ABSTRACT:
Non-communicable diseases (NCDs) are the leading cause of death globally, accounting for approximately 71% of all mortality. South Africa mirrors this transition, with NCD-related deaths increasing by nearly 60% between 1997 and 2018. Rising consumption of alcohol and ultra-processed foods and beverages (UPFs/UPBs), driven in part by Unhealthy Commodity Industries (UCIs), has been identified as a key contributor. Despite increasing attention to the Commercial Determinants of Health, policy-relevant evidence on how UCI market structures, pricing, and marketing strategies shape population exposure in South Africa remains limited. This study examines trends in sales volumes, values, and prices of alcohol and UPF, assesses market concentration within UCIs, and explores implications for NCD prevention and fiscal policy in South Africa.Secondary data on retail sales volumes, values, and prices for alcohol and soft drinks were obtained from the Euromonitor Passport Database for 2010–2025, with projections to 2029. Per capita sales volumes were estimated using national population data. Market concentration was measured using the Herfindahl–Hirschman Index based on company market shares. Trends were analysed using descriptive statistics. Alcohol markets display a pronounced divergence between physical exposure and economic value: beer dominates per-capita volumes but generates relatively low per-capita sales value, while spirits contribute disproportionately to sales value despite lower volumes. Ultra-processed beverages show substantially higher per-capita volumes and values than alcohol, with juice and 100% juice accounting for the largest economic exposure. Evidence of product differentiation and pricing power is observed across beverage categories.The findings reveal clear price and harm gradients across alcohol and ultra-processed beverage markets, highlighting the role of UCIs in shaping consumption patterns. These results support product-specific excise reform, expanded nutrition-related fiscal measures, and stronger regulation of commercial practices to reduce NCD risk and promote equity in South Africa.