Global Tax Program

Focal Areas of Support

Improving health taxes requires engaging across the following focal areas of support, which are often applied in tandem. Countries can request support on health taxes from the GTP health taxes global team directly, or via other teams from across the Bank who channel these requests. Regardless of where the request originates, work is always undertaken in close collaboration with our Bank country colleagues and relevant global teams, and as a complement to activities implemented by partners.

The following table depicts focal areas of support provided by the Health Taxes Project:

The Health Tax project provides Bank-executed resources across all three areas of health taxes (tobacco, alcohol and SSBs) and is active in every region where the World Bank operates. In the majority of the 40+ countries where the project has engaged or is exploring support, work focuses on tobacco as well as at least one other health tax area.

Country Briefs

📑Monitoring, Evaluation, and Opportunities for Improvement in Governance (Spanish)

📑Lao Economic Monitor Launch features Health Taxes

📑North Macedonia Health Tax event

📑North Macedonia HTP Study

📑West Africa

By situating our work within the GTP, the project ensures that health taxes are considered within countries' broader tax reform programs and excise tax policy and administration. For instance, in Cambodia, Ethiopia and Ghana, the Health Tax project work is integrated into broader tax system diagnostics and reform support and a part of efforts to modernize the excise tax regime within these countries. In Kosovo, Lao People’s Democratic Republic and North Macedonia, health tax analyses have contributed to core World Bank country diagnostics such as Public Finance Reviews, which are the main vehicles for the Bank to hold dialogue on fiscal policy.

The World Bank focuses on responding to demand in low- and middle-income countries who have expressed interest in support: With staff in over 130 countries, we have direct relationships with government counterparts whom we work with on a daily basis and who channel requests for support, including priorities for learning from other countries.

The Global Tax Program’s Health Tax project also collaborates with global teams from across the Bank including Poverty, Governance, Macroeconomics Trade and Investment (MTI), and Health, Nutrition and Population to provide support to countries considering reform, and in collaboration with other organizations including the IMF, WHO, PAHO, OECD, and other academic and civil society partners.

The Health Taxes Knowledge Note Series, produced by the Global Tax Program’s workstream on Health Taxes, focuses on crucial considerations to achieve well-designed and effective implementation of excise taxes on tobacco, alcoholic drinks and sugar-sweetened beverages. The purpose of this series is to provide policy makers with an overview of relevant issues and feasible policy choices in setting health taxes based on questions that emerge from the field during health tax reforms.

📑 Knowledge Note #1: Why Health Taxes Matter: A Mechanism to Improve Health and Revenue Outcomes

This first knowledge note in the series, “Why Health Taxes Matter: A Mechanism to Improve Health and Revenue Outcomes” presents an economic framework exploring how health taxes can be used as a mechanism to generate both health and fiscal outcomes. The note also discusses the link between health taxes and tax policy and administration, and actions that countries can take to improve health and revenue outcomes. 

📑 Knowledge Note #2: Health Taxes and Inflation

The second knowledge note in the series, “Health Taxes and Inflation” explores the interaction between inflation and health taxes and presents a set of good practice policy considerations related to indexation of specific taxes in order to retain revenue potential.

📑 Knowledge Note #3: Tobacco Excise Taxes and Tobacco Leaf Farming— Key Considerations

The third knowledge note in the series, "Tobacco Excise Taxes and Tobacco Leaf Farming— Key Considerations" looks at the interaction between tobacco farming and excise taxation across a set of countries that grow tobacco leaf, providing policy makers with an overview of how tobacco excises do or do not impact factors in countries that farm tobacco such as growth, employment and domestic demand.

📑 Knowledge Note #4: Unpacking the Empirics Behind Health Tax Revenue

The fourth knowledge note in the series, "Unpacking the Empirics Behind Health Tax Revenue" gives policy makers an overview of the revenue potential for health taxes, including from policy changes related to adjusting existing tax structures and rates. 

📑 Knowledge Note #5: Sugar-Sweetened Beverage Taxes: Rationale, Evidence and Design for Improving Health

The fifth knowledge note in the series, "Sugar-Sweetened Beverage Taxes: Rationale, Evidence and Design for Improving Health" provides an overview of the rationale for implementing sugar-sweetened beverage (SSB) taxes, their impacts, and relevant design and tax administration considerations. 

📑 Q&A on Nutrition-Related Excise Taxes

This Q&A provides detailed responses to commonly asked questions about what and how to tax when it comes to nutrition- related targets of excise taxes, including sugar-sweetened beverages, ultra-processed foods, and implications for taxing inputs such as raw sugar or salt. It is a companion to Knowledge Note #5 on Sugar-Sweetened Beverage Taxes: Rationale, Evidence and Design for Improving Health.

📑 Knowledge Note #6: Saving Lives While Raising Revenue: Opportunities in Brazil’s Reform of Indirect Taxes to Improve Tobacco, Alcohol, and Sugar-Sweetened Beverages (SSBs) Excise Taxes

The sixth knowledge note in the series, "Saving Lives While Raising Revenue: Opportunities in Brazil’s Reform of Indirect Taxes to Improve Tobacco, Alcohol, and Sugar-Sweetened Beverages (SSBs) Excise Taxes" explores the current situation and policy opportunities to implement well-designed health taxes in the country. The note shows that excise taxes and prices of these products in Brazil are low compared to international peers, and provides detailed recommendations to put in place well-designed excise taxes in the ongoing landmark reform of indirect taxes (PLP 68/2024 and forthcoming Ordinary Law). This Knowledge Note is also available in Portuguese.

📑 Knowledge Note #7: Alcohol Excise Taxes in Vietnam: Opportunity to Save Lives while Increasing Tax Revenues

Despite tax increases, Vietnam has experienced increases in alcohol related mortality and morbidity as a poorly designed ad valorem tax system has not resulted in tax increases leading to higher prices.

The seventh knowledge note in the series,  "Alcohol Excise Taxes in Vietnam: Opportunity to Save Lives while Increasing Tax Revenues" analyses the impact of tax increases on beer prices, affordability, sales and tax revenue, and conducts simulations of the impact of tax reforms including implementing specific taxes and tax increases. Results highlight how increasing specific taxes generates a larger impact on alcohol mortality and morbidity and supports ambitious reforms currently under consideration.

📑 Knowledge Note #8: Reforming Health Taxes to Improve Mexico’s Health

Reforming health taxes to improve Mexico’s health. Reforms on health taxes—excise taxes on tobacco, alcoholic beverages and Sugar-Sweetened Beverages (SSBs)—are urgently needed in Mexico to reduce preventable premature deaths. Beyond the health toll in noncommunicable diseases, consumption of these products also carries significant fiscal impacts.

This note reviews the current state of health taxes in Mexico and highlights opportunities to strengthen their design, with the aim of improving population health. The benefits from improving these taxes can be further enhanced through simultaneous progress in other cost-effective interventions. This Knowledge Note is also available in Spanish.

Last Updated: Oct 28, 2024

The Global Tax Program Health Taxes team also produces a host of other materials, including blog posts, case studies, and presentations across various contexts.  

Blogs

• A Healthier Kazakhstan: Cutting Sugary Drinks with Smart Taxes
• Raising fiscal revenue in times of crisis
• Smart health taxes: A win for public health and the economy
• The high cost of free sugars
• Health taxes for healthier populations: Cost-effective policy to save lives
• Smarter taxation can help boost government revenue and health outcomes
• Is taxing sugar-sweetened beverages a sweet deal?
• The seven salvos of sin (taxes)
• Sugar-Sweetened Beverages and Snack Taxes: All Eyes on Mexico (and Hungary)

Selected presentations

• The 7^th Annual Health Financing Forum: Special session on health taxes
• Regional health financing knowledge exchange in Caribbean and Central America
• Fiscal Policies for Healthier Diets
• Deep Dive on Key Considerations for SSB Taxation
• Launch Webinar: Global Tax Program Health Taxes Knowledge Note Series
• Design and Impact of Sugar-Sweetened Beverage Taxes: The Case of South Africa
• Health Taxes: Policy and Practice
• Side Event on Health Taxes at the 6th Annual Health Financing Forum | Recording

Other featured publications

• WHO Imperial college 2023 Health Taxes: Policy and Practice

• WB 2020 Knowledge Brief: Health Earmarks and Health Taxes What Do We Know? 

• WB 2022 Poverty and Shared Prosperity Report  

• WB Global Economic Prospects 

Please see the following page on health taxes for a compilation of World Bank and other partner work on the topic.