Local health experts say Zimbabwe must strengthen and properly govern health taxes if it is to protect its fragile health system, following new recommendations by the World Health Organisation (WHO) to significantly raise taxes on sugary drinks and other health-harming products.
Zimbabwe’s health sector remains heavily dependent on donor funding, which has been steadily declining, raising concerns about the country’s ability to sustainably finance essential health services.
Earlier this month, the WHO urged governments to increase taxes on sugary drinks, tobacco and other unhealthy products, warning that weak tax systems are keeping harmful products cheap while fuelling obesity, diabetes, heart disease, cancers and other non-communicable diseases (NCDs).
The UN health agency said well-designed excise taxes can reduce harmful consumption while generating much-needed revenue for health systems under growing financial pressure.
“Health taxes are a cost-effective but still underutilised tool that can save lives, reduce disease and mobilise much-needed domestic resources for health,” Community Working Group on Health (CWGH) executive director Itai Rusike told CITE.
“At a time when official development assistance is declining, countries like Zimbabwe have very few options left if they want to sustainably finance their health systems,” he added.
Rusike said several countries had already demonstrated that earmarked health taxes can deliver both public health and economic benefits.
“South Africa introduced an excise tax on sugary drinks in 2018 and reported a significant reduction in purchases of taxed beverages. Botswana followed with a sugar tax in 2021, while Ghana increased tobacco taxes in 2023 and earmarked part of the revenue for health,” he said.
Zimbabwe has also taken steps towards domestic health financing through mechanisms such as the AIDS Levy, the Health Levy and, more recently, the Sugar Tax.
The sugar tax, officially known as the Special Surtax on Sugar Content, was introduced in 2024 and targets sugar-sweetened beverages to fund cancer diagnosis and treatment.
Initially set at US$0.002 per gramme of sugar, the tax was reduced to US$0.001 in February 2024 following objections from the beverage industry.
While welcoming the policy intent, Rusike raised concerns about governance and transparency in the use of the revenue.
“The sugar tax is collected by ZIMRA and deposited into the Consolidated Revenue Fund. That creates a real risk that the money can be diverted to other government expenses instead of cancer services,” he said.
“To protect public trust, there must be enabling legislation to ring-fence these funds so that every dollar goes where it was promised.”
He added that stakeholders were increasingly questioning whether money raised through the sugar tax was being used efficiently and whether communities were seeing tangible improvements in hospitals and clinics.
The tax has also had ripple effects along the sugar value chain, with beverage manufacturers and sugar producers reporting declining volumes and revenues.
However, Rusike said the broader public health context should not be overlooked, arguing that the long-term benefits of reduced disease burden and stronger domestic health financing outweighed short-term economic adjustments.
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