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Global Tax Program

Health Tax


In many low- and middle- income countries, high and growing consumption of unhealthy products- which contribute to non-communicable diseases including obesity – take a large toll, and have dire implications for both human capital outcomes and economic productivity.

More than 11.4 million premature deaths annually – or 20 percent of all global deaths– could be prevented by reducing consumption of tobacco, alcohol and sugar sweetened beverages (SSBs).

Further, economic pressures including higher food, fertilizer and energy prices, rising interest rates, and growth slowdown add up to a difficult fiscal equation for many developing countries.  While almost all countries increased overall government as well as health spending in the last few years, only a few of them—mostly high-income countries— can sustain these levels in the years ahead. Improving domestic resource mobilization, especially in a way that can broaden tax bases in a sustainable manner, will be central.

Why health taxes?

Health taxes are excise taxes imposed on products that negatively impact public health (e.g., taxes on tobacco, alcohol, SSBs). Because excise taxes can be used to target specific goods and services, they differ from other types of indirect taxes such as VAT or GST. In this sense, they are discriminatory: their special nature can be used to tax products that cause health related harms and generate negative externalities- harm to society; and negative internalities- harm to oneself.

As a policy tool, excise taxes are one of the most cost-effective ways to tackle consumption of these products: higher rates can lead to higher prices, and reduce affordability- curbing use and raising revenues, even in low capacity environments.

However, it is not just the tax rates that matter. Overall design of health taxes requires considering rates as well as the structure (i.e. ad valorem, mixed or specific) and base (i.e. value or volume, alcohol or sugar content). Further, the way that these taxes are implemented and enforced matters. Policy is only as good as the underlying tax and customs administration capacity that are in place to support collection. Developing efficient and effective tax administration ensures that the impact of health taxes is maximized and not undermined by tax avoidance and evasion, including illicit trade. Finally, the ecosystem in which health taxes evolves matter: Health taxes are part of larger tax systems, and recognizing this is critical to their success.

Our Work and Approach

Embedded in the Global Tax Program (GTP), the new Health Tax Workstream funded by the Government of Norway and Bloomberg Philanthropies bolsters the World Bank’s unique capacity to support countries in health tax reforms with a fiscal policy lens. From this vantage point, the program leverages World Bank expertise on taxation, close linkages with country economists, as well as multi-sectoral partners from outside and within the World Bank who are well positioned to support work at country and global levels.

Under the Health Tax Workstream, the majority of resources go to supporting country engagements across varying entry points, and with a focus on supporting core World Bank diagnostics such as Public Expenditure Reviews. This support seeks to connect with the broader tax reform dialogue at country level to ensure coherence. World Bank experts also thoughtfully synthesize lessons from these engagements and respond to other needs of countries that emerge on a demand driven basis to produce and disseminate learnings. Further, we leverage and participate in efforts with other partners in order to explore synergies and support strengthening the global knowledge base.

Last Updated: Sep 02, 2022

Events and Activities

Global Tax Program Health Taxes Knowledge Notes Launch Webinar

Launch Webinar: Global Tax Program Health Taxes Knowledge Note Series

The GTP Health Taxes Knowledge Note Series was launched with a webinar on March 22, 2023. Speakers discussed the first notes in the series, "Why Health Taxes Matter" and "Health Taxes and Inflation."
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Banner for the event on Design and Impact of Sugar Sweetened Beverages Taxes: The Case of South Africa

Design and Impact of Sugar-Sweetened Beverage Taxes: The Case of South Africa

This webinar, held on November 30, 2022, discussed the recent work from South African researchers and policymakers, who evaluated the impact of the tax with evidence on policy reformulation, implementation and tax administration.
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Video cover for Health Taxes: Policy and Practice learning event
Learning Event

Health Taxes: Policy and Practice

On November 7, 2022, the Global Tax Program's Health Tax Workstream organized a learning event on the new book, "Health Taxes: Policy and Practice," in collaboration with WHO and Imperial College London.
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Four panel speakers sitting on the stage at the session on health taxes at the 6th Annual Health Financing Forum 2022

The Side Event on Health Taxes at the 6th Annual Health Financing Forum

The World Bank activities supported by GTP Health Tax Workstream were presented in this session.
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VIDEO Jun 16, 2022

Improving health and budgets through health taxes

In this video from the 6th Annual Health Financing Forum on June 16, 2022, Evan Blecher, Global Tax Program, Macroeconomics, Trade & Investment Global Practice, World Bank, talks about how health taxes can help improve health while generating additional tax revenues.


GTP Health Taxes Knowledge Note Series

GTP Health Taxes Knowledge Note Series

The Global Tax Program Health Taxes Knowledge Note Series, produced by the Global Tax Program’s Health Tax Workstream, focuses on topics linked to implementation of health taxes, or excise taxes on tobacco, alcoholic drinks and sugar-sweetened beverages.
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Workers in the sugar cane field

The High Cost of Free Sugar

This World Bank blog discusses the social costs to supporting production of free sugars, particularly when it comes to health, and examines health taxes as a potential policy response to address these social costs.
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no smoking sign in Nepal

Health taxes for healthier populations: Cost-effective policy to save lives

In this blog, four Global Directors of the World Bank Group explain how The Global Tax Program’s Health Tax Workstream brings together knowledge & expertise from across the bank.
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Health Taxes: Policy and Practice book cover

New Book | Health Taxes: Policy and Practice

This new book, published by World Health Organization and Imperial College London and contributed by the World Bank, discusses health taxes, their effects, policy design and tax administration considerations.
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A patient receives an intial vital signs check before seeing the doctor

Health taxes support better health outcomes and better tax revenues

Marcello Estevao, Global Director of Macroeconomics, Trade and Investment at the World Bank, discusses in this blog how supporting health tax reforms can help countries improve health and revenue outcomes.
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Sugar cubes in a glass next to a generic soda can

Is taxing sugar-sweetened beverages (SSBs) a sweet deal?

This blog discusses various aspects of SSB taxes.
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A man smoking on the side of a road

The seven salvos of (sin) taxes

Read more about seven lessons from international experience in implementing health taxes, or so -called "sin taxes"
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A woman standing behind a snack stand

Sugar-Sweetened Beverages and Snack Taxes

Learn how health tax policies enacted in Mexico and Hungary can inform similar measures around the world.
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GTP Program Manager
Ceren Ozer
GTP Health Tax Workstream Coordinator
Danielle Bloom