Source: Asia Development Bank
The implementation of health taxes requires coordination and collaboration across different government agencies to ensure alignment and coherence across all sectors, particularly the Ministry of Finance (tax administration and design) and the Ministry of Health (advocating for health and evidence). Several countries in Asia and the Pacific have successfully implemented health tax strategies to improve public health and achieve health-financing goals.
Case Study: the Philippines
The 2012 Sin Tax reform in the Philippines marked a landmark policy shift by introducing a unitary excise tax with scheduled increases annually on tobacco and alcohol products. The reform was framed as a health policy reform rather than revenue generation. It adopted a strong intergovernmental approach, with active collaboration from the Ministry of Finance and Department of Health. The reform received tremendous support from both the public and government agencies. Between 2012 and 2018, prices of tobacco products increased by 113%, which led to a 30% plunge in smoking prevalence among adults and a 10%–18% drop among young adolescents in 2009–2021. This tax scheme also tripled tax revenues, reaching almost $3 billion in 2022.
Despite these gains, the percentage share of health taxes remains limited, and the tobacco products are still relatively affordable due to the stagnant annual tax adjustment. The initial plan to adjust the tax every year according to inflation and population growth has not been applied, leading to limitations in deterring consumption. This emphasizes the importance of adjusting health tax rates in response to inflation, so the real value of the tax is maintained at the appropriate level.[1]
Case Study: Thailand
Thailand’s sugar-sweetened beverages tax, reformed in 2017 by the Ministry of Health, Ministry of Finance, and Thailand Health Promotion Foundation, represents another benchmark. It introduced a tiered-tax approach, where specific tax rates on sugar content and ad valorem (based on value) taxes were applied.
The new ad valorem tax was reduced from 20% to a range of 0%–14% based on the type of beverage (e.g., 10% for fruit-related drinks). An additional specific tax rate was also used to adjust for sugar content, where beverages with more than 6 grams of sugar per 100 milliliters are taxed at higher rates than those with lower sugar content. During the first phase of implementation, average sugar content in beverages significantly dropped from 16.7g to 10.6g per 100ml.
However, concerns have been raised regarding the impact of this tax on low-income populations. This situation emphasizes the need for clear and strategic communication to ensure transparency in monitoring and evaluation.