With the Rise of Right‐Wing Governments, Why a One‐Time “50% Health Tax” Will Be a Hard Sell and How It Could Be Implemented

Recent calls from the World Health Organization (WHO) to globally impose a one-time tax, labelled as "Health tax", on tobacco, alcohol and sugar sweetened beverages (SSBs) aim to achieve a 50% retail price increase to reduce consumption and improve health outcomes. However, with the rise of right-wing governments globally, this substantial intervention might be a hard sell. Right-wing governments usually lean towards tax reductions to stimulate economic growth, job creation and encourage investments. In addition, they support free-market capitalism, deregulation and minimum government interventions. Furthermore, some of such governments share a sentiment of distrust in science and cut health and research spending. Moreover, regardless of political orientations, path dependence (the institutional resistance to change) is another hurdle. In addition, the expected restrictions on the availability and affordability of these products in case of implementing such tax may lead to public rebuttal. All these structural, political and commercial determinants of health raise concerns about the applicability of such intervention and its sustainability if implemented. This commentary argues that the implementation of this substantial one-time tax would be a hard sell and could backlash among most of the right-wing policy makers due to their inherent tax aversion stance and other factors. It suggests that advocacy using a more negotiable approach could be a way forward. For example, "a gradual phased implementation" could offer a viable alternative following two successful case studies from the Philippines and Egypt under their right-wing governments. The Philippines implemented the "Sin Tax Reform" an annual excise tax increase on (tobacco, alcohol, and SSBs) from 2012 onwards, while Egypt imposed annual tax increases on tobacco products since 2010 onwards. These phased approaches seemed to have gained more favourable consideration from right-wing policy makers and contributed to smoking reduction in the Philippines but not in Egypt. In addition, some alternatives such as marketing restrictions on these products among other interventions could be considered. Context specific variations as well as the variations in readiness to adopt such fiscal policies for the health cause among the right-wing political spectrum are acknowledged.