Share a Coke, Share Diabetes – Coca-Cola consumption in Africa and the growing diabetes epidemic

With an advanced distribution system, subsidised prices, aggressive marketing to younger people, and a lack of nutrition knowledge regarding health risks; Coca-Cola products can fuel the growing diabetes epidemic in Africa to unprecedented proportions.

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Consumption Levels

Africa is an important market for the major players in the beverage industry such as Coca-Cola, which is the continent’s largest private-sector employer [1]. In 2015, Coca-Cola saw net operating revenues of nearly $2.5 billion across Africa and the Middle East [2]. South Africa is responsible for the majority of Coca-Cola product consumption in Africa. In 2012, the average South African consumed 260 (237ml) servings of Coca-Cola products per year; an 80% increase over a 20-year period. When compared to the global average of 94, this places South Africa in the top ten Coca-Cola product consumers worldwide [3]. Regarding annual consumption, South Africa alone was responsible for 14% of unit case volume consumption, compared to 16% for Central, East and West Africa combined [4]. Hence other parts of the continent have enormous opportunities for growth in the number of consumers. For example, in largely populous Nigeria, annual per-capita consumption was only 27 per person in 2011; making the country a highly attractive market for expansion [5].

Affordability and Accessibility

In Africa as with other developing regions, the price of Coca-Cola products is kept strategically low to ensure affordability. This is possible due to the subsidies Coca-Cola receives from the International Finance Corporation, a unit of the World Bank Group [6]. In addition, Coca-Cola’s incredibly advanced distribution system is the envy of even the Bill and Mellinda Gates Foundation, as it boasts of the ability to reach remote areas of Africa where basic essential medicines are inaccessible [7].

Considerable research has been conducted on the link between sugary drink consumption and obesity, which increases the risk of diabetes and other non-communicable diseases. The average 330ml serving of sugar-sweetened soda or fruit juice contains anywhere between 40-45g of sugar [8]. These drinks contribute to a considerable proportion of total per capita sugar and energy consumption [8]. Thus, ease of access coupled with affordability and insufficient nutritional and health knowledge, Coca-Cola products and other sugary drinks can indeed fuel diabetes and other non-communicable disease epidemics to unprecedented proportions.

 

Diabetes Burden

Africa’s disease burden has grown significantly due to the increased prevalence of non-communicable diseases such as type-2 diabetes [9] In 2012/2013 Africa was said to have approximately 7.4% of the global diabetes burden (27.5 million out of 371 million people). This was predicted to increase to 9% by 2030 (49.7 million people) [10]. It is very likely that the full extent of diabetes burden may be underestimated due to poor disease surveillance [9,10]. By 2030, diabetes is expected to grow by 67% in the world’s poorest countries, and only 27% in the world’s richest [11]. It is also predicted that nine out of 10 countries with the highest rates of diabetes will be in Africa [11]. In fact, by 2030 the total burden of non-communicable diseases in Africa is expected to surpass that of infectious diseases.

Marketing to Younger People

With regards to the marketing of its products to younger people, Coca-Cola has explicitly made the following claims: “We do not advertise to children under 12 years old”; and “We do not place advertising in media where the audience is over 35% children under 12 years old.” [12]. However, data is now available that show the contrary. Moodley et al. [13] used a digital camera and a global positioning system to map the locations of sugary drink advertising in relation to schools within a specified area in Soweto, South Africa; and found that 14 out of 28 primary and secondary school properties were branded with Coca-Cola advertising. Thirteen of these advertisements were on the school sign itself. In addition, researchers utilised spatial analysis to determine that within each square kilometre of the study area contained one school, four Coca-Cola advertisements, and five vendors, three of which sold sugary drinks [13]. Such early brand recognition will carry on into adolescence and adulthood, thus ensuring life-long product consumption.

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Beverage industry giants including Coca-Cola and PepsiCo signed up to reduce the calorie content in products destined for the US market by 20% by 2025 [14]. Similar pledges have not been made for products to be sold on the African market. Companies are instead clamouring to increase consumption of the same high calorie products [15]. Coca-Cola projected an expansion of retail sales by over $600 billion by 2020; fulfilling its commitment made in 2010 to doubling its African investments. Should the beverage industry wish to minimise its contribution to obesity, diabetes and the remaining non-communicable disease burden in Africa, it can and should consider adhering to nutritional guidelines and regulatory measures, including smaller portion sizes, warning labels, and reduced marketing to children; including the use of celebrity endorsements [6, 14].

 

 

Reference list available on request

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