'The courage and leadership that has been shown towards tobacco regulation is missing when it relates to obesity.' Photo: Penny Bradfield
It is a grotesque ad. A smiling boy sitting in a restaurant swallows 16 satchels of sugar. The punchline: you wouldn't eat 16 packets of sugar, so why would you drink it? Because that's how much sugar there is in a 600ml bottle of soft drink.
At the recent media launch, a representative of the Australian health groups behind the ad brought a wheelbarrow full of sugar. That's how much sugar a person consumes in a year if they drink a standard serve of sugary soft drink a day.
In the US, Coca-Cola made headlines recently with its new advertising campaign that for the first time links their products with obesity. It then lists how it is helping promote public health.
The local campaign is being run by a coalition of the Cancer Council, Diabetes Australia and the National Heart Foundation. It is trying to raise awareness about the contribution of soft drinks to the obesity epidemic in Australia and to win support for a contentious policy plan to turn things around.
Up to now, recognition of the problem has not been matched by effective policy.
Yet, as tobacco regulation has shown, things can change dramatically under the weight of evidence, shifts in public opinion and political courage from policymakers.
Action is needed urgently. Australia's weight gain has been quick and extreme. About two-thirds of adults and a quarter of children are overweight or obese. In 1980, about 60 per cent of adults had a healthy weight, today it is only 35 per cent. In 1980, just 10 per cent of adults were obese, now this figure tips 25 per cent.
Obesity recently overtook tobacco as the major burden of disease and, according to a 2010 study, costs Australia $56 billion a year in healthcare costs and subsidies, and places a drag on national productivity.
The health group's policy plan has three main strands.
1) Increase funding for social marketing to promote a good diet and lifestyle.
Government spending on education campaigns or social marketing has declined in recent years. As Britain and the US are embracing policies to nudge people into healthier lifestyles, our state and federal governments have cut funding to such programs.
2) Restrict children's exposure to sugar-sweetened drinks.
Industry self-regulation has been used to restrict children's exposure to unhealthy food through initiatives such as advertising restrictions and better labelling. However, the results would suggest a stronger hand is needed.
Restrictions on advertising during children's programs are no barrier to marketers. And while soft drinks are no longer sold in most primary schools, a recent survey found that one in five secondary schools had vending machines - 49 per cent of which contained sports drinks and 38 per cent soft drinks.
3) An investigation into tax options on soft drinks.
Health economists support taxes as the most cost effective intervention to curb obesity. If you want to cut consumption make it more expensive. But taxes are not the simple answer they seem. They need to be well-designed - high enough to deter consumers (studies suggest a rate of at least 10 or 20 per cent) and broad enough to stop them switching to other unhealthy foods. These taxes also tend to disproportionately affect the poor. End products, like sugary soft-drinks, are a better target than inputs like sugar and fat.
But more significantly, sugar and fat taxes keep getting mugged by political reality. From 2003 to 2006, Australia had a 3¢-a-kilogram surcharge on sugar purchases to help restructure the sugar growing industry. The Australian Beverages Council lobbied against the impost and it was removed.
In November, the Danish government dumped a one-year-old tax on saturated fat and a planned tax on sugar. The government said it had listened to retailers who complained that Danes simply went to Sweden and Germany, where prices were lower. In the same month voters in two small cities in California rejected a ballot to introduce a sugar tax on soft drinks with industry groups spending millions to defeat the measure. In September, New York City passed a law to ban extra-large size sugar drinks but a sugar tax failed to pass the legislature.
Worldwide a huge amount of policy experimentation is being conducted to try to beat obesity. With some notable exceptions, Australian policymakers have not been innovators in this field. It seems our lawmakers are not prepared to go after sugar and fat in the same way they have gone after tobacco. This is partly explained by the fact that unlike tobacco, sugar and fat can be consumed in moderation as a part of a healthy lifestyle.
A fuller explanation must include the political reality that very few politicians want to be branded a supporter of the ''nanny state'' or take on industries associated with the production and sale of unhealthy food and beverages. And yet our political leaders have good reason to show some courage, to make some stronger interventions.
It is an Australian paradox that despite our carefree attitude and self-reliance, our governments have a long tradition of intervening in private behaviour.
In areas like tobacco and road safety, Australians have led the free-world in accepting state paternalism, tough regulations and higher taxes and fines. They were for our own good.
In the same vein, Australia should be a leader, not a laggard, in tackling obesity.
Nicholas Reece is a public policy fellow at the Centre for Public Policy at the University of Melbourne.