CETA amendment bill: A tax for good health
By Robert Egbe
Something strange happened to Enugu-based paediatrician, Dr. Chiwetalu Odoh, last Christmas eve. Summoned to the Children’s Emergency Unit at the hospital in Enugu, he expected to meet a critically ill child. Instead, he found a little girl, her mother and her aunt, seated quietly in the waiting area. At first glance, she appeared to be healthy.
But the night before – between bedtime and that morning – the child drank over 17 sachets of water. She repeatedly woke to urinate. Her aunt, a nurse, had also observed that the child seemed to have lost weight in three months and had developed a voracious appetite.
The patient’s test result alarmed everyone. Her Random Blood Sugar read “Hi” and her urine ketones were significantly positive. She was diagnosed with Diabetic Ketoacidosis (DKA) from newly diagnosed Type 1 Diabetes Mellitus. Type 1 Diabetes Mellitus, like other noncommunicable diseases (NCDs), is generally an incurable, long-term or lifelong condition.
She was just nine years old.
“Cases like this often arrive at the hospital when the patient is already unconscious,” Odoh said in a Facebook post. “….A few more hours or days of delay could have led to severe consequences including but not limited to shock, heart failure, kidney failure, respiratory failure, confusion, seizures, coma and even death.”
The child’s case is a reminder of how suddenly many NCDs creep up on a family, hence, their moniker “silent killers.” It is also a reminder of Nigeria’s growing burden of non-communicable diseases (NCDs) – no fewer than 28 per cent of all annual deaths in Nigeria are caused by NCDs – and the urgency for healthy food policies to tackle same.
It must be clarified that Dr. Odoh neither disclosed the cause of the child’s medical condition, nor said unhealthy diets are the sole cause of NCDs.
However, several studies, including by the World Health Organisation WHO and the NCD Alliance, show that unhealthy diets, particularly heavily processed and pre-packaged products high in sugar, salt, trans fats and chemical additives, known as ultra-processed foods (UPFs), are a leading risk factor for heart disease, stroke, diabetes, some cancers and other NCDs.
These UPFs have in the past few decades arrived to virtually every community in Nigeria, gradually replacing our healthier, more traditional diets. Their increased availability, engineered by aggressive marketing by the junk food industry, has dramatically changed the way Nigerians eat and drink, contributing to escalating rates of NCDs, straining families, deepening poverty, and overwhelming an already fragile health system.
For instance, the disease burden associated with sugary drinks, or SSBs, has become one of the most alarming public health challenges of the century. Globally, regular consumption of SSBs have been proven both scientifically and medically to be among the leading dietary drivers of obesity, type 2 diabetes, cardiovascular complications, child malnutrition, and the rising tide of NCDs and preventable deaths.
To compound the problem, most Nigerians have no health insurance, with out-of-pocket spending accounting for almost 75 percent of Nigerians’ total health expenditure, the fourth-highest share globally.
Worse yet, the country allocates less than six percent of its national budget to health. This chronic underfunding contributes to overstretched health facilities, inadequate infrastructure, and the continued emigration of health workers facing poor work conditions.
In 2021, the Nigerian government took a bold step towards tackling the NCDs and health financing challenges. Through the Finance Act of 2021, it introduced a specific excise duty on SSBs and, in the process, amended the Customs, Excise Tariffs, etc. (Consolidation) Act (CETA) by inserting Section 21(3), which imposes a fixed N10 per litre duty on non-alcoholic, carbonated, and sweetened beverages. The measure reflected growing recognition that public health taxation can be used a life-saving tool capable of reducing preventable disease, curbing harmful consumption, and mobilising domestic resources to strengthen the nation’s health system.
But the fixed duty of N10 per litre has not been effective. It amounts to a fraction of one percent of the average retail value of most sugary drinks sold in Nigeria. This means the tax barely alters the final price consumers see on the shelves and in markets. It is too small to discourage consumption, too insignificant to trigger industry reformulation, and too easily absorbed by manufacturers and retailers without affecting demand.
Last year, the national assembly rightly proposed an amendment to CETA to replace the N10 per litre excise tax on SSBs with a value-based, ad valorem tax linked to retail prices. The Senate passed the bill on June 4, 2026, and it is currently awaiting concurrence in the House of Representatives before it can be sent to the president for assent.
Critics of a stronger SSB tax argue that it will increase production costs, raise prices or hurt manufacturers and consumers at a time of economic difficulty. What they fail to mention is that Nigerians and the government are already paying for the consequences of preventable NCDs through humungous medical bills, lost working hours, reduced productivity and pressure on an underfunded health system.
Furthermore, Nigerians spend about N1.9trn yearly to treat diabetes and other NCDs, with health-related expenses pushing over one million Nigerians into poverty annually. Thus, millions of children, pregnant women, and low-income households, continue to face financial hardship when seeking health care.
So, yes, Nigeria needs manufacturing, investment and jobs, but without the irreplaceable trade-offs in health. The irony of such jobs lies in the long-term impact of chronic diseases on the population as individuals who manage these lifelong diseases lose productive years. Thus, public health is itself an economic investment.
For too long, the conversation around public health has focused on treating disease after it appears. With the proposed CETA Amendment Bill Nigeria has an opportunity to invest in preventing SSBs-linked NCDs before they take hold.
The child in Enugu did not choose the burden of a serious illness. Nor should Nigeria wait until millions more families are sitting in hospital waiting rooms before recognising the economic value of prevention.
The SSB Tax Bill offers an opportunity to make prevention part of fiscal policy. Alongside its bold move to ring-fence a percentage of the SSB tax for public health intervention, the move by the National Assembly builds on Nigeria’s cohesive efforts in protecting the wellbeing of her citizens
If implemented effectively, together with broader measures to improve Nigeria’s food environment, like a Nutrient Profile Model (NPM), Front-of-Pack Labelling (FOPL), mandatory sodium reduction, and marketing restrictions, an improved SSB Tax will help reduce sugary-drink consumption, generate resources for health promotion and contribute to a healthier, more productive population.
The CETA Bill Amendment is, therefore, not a punitive tax on Nigerians’ lifestyle, but an investment in their wellbeing.
Egbe, a healthy food policy advocate at Corporate Accountability and Public Participation Africa (CAPPA) writes from Lagos.
