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Oct 16 '20, 4:00 PM - 6:00 PM

The role of Health Taxes in Health Systems during and post COVID-19 in the Caribbean

Friday, October 16, 2020, at 10.00 am – 12:00 pm (time in Washington, DC)

Participation details

Hosts: Pan American Health Organization and Economic Commission for Latin America and the Caribbean
Date: October 16, 2020
Time: 10:00 am – 12:00 pm (US EST)
Language: English
Zoom link to register, click here.


The COVID-19 pandemic is causing large-scale loss of life and severe human suffering. It is a public health crisis without precedent in living memory. But the pandemic has also set in motion a major economic crisis that will burden our societies for years to come.
The health and economic impact of this crisis are increased by the unprecedented deadly relationship between an infectious disease, COVID-19, and Non-Communicable Diseases (NCDs). Indeed, the scientific evidence indicates that those with NCDs are at higher risk of serious complications if they contract COVID-19.
Noncommunicable diseases (NCDs) and their risk factors are the main cause of morbidity, mortality and disability, and constitute a complex public health challenge, as well as a serious threat to economic and social development.

In the Caribbean, NCDs cause approximately 76.8% of all deaths. Of this total number of deaths from NCDs, 38.1% are premature deaths occurring in people under 70 years of age. Macroeconomic simulations suggest that globally, cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental health could cost cumulative production losses of USD 47 trillion (approximatively 75% of 2010 global GDP) during the two decades 2010-2030.
In response to the COVID-19 crisis, governments around the world have ramped up their relief and stimulus spending to unprecedented levels—just as tax revenues have slumped. While health and social expenditures have risen, tax revenues have plummeted. At the same time, many Caribbean countries are dealing with high public debt burdens. In 2019, 10 Caribbean Community (CARICOM) Member States had total public debt above the sustainable threshold of 60% of GDP. As a result of COVID-19, governments will be forced to run budget deficits to cope with the fiscal fallout of the pandemic. This will worsen the public debt burden of the Caribbean and more countries stand the risk of falling into an unsustainable debt bracket.

Excise taxes help prevent NCDs by reducing the consumption of tobacco, alcohol, and sugar- sweetened beverages. Furthermore, in a context where countries may need additional resources to respond to the COVID-19 pandemic and to finance economic recovery plans, excise taxes on these products could be used as a source of additional and immediate tax revenue. After the pandemic, tax revenues could serve as partial compensation for the expenses incurred in NCD care and participate in increasing the budget for public health towards achieving Universal Health Coverage.
Taking into account the impact of COVID-19, governments need to identify ways to sustain and strengthen their health systems and advance towards the proposed goal of public health expenditure representing 6% of GDP. The concept of fiscal space for health refers to the ability of governments to provide additional budgetary resources for health systems without affecting the financial position of the public sector or supplanting other socially necessary expenditures that in turn impact health. There are potential sources of fiscal space through economic growing, reprioritization of health in the government budget, grants and debt, taxes in general, including here health taxes, and increasing efficiency on health expenditure.


  1. Promote the increase of excise taxes on unhealthy products such as tobacco, alcohol and sugar-sweetened beverages as a tool to prevent NCDs, collect tax revenues and promote sustainable development.
  2. Discuss the use of excise taxes on unhealthy products in the context of the COVID-19 pandemic.
  3. Present the role of such taxes in reducing fiscal deficits and creating fiscal space for health while strengthening health systems.

Targeted audience

  1. Ministry of Finance (technical personnel in charge of excise taxes on tobacco, alcohol and sugar-sweetened beverages) from the Caribbean
  2. Ministry of Health (FCTC and NCDs focal points, HSS, health economics or Planning and budget departments) and subnational level Health entities (where relevant) from the Caribbean
  3. Tobacco Taxes network in the Americas – RITA, for its acronym in Spanish (coordinated by
    Campaign for Tobacco-Free Kids)
  4. PAHO/WHO focal points for NCDs, tobacco and alcohol control, and nutrition of the
  5. Tobacco and alcohol control, and obesity prevention community of the Caribbean, and
    researchers and advocates
  6. Subregional Caribbean organizations and Civil society organizations


10:00 am – Welcome and opening words

  • Ms. Rosa Sandoval – Regional Advisor on Tobacco Control / Coordinator of the Economics of NCDs team, PAHO
    10:10 am – Fiscal deficits due to the COVID-19 pandemic
  • Dr. Abdullahi Abdulkadri – Coordinator, Statistics and Social Development Unit, ECLAC subregional headquarters for the Caribbean
    10:25 am – Health taxes: Their role during and after COVID-19 and the evidence
  • Ms. Ceren Ozer – Fiscal Policy and Sustainable Growth Unit, World Bank
  • Dr. Frank Chaloupka – Professor, University of Illinois at Chicago
    10:55 am – The need to create fiscal space for health
  • Dr. Camilo Cid – Regional Advisor, Health Economics and Financing, PAHO

11:10 am – Panel discussion – Country experiences on health taxes: Jamaica and Barbados

Moderated by: Ms. Charmaine Metivier – Centre for Health Economics, University of West Indies

  • Dr. Fabian Lewis (pending confirmation) – Director, Research and Analysis Unit, Taxation Policy Division, Ministry of Finance and the Public Service, Jamaica
  • Mr. Cyril Gill (pending confirmation) – Chief Economist (ag), Macro-Fiscal Section, Economic Affairs Division, Ministry of Finance, Economic Affairs and Investment, Barbados

Comments: From research to policy – advancing taxes for health in the Caribbean by: Dr. Stanley Lalta – Centre for Health Economics, University of West Indies

11:35 am – Open discussion

Moderated by: Ms. Rosa Sandoval – Regional Advisor on Tobacco Control / Coordinator of the Economics of NCDs team, PAHO

12:45 pm – Closure

  • Dr. Catarina Camarinhas – Social Affairs Officer, Statistics and Social Development Unit, ECLAC subregional headquarters for the Caribbean