Health Metrics proposes the introduction of a tax on sugar-sweetened beverages

A tax on sugar-sweetened beverages should be introduced in Bulgaria as part of the measures for the prevention of non-communicable diseases among the population. This is the recommendation of experts from Health Metrics—a company that collects, analyzes, and presents health, social, and economic information aimed at providing quality data for better health policies and decisions in the country.

“The introduction of a tax on sugar-sweetened beverages in Bulgaria can be viewed as part of a comprehensive strategy for the prevention of chronic diseases. However, a key condition for this objective is that the revenue from this tax be specifically invested in children’s and school health programs, the promotion of healthy eating, as well as in prevention and educational campaigns. We should not view this tax as a punitive measure, but as a necessary public health tool and a signal that the state places the health of children and future generations at the center of its policies,” commented Arkadi Sharkov, health economist and managing partner at Health Metrics.

A similar tax has already been introduced in a number of countries worldwide. In the European Union (EU), there is no single unified tax—each country applies its own rate and scope. Some countries charge only if the sugar content exceeds a certain threshold. Others have tiered rates based on sugar content. Some use fixed amounts per liter, while others apply combined taxation models.

The tax on sugar-sweetened beverages brings a double benefit—in addition to health, it is also fiscal. In EU member states that apply such taxes, the revenue collected in 2021 amounted to 2.13 billion euros (the sum of reported revenues by country). In parallel, a measurable effect on consumption is also observed. In most cases, tax rates are progressive and linked to the amount of sugar, which further incentivizes the transition to products with lower sugar content.

The proposal by Health Metrics experts is based on the analysis of a range of data, reports, recommendations, and policies at a global level.

For example, according to the World Health Organization (WHO), over 80% of deaths in the European Region are due to chronic non-communicable diseases, with unhealthy diets being among the leading preventable risk factors, and increased consumption of free sugars being among the primary causes of elevated obesity levels among both adults and adolescents.

International trends in health policy clearly show that the fight against chronic non-communicable diseases requires systemic measures. In this context, the U.S. Department of Health and Human Services (HHS) announced a “historic reset” of federal nutrition policy, placing a strong emphasis on limiting ultra-processed foods, added sugar, sugar-sweetened beverages, and others in the new “Dietary Guidelines for Americans, 2025-2030.”

Bulgaria is no exception to global trends. Our country faces serious challenges related to childhood obesity, diabetes, and other chronic diseases directly influenced by the excessive consumption of processed foods, sugar, and specifically sugar-sweetened beverages.

According to UNICEF data from September 2025, Bulgaria is among the countries with the highest levels of childhood obesity in Europe, with nearly one in every three children being overweight.

Data from a study conducted in the period 2022-2024 within the framework of the World Health Organization’s European Childhood Obesity Surveillance Initiative (COSI) show that 17.8% of children aged 6-9 in Bulgaria consume soft drinks more often than three times a week.

At the same time, the “Health at a Glance 2025” report by the Organisation for Economic Co-operation and Development (OECD) indicates that 30% of 15-year-olds in Bulgaria consume sugar-sweetened beverages daily.

According to National Statistical Institute data, the consumption of carbonated beverages per person per household increased from 29 liters in 2020 to 37.9 liters in 2024, indicating a steady trend of increasing consumption.

Regular intake of sweetened beverages (including sweetened carbonated and non-carbonated drinks, fruit drinks, concentrates, flavored water, energy and sports drinks, flavored milk, etc.) is associated with a higher risk of obesity, type 2 diabetes, arterial hypertension, cardiovascular diseases, dental issues, and other health problems.

Health Metrics experts warn that these trends represent not only a health issue but also a serious long-term economic problem. Chronic diseases related to nutrition and increased intake of free sugars lead to higher treatment costs, lost productivity, and growing pressure on the health budget.

According to data from the Global Burden of Disease (GBD 2019), presented by the European Commission, a “diet high in sugar-sweetened beverages” leads to 532,500 disability-adjusted life years (DALYs) annually for the EU, which equates to an average of 59.4 billion euros in socio-economic losses on an annual basis.

“International experience shows that the taxation of sugar-sweetened beverages is an effective tool for improving the environment. In the UK, the introduction of the so-called ‘Soft Drinks Industry Levy’ led to a 50% drop in sales of high-sugar drinks and encouraged manufacturers to reduce sugar in their formulas without a compensatory increase in the consumption of other harmful products. Similar policies in several other countries not only reduce consumption but also generate significant public revenue, which is reinvested in prevention, diabetes control programs, and more,” says Sharkov.

He adds that the current proposal is in line with the new U.S. federal approach to nutrition, which identifies added sugars and sweetened beverages (including soft and energy drinks) as key risks to children’s health. The recommendation is to avoid them, and for the youngest children, no intake of added sugar is recommended. This is an important signal that prevention begins at an early age, when habits are formed and ‘liquid calories’ most easily become a permanent risk.