Johannesburg, January 2026: When Petrus Cockrell wakes up each morning, the first thing he reaches for is his wheelchair. Diabetes took both his legs before he turned 50. It robbed him of his mobility, his job and the simple joy of walking beside his dog.1 Petrus is one of millions of South Africans living with a disease that did not need to progress this far. Behind every statistic is someone like him, a parent, a worker, a caregiver whose life has been cut short or forever altered by a preventable illness.
With the National Budget Speech scheduled for February, the Healthy Living Alliance (HEALA) is calling on government to increase the Health Promotion Levy (HPL) on sugary drinks from 11% to 20%, a life-saving decision backed by evidence.
The HPL is part of South Africa’s broader package of health taxes, alongside tobacco and alcohol excise duties, which have long been used to protect the public from preventable harm.
“Every amputation, every blindness diagnosis, every child who loses a parent to diabetes is a reminder that we have waited too long,” says Nzama Mbalati, CEO of HEALA. “The HPL is not a standalone experiment; it is a proven health tax. Government has used health taxes successfully for decades. Strengthening the HPL simply extends that legacy to protect South Africans from excessive sugar consumption.”
The urgency of this demand is underscored by modelling from PRICELESS SA (University of the Witwatersrand). The data indicates that increasing the HPL to 20% could prevent 619 000 new diabetes cases, save approximately 72 000 lives, prevent 85 000 strokes and save South Africa R23.9 billion in healthcare costs over 25 years.2
“We treat people every day for conditions that should never have progressed this far. The HPL is not just a tax, it is a protective shield for millions of South Africans,” says medical doctor and health advocate Dr Darren Green, featured in HEALA’s upcoming campaign. “Strengthening it means fewer amputations, fewer patients on dialysis and fewer children growing up without parents. Very few interventions deliver such measurable health benefits, especially for communities already carrying the heaviest burden.”
As tariff disputes and import pressures dominate sugar industry news, HEALA emphasises that tariffs and the HPL must not be conflated. Tariffs are trade instruments designed to stabilise industries. The HPL is a public health instrument designed to save lives.
“We cannot allow tariff debates to derail a health tax that works,” Mbalati adds. “Just as we use tobacco and alcohol taxes to protect South Africans from harm, the HPL is a critical part of our national health tax framework. Strengthening it is a public health necessity, not an industry target.”
HEALA’s documentary series continues to reveal the human cost of diabetes. Alphinah, who lost both legs and her eyesight; Mpho, who believed sugar was harmless until he lost his leg at 45 and now Petrus, each offering a powerful reminder that these outcomes were preventable. Their message is clear: if they had known sooner, their lives would look different. Government now has the power to prevent thousands more from walking the same path.
HEALA calls on the public to stand with Petrus and millions of others by demanding decisive government action. As the Budget Speech approaches and the Health Promotion Levy faces growing pressure from industry interference, South Africans are urged to sign the petition supporting the increase of the HPL to 20% before the Minister of Finance takes the podium in February. Sign the petition at www.heala.org.