As Big Soda faces increasing pressures in high-income countries–declining sales in the United States and a soda tax in the United Kingdom among other countries, Coca-Cola and PepsiCo are revving the engines of their marketing juggernaut in low- and middle-income countries.

“Carbonating the World,” a recent report by the Center for Science in the Public Interest, documented Big Soda’s efforts, which look like they came straight out of the Big Tobacco playbook. For instance, Coca-Cola expects to invest more than $40 billion in emerging markets (i.e., developing countries) with the aim of doubling its revenues between 2010 and 2020.

PepsiCo is not far behind in this marketing arms race in low- and middle-income countries. Take China, where the sales of carbonated drinks are expected to grow to $16.2 billion by 2018. Coca-Cola invested $3 billion in China between 2009 and 2011 and plans to ante up another $4 billion between 2015 and 2017. PepsiCo has invested $2.5 billion over a recent three-year period.

The real price of these investments, however, comes in the rising rates of soda-related diseases such as diabetes, heart disease, obesity and tooth decay. In India, where 51 million of its people already live with diabetes, the Indian Diabetic Foundation is projecting that number will rise to 80 million by 2025.

Moreover, the soda companies readily admit they are targeting young people, ensuring these health burdens will only grow in these countries with health care infrastructures that are already stretched to the breaking point. Coca-Cola’s chief financial officer Gary Fayard has called the world’s 3.5 billion young people in their teens and twenties “our core demographic.” That company’s head of marketing in Egypt was even more telling in his comment: “We have young generations who can consume any kind of food and beverage, [they’re] not caring about their health yet.”

Big Soda continues to market to children

In fact, what “Carbonating the World” documented was how Coca-Cola and PepsiCo repeatedly broke their pledges not to market to children. School entrances in South Africa and Ghana are festooned with Coca-Cola signage, and in India the company sponsors the Coca-Cola Cup, a cricket tournament for children aged 12 to 16. Not to be outdone on the cricket field, PepsiCo launched a Facebook-based game called the “Great Indian Catch.” In the Philippines, PepsiCo used young Filipino celebrities Daniel Padilla and Kathryn Bernardo to hawk their products.

This global tidal wave of Big Soda marketing calls for a united and collaborative response from nations, the World Health Organization, civil society–and, yes, the companies themselves. Coca-Cola and PepsiCo need to drop their obstructionist ways, aimed at stopping public health measures brought forth by countries and health advocates. WHO in its recent report “Ending Childhood Obesity,” called for adopting sugar taxes and ending the marketing of sugary drinks to children.

WHO needs to continue its drumbeat and also offer technical assistance where needed. Nations and their civil societies should enact soda excise taxes and use the revenues for health programs and interventions, require warning labels on sugary drinks, and enact strict and enforceable marketing codes to protect children.

We should not look back in 20 years and regret not having taken the necessary steps to protect this generation of young people and those to follow.

About Michael F. Jacobson

Michael F. Jacobson, Ph.D., is co-founder and president of the Center for Science in the Public Interest (CSPI), a nonprofit health advocacy organization supported largely by the 700,000 subscribers to its Nutrition Action Healthletter. CSPI is a key player in battles against obesity, cardiovascular disease, and other health problems, using tactics ranging from education to legislation to litigation. Jacobson has written numerous books and reports, including Nutrition Scoreboard, Six Arguments for a Greener Diet, "Salt: the Forgotten Killer," and "Liquid Candy: How Soft Drinks are Harming Americans’ Health."