July 10, 2018
United Nations High-Level Meeting on NCDs: An opportunity to use fiscal measures to reduce the health and economic impact of NCDs
As part of the preparatory process for the upcoming third High-Level Meeting of the General Assembly on the prevention and control of non-communicable diseases (NCDs) on September 27, 2018, the President of the General Assembly, with the support of the World Health Organization (WHO), hosted an interactive hearing on July 5th, 2018. The hearing was an opportunity for both civil society and all stakeholders to share their priorities for the high-level meeting with Member States in September, and to provide feedback on the zero draft of the outcome document.
In response to the draft report of the WHO Independent High-level Commission on NCDs, which served as an input into the zero draft of the outcome document, the Tobacconomics team submitted comments on the report and participated in the interactive hearing to contribute to the process. Our comments are summarized below.
While the Commission’s strategies for preventing NCDs included a broad range of suggestions, we support the recommendations made specifically on the use of tax policies to increase the price of alcohol, sugar-sweetened beverages, and tobacco products.
Firstly, we note that raising tobacco taxes through small and gradual increases may not be sufficient to reduce tobacco use and NCD incidence. In many low- and middle-income countries, rapidly growing incomes may result in tobacco products becoming more affordable despite increases in taxes and prices. Therefore, we recommend that the Commission focuses the attention of countries on raising tobacco taxes significantly enough so that tobacco products become less affordable over time. This will ensure that the taxes will actually result in behavior change, which will in turn result in the maximum health benefit for the population.
While the use of tobacco taxes as a public health tool has increased substantially in recent years, the use of taxes on alcohol for public health has not enjoyed the same degree of interest and action. Although tobacco products have become progressively less affordable in many countries, the opposite is true for alcohol. We are encouraged that the Commission chose to highlight that the harmful use of alcohol is a significant contributing factor to NCDs and hope that the outcome document includes alcohol as an object of fiscal measures.
Finally, reducing the prevalence of unhealthy diets is a critical avenue to reducing the burden of NCDs. The implementation of effective tax structures on sugar-sweetened beverages is an effective tool, and recent reports are showing dramatic changes in the number of sales between sugar versus non-sugar-sweetened beverages. One of the fundamental reasons for these findings is that the responsiveness of consumers to changes in prices of sugar-sweetened beverages is significantly larger than that for tobacco or alcohol. This is mainly because there are a large number of substitutes available. Thus, we recommend that taxes should be implemented early on in the supply chain. In addition, the taxes should focus on sugar content, including through sugar-based tiers to encourage producers to reformulate products, and encourage the use of fiscal measures on other aspects of nutrition to discourage consumption of other unhealthy foods, while using the revenues to make healthier food options more affordable.
Based on our research, the Tobacconomics team finds that fiscal policies are important yet underutilized tools to address the causes of NCDs. Global settings, such as the Third High-Level Meeting of the General Assembly on the Prevention and Control of NCDs, are strategic opportunities to offer evidence-based solutions to assist Member States’ efforts to make substantial global commitments in achieving better health outcomes. Participating in the interactive meeting was a unique opportunity to advocate for the importance of effective fiscal measures, such as taxes on tobacco, alcohol and sugar sweetened beverages, as well as other tools to combat NCDs.