Reports Highlight Impact of Taxing Unhealthy Products to Combat Chronic Diseases Worldwide

Noncommunicable diseases (NCDs), such as stroke, heart disease, diabetes, and cancer, are rising throughout the world and are associated with poverty and inequity in countries. Papers from The Lancet Taskforce on NCDs analyzed the potential health and economic impact of implementing taxes on soft drinks, alcohol, and tobacco to combat the rising rates of the chronic diseases.

The papers highlighted how taxes on unhealthy products can improve health among the poorest members of society, who are disproportionately affected by NCDs.

“Noncommunicable diseases are a major cause and consequence of poverty worldwide,” Rachel Nugent, PhD, of RTI International and chair of The Lancet Taskforce on NCDs and economics, said in a statement. “Responding to this challenge means big investments to improve healthcare systems worldwide, but there are immediate and effective tools at our disposal.”

In a commentary¹ accompanying the Taskforce’s series of reports, Lawrence H. Summers, PhD, of the Harvard Kennedy School at Harvard University, explained that while opposition to taxes on unhealthy products often claim the taxes are regressive and unfairly punish poor people, who will have to pay a larger share of their limited income compared with richer people, these taxes can actually help poorer members of society.

People with lower incomes have a higher burden of preventable NCDs, with more of them getting sick and dying earlier as a result of consuming the products these taxes target compared with richer households. In addition, “poorer households are more likely to incur catastrophic costs than wealthier ones” in order to treat these diseases. Summers also highlighted the fact that poor households tend to eliminate consumption of products that are taxed,² and that the revenue raised by these taxes can benefit poorer members of society by funding programs to help people quit smoking or consume healthier diets.

“The evidence suggests that concerns about higher taxes on tobacco, alcohol, and soft drinks harming the poor are overstated,” Nugent added. “Some degree of taxation on tobacco is common in many countries, and while we are starting to see progress on alcohol taxes, there is much more governments should be doing—in both high- and low-income countries—to consider the careful introduction of taxes on other unhealthy products like soft drinks and snacks. Price policies such as taxes will be a key part of the response to rising rates of non-communicable diseases.”

In one of the Taskforce’s reports, researchers found that investing $120 billion for cardiovascular disease prevention into the 20 countries with the highest NCD burden would avert 15 million deaths, 8 million incidents of ischemic heart disease, and 13 million incidents of stroke between 2015 and 2030.³ Cardiovascular disease currently accounts for nearly half of all NCD deaths every year. Interventions to reduce smoking and salt intake, and pharmaceutical interventions for the prevention and treatment of ischemic heart disease and stroke, were analyzed in the report.

“Effective and low-cost interventions, including reducing smoking, salt reduction in food, and available medication, are still not implemented widely enough in low- and middle-income countries,” Melanie Bertram, PhD, World Health Organization, said in a statement. “Our analysis shows that investing in cardiovascular disease prevention and intervention is integral to achieving the [Sustainable Development Goal] target to reduce premature deaths from NCDs.”

References

1. Summers LH. Taxes for health: evidence clears the air. [published online April 4, 2018]. Lancet. doi: 10.1016/S-140-6736(18)30629-9.
2. Sassi F, Belloni A, Mirelman AJ, et al. Equity impacts of price policies to promote healthy behaviors. [published online April 4, 2018]. Lancet. doi: 10.1016/S0140-6736(18)30531-
3. Bertram MY, Sweeny K, Lauer JA, et al. Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services. [published online April 4, 2018]. doi: 10.1016/S0140-6736(18)30665-2.