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The third plenary of the Union World Conference on Lung Health 2015, explored how governments are innovating to transform under-funded areas of public health through taxing products that harm health, and earmarking these increased revenues for specific programmes.

The three speakers discussed the current models being used and developed in their respective countries – with a focus on tobacco control as the first area of health programming to have widely introduced these finance mechanisms. The conversation was moderated by Dr Yussuf Saloojee, executive director of the National Council Against Smoking, South Africa.

The discussion was framed for the conference by Dr Saloojee who said: ‘Tobacco control is a vital part of TB control. One in five people who die from TB are smokers. And it’s not just about cessation. It’s about helping people to make good health decisions by changing the environment in which they live.’

He summarised this form of sustainable funding for health as, ‘Taxing bad for good’ and highlighted its potential for tackling issues beyond tobacco use, referring to alcohol and sugar specifically.

Mr Kaul Singh Thakur, Minister of Health and Family Welfare, Law and Revenue for the Government of Himachal Pradesh, India spoke about the success of the tobacco control programme in his state. Smokefree laws now cover all public places across the state and the sale of single cigarettes has also been banned. He spoke about the challenge of sustaining funding for the programme while it remains unfunded by the federal government. Mr Thakur said that the state used innovative sources of funding for tobacco control generated at state level, including revenue from fines for violating the smokefree law, and corporate social responsibility funds from business – highlighting the importance of protecting these funds from tobacco industry interference.

Mr Jeremias Paul, Undersecretary of the Department of Finance, the Republic of the Philippines illustrated the success of the country’s ‘SIN tax’ for both reducing prevalence of smoking and increasing revenues through soft earmarking of taxes. These funds have countered the regressive nature of increased tobacco taxes by using the additional revenue to subsidise Universal Health Care for the poorest in the country. He said health promotion funds must track and report both how money is spent, and its impact on health data. Where programmes are proven to be effective, they will attract greater funding: ‘Money begets money,’ said Mr Paul.

Ms Anne Jones, technical advisor for The Union and focal point for Viet Nam, replaced Dr Luong Ngoc Khue, Director of VINACOSH, on the panel. She spoke about how the Viet Nam government became the latest to take action in this area by establishing its own Tobacco Control Fund – with compulsory contributions from the tobacco industry in a ‘polluter pays’ approach. Following the success of this work on tobacco control funds, future plans are being developed to include taxes on additional harmful products – this will fund its action plans to reach their national health goals, including a reduction of non-communicable diseases.

‘The main lesson from Viet Nam is that they implemented a comprehensive tobacco control law that included a Tobacco Control Fund to strategically reach national health targets and evaluate outcomes,’ Ms Jones concluded.

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