Surcharge tax for tobacco and health promotion: measure for sustainable development

Background and challenges to implementation: Funding for public health is a major problem in many countries especially in low income countries where the burden of disease is huge. In developing countries, while infectious diseases are still a problem, non-communicable diseases are soaring. With low health care budget especially on health promotion, to achieve the sustainable development goals especially in the area of NCDs are a long and winding road. Since the nature of health promotion is beyond the health care scope and needs multi-sectoral collaboration, it is essential to have a new financial mechanism which is sustainable for innovative health promotion projects. Intervention or response: Among all the risk factors, tobacco use contributes to all four major NCDs. Therefore, taxing harmful product such as tobacco for public health is a sound measure which is recommended by the Article 5 general obligation and the article 26 of the Framework Convention on Tobacco Control (FCTC). More than 40 countries used earmarked tobacco tax for health globally. Experts are now discussing on earmarking tobacco tax for development. Results and lessons learnt: In many countries health promotion projects were not sustainable due to lack of funding. For this reason, countries need to find local and sustainable financing mechanisms. Surcharge tax is recommended for countries because the revenue is predictable, sustainable and most importantly, it is paid by the industry causing the NCDs. Therefore, it is a win-win for both revenue and public health. In ASEAN, Singapore, Thailand, Malaysia, Vietnam and Indonesia has local funding mechanism for tobacco control or health promotion. Different countries have different funding mechanisms. Conclusions and key recommendations: Southeast Asia Tobacco Control Alliance (SEATCA) is working with ASEAN countries on tobacco taxation policy and mechanisms to earmark or surcharge tobacco taxes for tobacco control or health promotion. Experiences and lesson learned from countries will be discussed in this paper.