Kamal Ghorui
NEW DELHI: Despite strong evidence linking alcohol and sugar-sweetened beverages to cancers, liver disease, obesity, diabetes, heart disease and road injuries, both products are becoming more affordable in India, the World Health Organisation (WHO) has warned, calling weak tax design across South-East Asia a major public-health failure.Across two recent global reports, the WHO ranks South-East Asia — including India — among the weakest regions on health-oriented taxation. While taxes exist, they have failed to curb consumption because they are not linked to alcohol strength or sugar content, nor adjusted for inflation or rising incomes. As a result, prices fall in real terms even as health harms rise.On alcohol, the Global Report on Alcohol and Health and Treatment of Substance Use Disorders notes that only about one-quarter of countries worldwide automatically adjust excise taxes for inflation. South-East Asia performs especially poorly on alcohol-content–based taxation, which WHO considers the most effective deterrent. Instead, flat or category-based taxes allow high-strength alcohol and binge drinking to remain affordable.Doctors say the consequences are already visible. Dr Sharad Malhotra, Senior Consultant & Director, Gastroenterology and Hepatology, Aakash Healthcare, said hospitals are seeing younger patients with advanced liver disease, alcohol-related cancers, heart problems and mental health disorders linked to heavy drinking. Rising incomes, celebrity promotion and peer pressure, he warned, are fuelling binge drinking among youth. “When alcohol keeps getting cheaper, we are effectively subsidising future disease and premature deaths,” he said.WHO identifies alcohol as a leading risk factor for premature death and disability, contributing to liver cirrhosis, cancers, cardiovascular disease, injuries and violence. The burden is shifting rapidly to low- and middle-income countries like India, where consumption is rising faster than policy responses.A similar pattern is seen with sugary drinks. The WHO Global Report on the Use of Sugar-Sweetened Beverage Taxes 2025 found that the median total tax on a 330-ml sugary carbonated drink in South-East Asia is about 22.7%, but most of this comes from GST or VAT — broad consumption taxes that do little to reduce intake. The excise component remains weak.Excise taxes on sugary drinks exist in six of eight South-East Asia countries, including India, but levels are too low to significantly reduce consumption. Rising incomes have again outpaced price increases, making sugary drinks progressively cheaper.Dr Anoop Misra of Fortis C-DOC said sugary drinks are driving obesity, type-2 diabetes and heart disease, increasingly in adolescents and young adults, warning that many packaged fruit juices contain as much sugar as soft drinks.WHO says weak tax design blunts impact, as fruit juices, sweetened milk drinks and ready-to-drink teas and coffees are often lightly taxed, allowing consumers to switch products rather than cut intake. Only 25% of countries tax sugary drinks based on sugar content.Consumer policy expert Prof Bejon Kumar Misra of Healthy You Foundation said India’s GST-heavy approach weakens the health signal. “When taxes are not linked to alcohol strength or sugar content and not adjusted for inflation, harmful products become more affordable as incomes rise. Strong excise taxes work; GST-heavy systems do not,” he said.WHO says strong excise taxes cut disease, reduce healthcare costs and raise revenue. Without reform, alcohol and sugary drinks will keep getting cheaper, shifting the burden of preventable illness to health systems.
