Non-communicable diseases (NCDs) are projected to represent a staggering 75% of all global deaths annually by the year 2030, with a notable portion of these fatalities, specifically eight percent of NCD-related deaths, occurring in the global south. These conditions, often referred to as 'silent killers,' primarily include type 2 diabetes, high blood pressure, heart disease, and an increasing incidence of certain cancers affecting younger populations. The escalating prevalence of these diseases is substantially fueled by the widespread consumption of sugary drinks and processed foods laden with high levels of sugar, salt, and saturated fats.

A critical factor in this growing health crisis is the pervasive influence of advertising, which actively promotes the consumption of such unhealthy products. This dynamic, where market forces and industry practices shape social norms towards the intake of harmful substances like tobacco, alcohol, unhealthy foods, and sugary beverages, is identified as 'commercial determinants of health.' Products posing the highest health risks—tobacco, sugary beverages, ultra-processed foods, and alcohol—are subjected to intensive advertising campaigns. For instance, in South Africa, manufacturers of sugary beverages expended US$191 million (R3.7 billion) on advertising between 2013 and 2019, often targeting child and family viewing times for television advertisements.

In response to this mounting threat, several countries have, over the past decade, implemented policies aimed at curtailing the consumption of these harmful products. These measures have included taxation on items like sugar, alcohol, and tobacco, as well as outright bans on advertising, many of which have demonstrated effectiveness. However, substantial gaps persist in the policy landscape for controlling these detrimental products. Academics with extensive research experience in this domain propose that the G20 nations can play a crucial role in addressing these deficiencies. Representing two-thirds of the global population, G20 countries are all grappling with an increasing burden of obesity-related illnesses such as diabetes, high blood pressure, and cancer at progressively younger ages. Aligning with this, one of South Africa's G20 presidency health priorities is to "stemming the tide of non-communicable diseases."

This presents an opportune moment for the G20 to make a concerted pledge to combat the drivers of NCDs. The G20 can formally acknowledge that these diseases are embedded within a pathological system where commercial entities contribute to ill health. Furthermore, G20 leaders can recognize the stagnation in the progress of enacting health taxes in most member countries. By focusing attention on these issues, the G20 can provide significant impetus to a high-level United Nations meeting scheduled for 2025, where a new global vision for the control and prevention of NCDs is expected to be established, with health taxes and marketing bans as central themes.

Efforts by various nations to reduce the consumption of harmful products have underscored that there is no single solution. Nevertheless, compelling evidence indicates that consumers, particularly younger ones, are responsive to price changes, highlighting taxation as a vital instrument for decreasing demand. Research further supports that health taxes tend to be progressive for population health outcomes and typically have minimal, if any, adverse effects on overall employment. Despite this, progress on alcohol and tobacco taxes has been slow, and there has been limited advancement in taxing sugary beverages, with existing taxes often set too low to be effective. This inertia is largely due to formidable resistance from industry groups, which employ various tactics such as denying harms, sowing doubt, diverting public attention, disseminating disinformation, establishing front organizations, and attempting to burnish their reputations through corporate social responsibility initiatives. When health promotion taxes do move through legislative or regulatory channels, industries often influence the proposals to dilute their effectiveness or offer voluntary commitments, which have proven to be ineffectual.

The potential benefits of implementing robust health-promoting fiscal policies are substantial. A 2024 report by a panel of experts indicated that an additional US$3.7 trillion in revenue could be generated over five years if all countries were to increase the prices of tobacco, alcohol, and sugary beverages by 50%. These funds are desperately needed to bolster healthcare systems, which are increasingly strained by NCDs that disproportionately affect the poorest and most vulnerable populations. Such taxes could also save an estimated 50 million lives globally over a 50-year period. Screening, diagnosis, medication, and treatment for NCDs impose significant financial burdens on both national finances and individual households, often leading to catastrophic expenditures.

The G20 platform offers a sound basis for championing efforts to curb the consumption of these harmful products, especially since half of its member countries already have one or two food-related policies, such as taxes on sweetened beverages. Their collective experiences can inform crucial debates on protecting public health. To build a solid foundation, the G20 should champion several key points: Firstly, prioritizing health promotion before illness onset is imperative due to the high financial and human costs of inaction. Secondly, there is a need to advocate vigorously for increased tobacco taxes, as tobacco remains a leading cause of death and illness, yet taxation efforts have stalled, with cigarettes becoming more affordable in many countries. Thirdly, a renewed emphasis on alcohol taxes is crucial, as these have seen little improvement and are not being used effectively. Fourthly, there must be fresh impetus to increase taxes on sugar-sweetened beverages to a level where they effectively raise product prices by at least 20%. Fifthly, the G20 should champion nutrition regulation within the broader trade and nutrition policy environment, as trade policies can sometimes conflict with health objectives. Lastly, it is vital to push for stronger global monitoring frameworks to ensure corporate accountability in health. This includes implementing clear conflict of interest policies, managing information effectively, and exposing corporate attempts to shape their own evidence base or discredit research that supports public health policies.