Potential impact of new tax proposals on public health response

As Uganda considers new tax proposals for the Financial Year 2024/2025, it is crucial to analyse their potential consequences beyond economic aspects, particularly within the context of public health, including the nation’s ongoing battle against rising new HIV infections and other diseases caused by climate change.

The proposed tax measures could potentially hinder Uganda’s efforts to combat HIV/Aids and other public health challenges.

With infectious diseases still prevalent, taxing essential resources like clean water could worsen the burden of communicable diseases, posing additional challenges to already strained healthcare systems.

Access to clean water is critical for maintaining good health, particularly for individuals with compromised immune systems like those living with HIV/Aids. Any increase in the cost of bottled water and drinking water could reduce access, worsening health disparities and increasing the risk of diarrheal diseases and dehydration, especially with rising temperatures due to climate change.

Furthermore, the recent cholera outbreaks serve as a stark reminder of the consequences of limited access to clean water. Taxing access to clean and safe water risks worsening such outbreaks, undermining efforts to control and prevent waterborne diseases.

High land taxation may impose a significant burden on individuals and households, particularly in rural areas where agriculture is a primary source of income. This economic strain could result in reduced disposable income and constrained resources for healthcare, including HIV prevention, treatment, and support services. 

Additionally, increased taxes could make it harder for vulnerable young women and adolescent girls (YWAGs) to continue their education, increasing their susceptibility to HIV and teenage pregnancy, further straining an already stretched economy.

Furthermore, the proposed levies on fuel and kerosene could lead to cascading effects on healthcare access and service delivery. Higher transportation costs could inflate operational expenses for healthcare facilities, potentially leading to budget cuts or service disruptions. But also, individuals living with HIV/Aids who rely on transportation to access treatment centres may face difficulties in adhering to their treatment, leading to care gaps and increased transmission rates.

Pregnant mothers facing increased costs may be discouraged from attending antenatal care (ANC) appointments, leading to potential complications during childbirth including HIV transmission and increased maternal and infant mortality rates, eroding progress so far made in those areas. Additionally, other public health threats such as malaria and tuberculosis could worsen if access to healthcare services is compromised due to economic constraints imposed by these tax measures.

In the face of threats to donor funding for health and shifts in health funding priorities, implementing tax measures that promote good health behaviours can serve as one of the financing alternative approaches. By incentivising healthier choices through taxation, governments can generate revenue while simultaneously promoting public health objectives. This approach aligns with the Sustainable Development Goals targets 2030 towards sustainable and domestically driven financing mechanisms for health.

Policymakers must consider the broader social and public health implications of these tax proposals. As stakeholders and citizens, we must advocate for tax policies that promote social equity, safeguard vulnerable populations, and strengthen sustainable development, including the fight against HIV/Aids and other public health challenges.

Ms Diana Tibesigwa, Advocacy and Policy manager East and West Africa Bureau, AIDs Health Care Foundation.