Cheap sweetened drinks are costing Filipino lives

When an illness affects a household, it rarely only affects one person. It reshapes a family and forces difficult choices that no one should have to make. For many Filipino families, getting sick means worrying about how to pay for a doctor and medication and missing work. What starts as a health issue turns immediately into a fight for survival.

The World Health Organization (WHO) has warned that sweetened drinks are becoming more affordable in many countries, including the Philippines, because taxes have not sufficiently decreased their affordability. For many low-income households, sweetened drinks are all they can afford, especially when clean and healthier options are costly.

Diabetes is no longer just a health issue in the Philippines; it is becoming an economic crisis. According to the International Diabetes Federation in the Philippines, about 4.7 million Filipinos were living with diabetes in 2024, with a prevalence rate of 7.5%. Diabetes has also been consistently among the top five causes of death in the country with 43,944 lives lost in 2024 alone, according to the Philippine Statistics Authority.

Globally, the situation is equally alarming. The WHO notes that diabetes, especially type 2, characterized by insulin resistance, is rapidly rising in low- and middle-income countries. Chronic complications like cardiovascular disease, kidney failure, and nerve damage make it a costly burden, both for individuals and for government health systems.

My grandmother, an avid drinker of sweetened beverages, was diagnosed with diabetes years ago. Meals at her house were incomplete without a 1.5 liter bottle of soda or a pitcher glass of powdered juice. Surprisingly, even though it’s been 15 years since my usual long summer trips to my grandmother’s house, the price of soda has barely increased, making it easier for families to keep choosing the same drinks, even as the health risks grow. Its affordability keeps it within reach.

This cultural embedding of sugary beverages is significant. Studies in the Philippines by Aguilar & Tolabing (2025) reveal a high prevalence of daily sugar-sweetened beverage (SSB) consumption: over 64.41% of Filipinos aged 15 to 70 report drinking at least one sweetened drink per day. For many, these drinks are a part of everyday life.

To put the sugar content of these beverages into perspective, a standard 12-ounce can of a popular soft drink contains around 39 grams of sugar, or nearly 10 teaspoons. On the other hand, a typical serving of a popular local powdered drink carries about 16 to 18 grams of sugar. When consumed daily, these sugary beverages contribute heavily to the increased risk of insulin resistance and ultimately, type 2 diabetes.

Because of this habit and culture of SSBs being a staple in a normal Filipino household, it wasn’t surprising to me when my grandmother was diagnosed with diabetes. But what surprised me and continues to weigh on my mind is how much this disease costs her every day, and what it means for the Filipino economy at large.

The rising economic burden of sweetened beverages is reflected in the day-to-day realities faced by individuals living with diseases attributable to SBs. In 2021, a patient with type 2 diabetes without complications spent an estimated P33,873.99 each year on consultations, medication, and routine monitoring. By 2023, this amount had already increased to P36,113.64. For those who develop complications, the financial burden becomes far heavier. In 2021, total medical costs for a patient with complications reached P89,248.13. This was nearly three times higher than managing diabetes without complications. By 2023, this climbed to P91,899.96, driven largely by higher hospitalization-related expenses.

According to a study on the status of diabetes care in the Philippines (PhilDiabCare 2020), 49.41% of diabetes cases develop complications. Hence, this means that in 2021, out of the 420,012 diabetes patients attributable to SBs, approximately 207,528 patients had complications, while in 2023, out of 446,607 patients, around 220,668 had complications. Multiplying this by the estimated individual cost of treatment based on the presence of complications, the total direct cost of type 2 diabetes in 2021 was a whopping P25.72 billion, while it was P28.44 billion in 2023.

Given this burden, why should the government act and impose stronger tax measures, especially when it comes to sugar-sweetened beverages? First, because SSBs are a modifiable risk factor. Unlike genetics, sugar consumption through drinks is something that can be taxed and discouraged through policy. Second, the government already has a precedent, under the TRAIN (Tax Reform for Acceleration and Inclusion) law, sweetened drinks are taxed P6 per liter for drinks sweetened with caloric or non-caloric sweeteners, and P12 per liter for beverages using high-fructose corn syrup. But policy can go further and stronger by adding automatic indexation, removing exemptions on products like 3-in-1 coffee, and raising tax rates by at least 20%. Third is the return on the Universal Health Care Law. The same WHO-Philippines study shows that preventive Non-Communicable Disease interventions are cost-effective: investing in public health now can save not just lives, but economic burden in the long run. Preventing diabetes means fewer hospitalizations, less medication burden, and a more productive workforce.

In my view, the Philippine government must intensify its fight against sugary drinks. It must treat SSBs as a good that is harmful and costly to society.

Ella Iellamo is a health advocate and a former member of Action for Economic Reforms’ health policy team.