Taxes on unhealthy products have the potential to produce major health gains among the poorest in society, who are disproportionately affected by NCDs, according to an analysis released by a taskforce of The Lancet today.

The evidence will help to counter fears that such taxes, on items like soft drinks, alcohol and tobacco, will necessarily disproportionately harm the poor, says The Lancet Taskforce on NCDs and Economics. In fact, says the analysis, NCDs create inequity within and across countries; both the poor and non-poor experience financial catastrophe from NCD-related medical care, often despite having insurance coverage.

NCDs such as stroke, heart disease, diabetes, chronic respiratory disease and cancer are major drivers of poverty worldwide. The diseases constitute 70% of health related deaths, killing more people earlier in developing counties than in the developed world – over 80 per cent of the 15 million NCD deaths that take place between ages 30-69 are in low- and middle-income countries.

“Responding to this challenge means big investments to improve health care systems worldwide, but there are immediate and effective tools at our disposal.” - Dr Rachel Nugent, RTI International (Seattle, USA) and Chair of The Lancet Taskforce on NCDs and economics

“NCDs are a major cause and consequence of poverty worldwide,” said Dr Rachel Nugent, RTI International (Seattle, USA) and Chair of The Lancet Taskforce on NCDs and economics. “Responding to this challenge means big investments to improve health care systems worldwide, but there are immediate and effective tools at our disposal.”

“Taxes on unhealthy products can produce major health gains, and the evidence shows these can be implemented fairly, without disproportionately harming the poorest in society,” she added.

The economic benefits of investing in NCDs are considerable, says The Lancet, citing the WHO package of ‘best buys’, which includes interventions to reduce smoking and salt intake, and pharmaceutical interventions for the prevention and treatment of ischaemic heart disease and stroke.

The cost of implementing the ‘best buys in 20 countries where 70% of cardiovascular deaths occur, is estimated at US$120 million for the period to 2030, equivalent to an additional US$1.50 per person. By 2030, this could prevent 15 million premature deaths, making it almost possible to achieve the Sustainable Development Goal target of reducing premature mortality from NCDs by a third by 2030.  

Other conclusions from The Lancet taskforce:

• Investments in prevention and control of NCDs offer a high return for countries at all income levels, contributing to economic growth; in the long term, NCD prevention offers a higher return on investment than NCD control, though both are essential to an effective response strategy
• Fiscal measures should be directed toward incentivising healthy diets and lifestyles, encouraging sustainable consumption and production, and providing the revenue to accelerate scale-up of universal health care; these policies can, and should, be designed to achieve favourable equity impacts
• Mutually reinforcing progress on at least nine Sustainable Development Goals (SDGs) will help achieve SDG target 3.4.

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