As countries confront a tightening fiscal environment and rising health needs, health taxes are increasingly viewed not just as a public health tool but as a lifeline for health financing. During the 78th World Health Assembly, policy-makers, researchers, and partners came together to examine how health taxes can help address today’s crises while advancing equity and universal health coverage.
The event – Health taxes for a healthy future: realizing fiscal opportunities for health and health care financing – was organized by the Alliance for Health Policy and Systems Research together with WHO, Bloomberg Philanthropies and the NCD Alliance, and sponsored by the Government of Tonga. Speakers included leaders from Tonga, Ghana, the Philippines and Thailand, alongside global partners.
Opening the event, Dr Kumanan Rasanathan, Executive Director of the Alliance, pointed to the urgency of the current situation. “We are in a 1989-style moment where international relations are changing dramatically,” he noted, which is why it’s important to have spaces like this to “discuss how health taxes can not only address this financing crisis, but also improve health and health equity.”
Health taxes: an underused but proven solution
In her keynote address, the Rt Hon Helen Clark, Chair of the Alliance Board and former Prime Minister of New Zealand, framed health taxes as a critical response to declining development assistance and rising noncommunicable diseases (NCDs).
“They raise money, they reduce consumption of harmful substances, and in the face of a fast-growing NCD epidemic, it’s really a no-brainer,” she said.
Clark cited WHO estimates showing only 13% of the global population is currently protected by tobacco taxes at recommended levels. She stressed the importance of framing, advocacy and evidence to counter industry resistance. “You need customised evidence, applied research and shared learning – to empower policy-makers to frame these taxes persuasively in their local contexts.”
Country experiences: political realities and policy progress
From Tonga, Minister of Health Dr ‘Ana ‘Akau’ola shared how the country raised taxes on sugary drinks and high-fat foods in 2016, and later addressed informal tobacco markets by introducing regulations on packaging and sales
“People were growing tobacco and selling it informally – and it wasn’t being taxed,” she said, explaining how new policies around packaging and retail sales were introduced to close this gap.
She highlighted forthcoming tobacco control action and called for support to evaluate impact and build local capacity. “We need technical assistance to do economic modelling and monitoring – but also to train our own people to do this work in the future.”
In Thailand, Dr Viroj Tangcharoensathien emphasized the importance of political integrity and institutional safeguards.
“Political interference is always there – yesterday, today and tomorrow,” he said. “You have to fight it through good governance.” He described Thailand’s surcharge on tobacco and alcohol, which generates over $120 million annually for health promotion – though even this has faced political threats.
In the Philippines, health taxes have dramatically expanded the government’s capacity to fund health. “The Department of Health budget has increased six-fold since 2013,” said Dr Albert Francis Domingo, Assistant Secretary of Health. “From under a billion US dollars then to over $5.4 billion today – and sin taxes, as we call them in the Philippines, were a major driver of that.”
He cautioned that such reforms require persistence. “It doesn’t stop with one reform. You need continuity, new champions, and you need to stay ahead of industry interference.”
Moderator Robert Marten, Unit Head at the Alliance, agreed with that sentiment, noting that even when passed, such measures face persistent pressure. “We know that it doesn’t stop there… there are active efforts to undermine that progress,” he said. “Industry is using all of its tools to do so”.
From Ghana, Dr Koku Awoonor-Williams, Senior Advisor to the Minister of Health, spoke about recent tax hikes on alcohol and sugary drinks, while encouraging a broader view of health financing.
“Not all health spending comes from health taxes,” he noted. “In Ghana, 12.5% of everything you buy – from water to goods and services – goes into our National Health Insurance Fund. That’s what’s driving our health system.”
He added that combining targeted and broad-based taxation enables Ghana to support both prevention and treatment, especially as NCDs now account for over 40% of post-all-age mortality.
Partners: a critical moment to act
Alison Cox, Policy and Advocacy Director at the NCD Alliance, pointed to growing momentum – including a proposed target in the zero draft of the upcoming political declaration for the September High Level Meeting on NCDs for 80% of countries to adopt recommended health taxes by 2030.
Jo Birckmayer of Bloomberg Philanthropies reiterated that health taxes are among the most effective tools available. “If countries raise prices by 50%, they could increase their health budgets by 40% – that’s not small change.”
Jeremias N. Paul, Jr., Coordinator of WHO’s Tobacco Control Economics Unit, described how WHO supports countries with tailored fiscal policy advice.
Final reflections: supporting countries with evidence that drives action
Closing the event, Dr Rasanathan stressed the need to shift from global conversations to local action. “If we don’t adapt, we risk becoming irrelevant. The real decisions aren’t made in Geneva or New York – they’re made in countries, by policy-makers, researchers and communities."
He emphasized that for health taxes to succeed, countries need not just political courage, but robust, timely and locally relevant evidence. “What we’re here to do is help people like Minister ‘Ana get the data she needs to make her case, or support leaders like Dr Viroj and Dr Domingo as they face down industry interference,” he said. “Evidence, in the right hands, is what helps overcome resistance and accelerate reform,” he concluded.