication, and an additional 10.2 percent classified as having impaired fasting blood glucose (pre-diabetes), according to the 2023 Ghana STEPS Survey.
Findings from the NutriNet-Santé prospective cohort study in France in 2019 showed that a 10 percent increase in UPF consumption was associated with a 12 percent increase in cardiovascular disease risk and a 14 percent increase in all-cause mortality, highlighting the role of UPFs in cardio metabolic health risks, including type two diabetes.
Economically, the burden of diet-related NCDs is profound. While exact national estimates are lacking, international data suggest that such conditions can cost low- and middle-income countries between 5 percent and 10 percent of their GDP annually through healthcare costs and lost productivity.
Given Ghana’s shifting dietary trends and the surge in NCDs, the global statistics are a clear testimony that demonstrates that the country is grappling with similar economic losses, compounded by healthcare costs, a weak healthcare system and loss of productivity.
The growing dominance of UPFs in Ghana is not only a public health issue but also a significant agricultural concern, emphasising the urgency of implementing a targeted excise tax, one that is comprehensive to encourage organic food and discourage food that are classified as nutrients of concern, including sodium, sugar, saturated fat and trans-fat, as well as non-sugar sweeteners.
As the demand grow, the agricultural sector is shifting toward monoculture farming to meet the needs of the processed food industry.
A well-designed tax on ultra-processed foods can act as a corrective measure—discouraging overreliance on nutrient-poor ingredients while encouraging healthier food production and consumption patterns.
In most urban and peri-urban settings, the UPF industry targets children, using not only aggressive, but misleading advertisements and marketing tactics – many crafted to subvert parental influence and to create early brand loyalty.
This is achieved through targeted colourful cartoon characters, jingles and digital content on social media and television, which are carefully tailored to appeal to children and young audiences; and normalise frequent consumption of these unhealthy products.
This systematic exploitation of vulnerable populations requires a policy response that prioritises public welfare over corporate profits.
Excise taxes serve as a corrective mechanism, holding manufacturers accountable for the societal and environmental costs of their products while helping to restore balance in food systems.
The imposition of such taxes can prompt industries to adapt by reformulating products to reduce harmful ingredients, or diversify their product lines to include healthier alternatives.
It is important to note that while reformulation could mitigate the harmfulness of some UPFs such as replacing sodium chloride salt with potassium chloride, it is not a solution that will make UPFs less detrimental on the whole, according to factsheet of the Global Food Research Programme.
Ghana is not starting from scratch. The country’s 2023 implementation of a 20 percent excise tax on sugar-sweetened beverages (SSBs) offers a valuable template.
Early assessments indicate reduced purchases among youth and low-income groups, demonstrating both the behavioural impact and equity benefits of fiscal policy.
Report from the Ghana Revenue Authority show that GHȻ9,302.67million was from excise taxes on SSBs, alcohol and tobacco combined.
Internationally, over 50 countries have adopted similar health taxes. Notably, Colombia became the first nation to enact a comprehensive tax targeting ultra-processed foods in November 2023.
Predictably, the food and beverage industry oppose taxation, citing concerns about regressive and economic harm.
However, evidences show that health taxes are progressive in outcome, delivering greater health gains among lower-income groups due to their higher baseline consumption and vulnerability.
Additionally, the revenues can be earmarked to subsidise healthy foods, improve school meals and expand public health campaigns.
The argument that small businesses will suffer is similarly unfounded. Most UPFs sold in Ghana are manufactured by large multinational firms.
A well-calibrated excise tax can exempt minimally processed or culturally significant foods and include transition support for small manufacturers.
Ghana must now move toward 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 allocated to health promotion, including the expansion of the Ghana School Feeding Programme and the National Health Insurance Scheme.
We recommend a ban or heavy advert restrictions on UPFs, and heavy excise tax on ultra-processed foods; this is not only timely but a moral and fiscal imperative.
Corporate practices fuel public health crisis by exploiting dietary vulnerabilities and undermine traditional food systems. With NCDs imposing estimated annual costs of US$351million on Ghana’s healthcare system according to WHO 2018 report and US$7trillion in projected losses across LMICs by 2025, the economic and human toll is unsustainable.
The country cannot afford inaction. Excise taxation on the UPF is not a punitive measure. It is an evidence-based tool to reclaim public health, restore food sovereignty and safeguard the country’s development trajectory.
Ghana must build on the momentum of its SSB tax and take the next bold step in food policy. The tools are available, and the evidence is robust.
The writer is the Executive Director, Vision for Accelerated Sustainable Development, Ghana (VAST Ghana); and can be reached on 0243211854 or [email protected].
