Tax tobacco, alcohol, soft drinks to help poor beat lifestyle diseases such as diabetes and strokes, global health leaders urge
Raft of studies, and editorial, in leading medical journal make the case for higher taxes to curb consumption of harmful products and fund treatment of diseases they cause among world’s poor
Global health leaders declared war on lifestyle diseases on Thursday, decrying the impact of tobacco, alcohol and soft drinks on the world’s poor and calling for taxes to curb their consumption and finance health care.
In six studies in leading health journal The Lancet, experts detailed the link between poverty and non-communicable diseases (NDCs) such as strokes and diabetes, and made the case for consumer taxes – opposed by industry and many politicians.
NDCs, which also include heart disease and cancer, “are a major cause and consequence of poverty worldwide”, said Rachel Nugent, vice-president of RTI International, a non-profit health policy institute in the American city of Seattle and chairwoman of The Lancet Taskforce on Non-Communicable Diseases.
Many of the United Nations’ Sustainable Development Goals, which run to 2030, will remain out of reach unless governments invest in policies that break the chains binding unhealthy habits and so-called “lifestyle” diseases, she said.
“Every year, almost 100 million people are pushed into extreme poverty because of out-of-pocket health spending,” Tedros Adhanom Ghebreyesus, head of the World Health Organisation, wrote in a comment, also in The Lancet.
“The costs of treating NDCs are a major contributor to this global scandal.”
NDCs are responsible for 38 million deaths – nearly half before the age of 70 – each year, a large share of them caused or aggravated by smoking, excessive drinking and/or unhealthy diets, according to the WHO.
One of the UN’s 2030 goals is to reduce deaths from NDCs by a third.
In 2011, world leaders at the UN general assembly pledged to develop national plans for the prevention and control of NDCs, and set targets to benchmark progress. But few have followed through.
“There has been a broad failure globally and in countries to act on the commitments made in the 2011 Political Declaration,” Richard Horton, editor-in-chief of The Lancet, and senior editor Jennifer Sargent, wrote in an editorial.
One of the most controversial remedies proposed for getting people to cut back on smoking and the consumption of alcohol or soft drinks is point-of-sale taxes.
Opponents argue such levies penalise the poor most of all, and amount to a regressive tariff.
The new studies show a more nuanced reality.
Research looking at the impact of price rises in 13 poor, emerging and wealthy countries, for example, found that – on alcohol and sugary snacks – low-income households were more likely than wealthy ones to cut back, leading to incremental health gains.
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And even if they pay more as a percentage of their income, families can benefit in other ways, the researchers argued.
“The extra tax expenditures involved should not deter governments from implementing a policy that may disproportionately benefit the health and welfare of lower-income households,” said Franco Sassi, a researcher at Imperial College Business School in London.
Additional tax revenue gained should be set aside for “pro-poor programmes”, he added.
For former New York mayor Michael Bloomberg, who has given away more than US$1 billion to curb tobacco use over the last decade, the benefits are obvious.
“Raising taxes on tobacco is the most effective way to drive down smoking rates, particularly among young people,” he said. “It is also the least widespread of all the proven tobacco control policies.
“If we can help more governments raise tobacco taxes, we could make a very big difference in smoking rates, and also raise revenue that countries can invest in other vital services.”
Tobacco claims nearly seven million lives yearly from cancer and other lung diseases, accounting for about one in 10 deaths worldwide, and a million in China alone, according to the WHO.
“The evidence suggests that concerns about higher taxes on tobacco, alcohol and soft drinks harming the poor are overstated,” said Nugent.