How critical a role can taxation play in the debate on strengthening the right to health

How critical a role can taxation play in the debate on strengthening the right to health?

Laila Abdul Latif

Forum on strengthening the right to health: Shared Issues? Shared Analysis, Strategic Meeting on global health and governance for

health. Rome - Italy

THE RIGHT TO HEALTH AND ITS FINANCING

Article 2.1 ICESCR (Governments to take steps to progressively realise the right to health through maximum available resources by all appropriate means including adoption of laws)

The Kenyan approach under Article 43 of the Constitution (separated socio economic rights from human rights; financing through social security and insurance schemes)

Tax Justice Network Perspective: Linking tax to human rights

Missing factor in debates on the attainment of the right to health (MDGs context): is the issues of finance

Rights require resources!

The upholding of rights requires finance and without financial resources, then it would be a fallacy to talk of rights. To achieve all the components that are said to comprise the right to health, infrastructure is needed and for such infrastructure to be availed, then financing is vital.

– Dr. Attiya Waris, University of Nairobi, School of Law

Why Does Health Financing Matter?

Enormous mismatch between countries health financing needs and

their current health spending

Low income countries carry 90% of the world’s health burden yet

only 12% of global health spending occurs in these countries

Mere increase in resource and spending is not enough to fully

realise the right to health

WHAT CAN BE DONE?

There is a need to restructure and reform the health systems –

social insurance financing program as well as private insurance

financing: looking to Islamic taxation as an option in Kenya

Larger portions of national budget to be assigned to the health

sector

Implement legal domestic enforcement of health policy initiatives

and funding

SUGGESTED MODEL ON FINANCING HEALTH

Reference: Dr Attiya Waris, Tax and Development

SUGGESTED MODEL ON FINANCING HEALTH (2)

Reference: Dr Attiya Waris, Tax and MDGs





All Things Must Pass: October 2002

WHY IS IT IMPORTANT TO LINK TAXATION TO THE REALISATION OF

HUMAN RIGHTS?

Broad tax base ensures that all income and wealth is taxed

A narrow tax base is vulnerable to fiscal crisis, and narrow interest group

capture of the state

Tax per GDP ratio is a key measure of governance and welfare

Need to understand its dynamics of components, and not confuse with total

government revenue / expenditure.

Tax expenditure estimates are crucial, need much more research; See the tables

next…

All Things Must Pass: October 2002 11

Tax per GDP

<10% (n=16)

10%-15% (n=19)

15%-20%(n=9)

>20%(n=7)

Country

Algeria, Angola, Central African Republic, Chad, Comoros, Democratic Republic of Congo, Republic of Congo, Equatorial Guinea, Guinea-Bissau, Liberia, Libya, Madagascar, Niger, Nigeria, Sudan, Sao Tome and Principe

Botswana, Burkina Faso, Cameroon, Côte d’Ivoire, Egypt, Eritrea, Ethiopia, Gabon, Gambia, Guinea, Malawi, Mali, Mozambique, Rwanda, Sierra Leone, Tanzania, Togo, Tunisia, Uganda

Benin, Burundi, Cape Verde, Ghana, Kenya, Mauritius,Morocco, Senegal, Zambia

Djibouti, Lesotho, Mauritania, Namibia, Seychelles, South Africa, Swaziland

All Things Must Pass: October 2002

Tax and

Development

Tax per GDP

includes:

Direct tax

Indirect tax

Trade tax

Resource revenues

are not included

Non-tax revenues

not studied

Tax revenue has

strongest

relationship

Tax and

Development

The lesser taxation

contributes to a

country’s GDP the

higher the rate of

mortality

The more taxation

contributes to a

country’s GDP the

lesser mortality

THE END