Kenya: Impose higher taxes on alcohol and tobacco to prevent diseasesACTA
The world is finally beginning to pay attention to what we have known for years: The most pressing and unaddressed health issues in much of Africa aren’t infectious diseases like malaria or HIV, but diseases like diabetes, cancer and hypertension known as noncommunicable diseases (NCDs). And these killers are poised to have a devastating impact on life expectancy across the continent.
With health systems in sub-Saharan Africa ill-equipped to diagnose and treat the coming wave of NCDs, emphasising prevention is paramount. And the most effective way to prevent these major killers is to implement policies – especially taxes – to reduce consumption of harmful products like tobacco, alcohol and ultra-processed foods. This is because, together with physical inactivity, they are the biggest risk factors to NCDs.
Whereas we are used to fighting vectors of communicable disease–like the mosquito for malaria–this 21st century health threat involves a more complex actor: International commercial companies pushing harmful commodities like tobacco, alcohol and ultra-processed foods. Unlike the mosquito, these companies fight back. In relentless pursuit of profit, the companies use lobbying and millions in public relations to persuade policymakers to enact policies that promote, rather than limit, consumption of harmful products.
Unfortunately, just recently, we saw this dynamic play out in Kenya. While tying excise taxes on harmful commodities to inflation is a best practice health policy, government caved to pressure and unmade a policy that ties cigarette and alcohol taxes from inflation. This seemingly small detail was snuck into a huge finance bill, but it will have a big impact. New data shows that young people of ages 15-35 account for the bulk of alcohol and tobacco users.
This change will make tobacco and alcohol cheaper over time, leading to more consumption by young people and others. The outcome is higher disease and death rates from conditions related to tobacco and alcohol, while these industries continue minting profits It will also starve the country of much-needed revenue and increase the health and financial burdens on everyday Kenyans.
Across the continent, policymakers should take note. Today, the number of people with noncommunicable diseases such as hypertension, diabetes and cancer have risen to account for 2.6 million deaths per year in sub-Saharan Africa—or 35 per cent of all deaths. In some countries, the rise has been even more explosive. In Kenya, for example, alcohol consumption, unhealthy diets, limited physical activity, obesity and smoking have contributed to soaring rates of NCDs, which account for more than 40 per cent of deaths and up to 50 per cent of the bed occupancy in public health institutions.
Stepping up detection and treatment, while important, will not stop the upward swing of noncommunicable diseases as long as governments fail to combat the industries that manufacture and market the products that are making people sick—tobacco, alcohol, sugary drinks and ultra-processed foods. The problem is clear. But so are the solutions.
It starts with taxing the bad to promote the good. Taxes on harmful products such as tobacco and alcohol, are a win-win proposition. They deter use of these cancer-causing products and raise revenues for governments that need funds for NCD treatment and prevention. Taxes on alcohol and tobacco top the WHO’s list of “Best Buy” strategies to reduce the burden of NCDs.
Of course, higher taxes on tobacco and alcohol raise objections and may stymie industry efforts to convince Africa’s young market–where around 40 per cent of the population is under the age of 15 years–to take up a lifetime of smoking and drinking.
For our healthiest future, it’s time to counter the industries’ lobbying and conflicts of interest and keep the tobacco and alcohol industry in the naughty corner. The tobacco, alcohol and food and beverage industries are always going to prioritise profit over public health and our long-term economic development and should have no place at the policy table.
In spite of their best efforts to frame themselves as “part of the solution,” these industries should not be considered a public health partner. Nor should they empowered to maintain influence over governmental processes.
As NCD levels rise, we cannot pretend we lack the means to stop them. In Kenya, this includes acting to reverse the cigarette and alcohol industries’ attack on Kenya’s smart taxation that will make cigarettes, beer and other unhealthy products cheaper and more widespread. We should urgently take rapid steps towards a progressive and ambitious taxation policy with an aggressive agenda to counteract this health and economic threat.
NCDs are estimated to account for 35 of all deaths in Africa today, and by 2030 they are projected to be responsible for more than half of all deaths. In Kenya, it is estimated that it will account for 55 per cent of deaths. The tides are rising too fast. We need to build the boat now.
Ms Awuor is Chief Executive Officer, International Institute for Legislative Affairs. Ms Kitonyo is Senior Tobacco Advisor, McCabe Centre for Law and Cancer. Mr Kamau, Executive Director, Students Campaign Against Drugs.