Eight combinations of taxation and revenue use

A PLOS Medicine study published on 13 August 2026 modelled how food and beverage taxation and the use of its revenue could affect overweight and stunting in Peru. It compared two tax options, each paired with four alternative uses of the revenue: expanding Juntos Basic Transfer coverage, increasing payments to existing recipients, expanding the Early Childhood Transfer, or subsidising fruit and vegetables.

One tax option maintained the beverage tax described in the study. The other increased the higher-sugar beverage tax by five percentage points and introduced a 10% tax on ultra-processed foods. The population model covered ages 0–49 and separated the poorest fifth from the remaining 80%. Its overweight measure included obesity. Policy effects were estimated for 2024–2040.

Projected reductions depend on the outcome and allocation

Compared with business as usual, the additional beverage and ultra-processed-food taxes alone produced a modelled difference of −58.6 million cumulative person-years lived with adult overweight during 2024–2040, with a 95% uncertainty interval of −77.7 to −37.9 million. The authors attributed most of the projected overweight benefit to these taxes, mainly among the higher socioeconomic group. Person-years represented the cumulative years lived with an outcome within each age and socioeconomic group.

Increasing the Basic Transfer payment to current Juntos recipients gave the largest modelled child-stunting reduction. With revenue from the additional beverage and ultra-processed-food taxes, the reported difference reached −876 thousand cumulative person-years during 2024–2040 compared with business as usual, with a 95% uncertainty interval of −1,139 to −567 thousand; 82% of the reduction was among the poorest group. For fruit and vegetable subsidies, the authors described a limited and uncertain effect on stunting among the poorest. They also reported a moderate reduction in overweight with wide uncertainty intervals, disproportionately benefiting wealthier groups.

Revenue totals and coverage assumptions

The model estimated almost S/39 billion in total revenue during 2024–2040 under the existing beverage-tax option and approximately S/51 billion under the additional beverage and food taxes. Revenue allocation used an idealised assumption of full earmarking. For coverage expansions, funds remaining after full coverage were left unspent.

The model assumed that children in the poorest group were already covered by the Basic Transfer. Expanding that transfer therefore reached the higher socioeconomic group, whereas increasing payments benefited existing recipients. The Early Childhood Transfer expansion prioritised the poorest group before extending coverage further.

What-if scenarios with limited local evidence

The model assumed uniform beverage and ultra-processed-food consumption across income groups because stratified data were unavailable. It applied the beverage consumption–overweight relationship to ultra-processed foods, used Mexican estimates for increased cash payments and drew on international evidence for produce subsidies. Tax and subsidy effects were assumed to weaken over time. The 95% uncertainty intervals came from 800 iterations varying selected inputs.

The authors stated that the model explored what-if scenarios rather than providing forecasts or precise effect sizes. They identified simplified policy and market assumptions, international estimates that might not reflect Peru, and limited socioeconomic detail as limitations. Regional inequalities and additional nutrition outcomes were not examined. Cost-effectiveness was not assessed because excluding people aged 50 and older would underestimate relevant health burdens.

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