EU proposals for financing public health systems during health crises

In light of the severe consequences of the COVID-19 epidemic on health, public health systems and economies, the International Union Against Tuberculosis and Lung Disease (The Union) published a policy brief on June 18, 2020, calling on countries to increase taxes on tobacco products to simultaneously improve population health, reduce health inequalities, and ease the financial burden on health systems.

The current COVID-19 pandemic is causing both a health and financial crisis. As of June 19, 2020, there have been more than 8.6 million cases of illness and approximately 457,000 premature deaths.[1] recorded. In addition to the human tragedy, protective measures aimed at containing the disease are seriously affecting economic activity. According to estimates by the International Monetary Fund (IMF), the contraction in global economic activity is expected to reach at least 31% in 2020. This is much more than during the 2008-2009 financial crisis.[2].

Public health systems in difficulty

The 2019 Global Health Security Index highlighted serious gaps in countries' preparedness to deal with health crises. These include insufficient funding, and the pressures induced by the current pandemic are literally paralyzing emergency services.

Low- and middle-income countries are unprepared to deal with pandemics

The situation is particularly dire in low- and middle-income countries where this lack of funding and resources is delaying government responses to COVID-19 and leading to high preventable loss of life.[3]-[4]. In India[5], lack of emergency preparedness combined with insufficient investment in the public health system hinder effective containment plans[6]. The Pakistani health system[7] is unable to adequately scale up both detection and treatment to address COVID-19 outbreaks due to its underfunded and fractured health system.

Raising tobacco taxes: a win-win solution to address public health emergencies

The World Health Organization (WHO), the World Bank, and researchers have been debating for years the best mechanism for robustly financing public health systems. Raising tobacco taxes is recognized as the most cost-effective measure to reduce tobacco consumption and related healthcare costs.[8]With smoking causing over eight million deaths each year, governments can easily raise taxes to encourage and incentivize smoking cessation and simultaneously generate much-needed revenue.[9]Currently, a large number of countries do not have tobacco product taxation that complies with good practice.[10]. Thus, according to the WHO, 155 countries have taxes below the recommended minimum threshold.[11].

Union proposals (in English)

©Generation Without Tobacco

[1] https://www.worldometers.info/coronavirus/#news

[2] MFI. World Economic Outlook, April 2020. https://www.imf.org/en/Publications/WEO/Issues/2020/04/14/weo-april-2020

[3] The Global Health Security Index. Nuclear Threat Initiative. October 2019. https://www.ghsindex.org/wp-content/uploads/2020/04/2019-Global-Health-Security-Index.pdf

[4] Rosie Perper. Bill Gates warns that a coronavirus-like outbreak will probably happen 'every 20 years or so'. Business Insider US, Apr 10, 2020, https://www.businessinsider.co.za/bill-gates-warns-coronavirus-outbreak-likely-every-20-years-2020-4?r=US&IR=T

[5] The Global Health Security Index. Nuclear Threat Initiative. October 2019. https://www.ghsindex.org/wp-content/uploads/2020/04/2019-Global-Health-Security-Index.pdf

[6] Patralekha Chetterje. Gaps in India's preparedness for COVID-19 control. Lancet. April 17, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30300-5

[7] https://www.generationsanstabac.org/actualites/quand-les-industries-du-tabac-deteriorent-le-systeme-de-sante-pakistanais/

[8] Addis Ababa Action Agenda Resolution adopted by the General Assembly on 27 July 2015. http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/69/313&Lang=E

[9] The health consequences of smoking – 50 years of progress: A report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014

[10] https://www.who.int/fctc/treaty_instruments/Guidelines_article_6_fr.pdf?ua=1

[11] WHO Report on the Global Tobacco Epidemic, 2019. World Health Organization, 2019

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