Article Text

Policy networks and competing interests in the development of the Mexican sugar-sweetened beverages tax
  1. Angela Carriedo1,
  2. Paul Cairney2,
  3. Simón Barquera3,
  4. Benjamin Hawkins4
  1. 1World Public Health Nutrition Association, London, UK
  2. 2Division of History, Heritage, and Politics, University of Stirling, Stirling, UK
  3. 3Centre of Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
  4. 4MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
  1. Correspondence to Dr Angela Carriedo; angela_carriedo{at}


Introduction Sugar taxes threaten the business models and profits of the food and beverage industry (F&BI), which has sought to avert, delay or influence the content of health taxes globally. Mexico introduced a sugar-sweetened beverage (SSB) tax in 2014 and other regulatory measures to improve population diets. This paper examines how policy networks emerged within and affected the development and implementation of the Mexican SSB tax.

Methods This qualitative study analyses 31 interviews conducted with key stakeholders involved in the soda tax policy process and 145 documents, including grey literature and peer-reviewed literature. The policy network approach was used to map contacts, interconnections, relationships and links between the state, civil society and commercial actors involved in the SSB tax. These findings were used to examine the responsiveness, participation and accountability of the soda tax policy formulation.

Results Complex interconnections were identified between state and non-state actors. These included advisory relationships, financial collaborations and personal connections between those in high-level positions. Relationships between the government and the F&BI were not always disclosed. International organisations and academics were identified as key financial or technical supporters of the tax. Key governance principles of participation, responsiveness and accountability were undermined by some of these relationships, including the participation of non-state actors in policy development and the powerful role of the F&BI in evaluation and monitoring.

Conclusion This case study exemplifies the importance of links and networks between actors in health policymaking. The F&BI influence endangers the primary aim of the SSB tax to protect health. The identified links highlight the normalisation of connections among actors with competing aims and interests toward health, thereby jeopardising attempts to tackle obesity rates.

  • Health policy
  • Public Health
  • Nutrition

Data availability statement

Data are available upon reasonable request.

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Data are available upon reasonable request.

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  • Handling editor Eduardo Gómez

  • Twitter @acarriedo

  • Contributors The paper was drafted by AC. PC, SB and BH provide critical revisions to the manuscript for important intellectual content. BH supervised the PhD of AC that led to completing this paper. AC is responsible of the overall content as the guarantor.

  • Funding BH’s position is supported by the Medical Research Council (Grant Number: MC_UU_00006/7).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.