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Most deaths in low- and middle-income countries are caused by non-communicable diseases such as cancers, diabetes, heart disease, and injuries. Many of these deaths could be avoided by reducing smoking, excessive alcohol consumption, and high-sugar diets. Uniquely placed at the intersection of the health policy, research, and finance communities, CGD aims to advance understanding of this problem, the industries that promote these products, and the cost-effectiveness of public policies including pro health excise taxes.
The Task Force for Fiscal Policies for Health, co-chaired by Michael Bloomberg and Lawrence Summers, was convened in 2018 to examine existing evidence and make recommendations on how countries can use excise taxes to raise the prices of harmful products, reduce consumption, save lives, and raise revenues. In addition to providing research and technical support to the Task Force, CGD experts, through research and policy outreach, are focusing on advancing high-level international efforts, including among the international financial institutions, to promote effective pro-fiscal health policies in LMICs. CGD’s efforts aim to strengthen post-COVID-19 pandemic financial resilience via strengthened domestic revenue mobilization and to improve public health by discouraging consumption of harmful products.
The Covid-19 pandemic has led to large budget gaps in low- and middle-income countries, with revenues projected to be reduced for years to come. This is the moment for policymakers to consider whether health taxes—levied on tobacco products, alcoholic and sugar-sweetened beverages, and polluting fuels—can play a part in boosting revenue while also supporting better health
Most money and responsibility for health in large federal countries like India rests with subnational governments — states, provinces, districts, and municipalities. The policies and spending at the subnational level affect the pace, scale, and equity of health improvements in countries that account for much of the world’s disease burden: India, Indonesia, Nigeria, and Pakistan.
India has fallen behind in both health expenditure and health outcomes compared to other lower-middle-income countries. Its burdens of tuberculosis and malaria, and increasingly noncommunicable diseases like diabetes, are one of the largest. Infant mortality and child malnutrition rates rival those in sub-Saharan Africa.
In the big federal countries where global disease burden is concentrated, most public money for health isn’t ultimately spent by the national ministry of health, the traditional counterpart for global health funders and technical agencies.