A recent post by a friend caught my attention. It discussed the link between Tunisia's prevailing dietary habits and the rising prevalence of diabetes. According to available figures, around 20% of the Tunisian population has diabetes. Despite this, Tunisian bakeries continue to produce one of the least healthy types of bread, one that contributes significantly to elevated blood glucose levels, while the government continues to subsidize it. This raised a question that, in my view, deserves broader discussion: does Tunisia's current food subsidy policy still achieve its social objectives, or has it reached a point where it should be reconsidered in light of the country's evolving health and economic challenges?
There is no doubt that the subsidy system places a significant financial burden on the public budget. However, this article will not focus on its economic costs. We have addressed that aspect in previous articles, and it will remain the subject of future research. Instead, this article approaches the issue from a public health and social perspective.
Since independence, subsidies for essential food products have played an important role in improving food security and reducing poverty and malnutrition. This policy was justified in a context where the main priority was to guarantee a minimum level of food consumption for all citizens.
More than six decades later, however, the nature of Tunisia's challenges has changed. Food scarcity is no longer the country's primary concern. Instead, non-communicable diseases such as obesity, diabetes, and cardiovascular disease have become some of the most pressing public health challenges. This shift calls for a reassessment of the priorities guiding public food subsidies.
Health Indicators Call for a Policy Review
According to the latest data from the World Health Organization, approximately 26.8% of adults in Tunisia are obese, compared with a global average of about 16%. The country also faces a high prevalence of diabetes and its associated risk factors, driven by changing dietary habits and increasing consumption of foods rich in refined carbohydrates, sugars, and fats.
The consequences of these diseases extend well beyond public health. Chronic illnesses require long-term treatment, placing additional pressure on public hospitals and health insurance funds. They also reduce labour productivity and ultimately weigh on economic growth.
When Social Policy Conflicts with Public Health Policy
If the primary objective of food subsidies is to improve citizens' well-being, it is legitimate to ask whether the current subsidy structure still serves that purpose.
According to data from Tunisia's Ministry of Trade for 2022, food subsidy expenditures were allocated as follows: 3 billion dinars for cereals, 160 million dinars for milk, 480 million dinars for vegetable oil, 10 million dinars for sugar, 10 million dinars for school paper, and 86 million dinars for pasta and couscous.
In total, 3.576 billion dinars are spent each year subsidizing products that may contribute to poor health outcomes, representing approximately 95% of all spending on essential food subsidies. To put this figure into perspective, Tunisia's annual budget deficit is around 11 billion dinars.
This does not mean that bread or pasta alone are responsible for the rise in obesity and diabetes. These conditions result from a combination of factors, including lifestyle, physical inactivity, genetic predisposition, and excessive calorie consumption. Nevertheless, it is difficult to ignore the fact that the current subsidy structure makes foods high in refined carbohydrates and calories more affordable than healthier and more balanced alternatives.
This discussion has not yet addressed fuel subsidies, despite their negative environmental consequences and the fact that they disproportionately benefit higher-income households. We have examined this issue in a separate study and intend to explore it further in future research, focusing on the unequal distribution of subsidy benefits.
Can Food Subsidies Be Better Targeted?
Perhaps the real question is not whether food subsidies should be abolished, but rather how they can be better targeted.
Instead of concentrating most public spending on a limited number of products, it may be more effective to redesign the subsidy system so that it aligns more closely with the government's public health and social objectives.
From an economic perspective, subsidized prices influence both consumption and production decisions. When subsidies remain concentrated on a specific group of products over a long period, they increase those products' price competitiveness relative to other foods. As a result, consumption patterns may no longer reflect the true social costs associated with these products. By contrast, redirecting part of the subsidy budget toward foods with higher nutritional value could gradually encourage demand for a more balanced diet while creating incentives for producers to invest in these sectors and expand their market supply.
Likewise, replacing universal price subsidies with direct support for eligible households could improve the efficiency of public spending. Such an approach would preserve the purchasing power of vulnerable households without continuing to subsidize consumption across all income groups, including high-income families. It would also reduce leakages within the subsidy system and ensure that public resources are allocated more accurately to those who need them most.
The benefits of such a reform would extend beyond social policy. Over time, improvements in dietary quality could help reduce the prevalence of chronic diseases, leading to lower public healthcare expenditure, higher labour productivity, and longer working lives.
Any reform, however, should be gradual rather than abrupt. It should be accompanied by transitional measures that protect vulnerable households from sudden price increases, safeguard food security, and give both producers and consumers sufficient time to adapt to the new subsidy framework.
Subsidy Reform Is Not Just a Fiscal Issue
Discussions on subsidy reform often focus on reducing the budget deficit or improving the government's fiscal position. While these objectives are important, the debate remains incomplete if it overlooks the long-term health and social consequences of the subsidy system. The way subsidies are allocated affects not only public expenditure but also dietary consumption patterns, with significant implications for both public health and economic outcomes.
From this perspective, redirecting part of the subsidy budget toward foods with higher nutritional value, or replacing universal price subsidies with direct support for eligible households, could help reduce the prevalence of chronic diseases over the long term, ease financial pressure on the healthcare system, and improve labour productivity. The evaluation of any subsidy reform should therefore extend beyond the immediate fiscal savings it generates and also consider its broader economic, social, and public health effects.
Conclusion
Tunisia's food subsidy system has achieved important social objectives during a historical period when ensuring food security and reducing poverty were the country's primary priorities. However, the profound health and economic changes that Tunisia has experienced over recent decades call for a reconsideration of both the priorities and the design of the current system.
This does not mean abandoning the principle of food subsidies. Rather, it means moving toward a system that allocates public resources more efficiently while achieving its social objectives at a lower economic and public health cost. Ultimately, the success of any subsidy reform should be measured not only by the fiscal savings it delivers but also by its ability to strike a sustainable balance between social equity, efficient public spending, and better health outcomes for citizens.