Where do the funds come from?
There is a wide range of potential sources for financing health promotion, from the health sector (e.g. health budget allocations, social insurance contributions) and beyond (e.g. tobacco taxes).
Finding long-term and sustainable revenue sources for health promotion and prevention is critical for achieving the 2030 Agenda for Sustainable Development.
There is a broad spectrum of potential sources to finance health promotion from within the health sector (e.g. health budget appropriations, social insurance contributions) and beyond (e.g. dedicated or surcharge tobacco taxes).
- General treasury budget
In most countries, health promotion and tobacco control programmes are typically funded from the general treasury budget for health.
But there are limitations; multiple government programmes are competing for the same funding, and funding may not be stable or sufficient (e.g due to changes in policies and government administrations).
- Dedicated or surcharge tax or value added tax (VAT)
Dedicated taxes have been shown to be a successful fiscal tool to finance health promotion. The taxes are levied on products that have a significant impact on health, such as alcohol and tobacco, or on activities like gambling. Over the past two decades, a number of countries and subnational states have dedicated part of their tax revenues to health care and health promotion, including tobacco control.
When managed effectively and transparently, allocating dedicated tobacco tax revenues for tobacco control or health promotion programmes ensures that these programmes have a regular source of funding that are not subject to annual budgetary review.
Currently there are 39 countries worldwide with dedicated tobacco tax revenues for health purposes. For example, in Austria, revenue from value added tax (VAT) is channeled into an Austrian Health Promotion Foundation (which was established in 1998).
- Health insurance
Since 1998, Switzerland has applied an annual insurance surcharge of USD 2.60 per insured person. to finance health promotion and disease prevention programmes implemented by the Swiss Health Promotion Foundation.
Similarly in the Netherlands where health promotion is funded by the social health insurance scheme, public health services are carried out by special institutions at the municipal level. The Netherlands Institute for Health Promotion and Disease Prevention is responsible for the development and implementation of health promotion programmes across the country.
References
World Health Organization. (2016). Earmarked Tobacco Taxes: Lessons Learnt from Nine Countries. World Health Organization. Geneva.
Vathesatogkit P, Yen Lian T, Ritthipakdee B. (2013). Health Promotion: Sustainable Financing and Governance. Bangkok, Thai Health Promotion Foundation (ThaiHealth).
Vathesatogkit P, Yen Lian T, Ritthipakdee B. (2011). Lessons Learned In Establishing A Health Promotion Fund. Bangkok, Southeast Asia Tobacco Control Alliance (SEATCA).
World Health Organization. (2021). WHO Report on the Global Tobacco Epidemic, 2021: Addressing new and emerging products. Geneva: World Health Organization.
Bayarsaikhan D, Muiser J. (2007). Financing health promotion. World Health Organization. Geneva.