1. How critical a role can taxation play in the
debate on strengthening the right to health?
Laila Abdul Latif
Forum on strengthening the right to health: Shared Issues? Shared
Analysis, Strategic Meeting on global health and governance for
health. Rome - Italy

2. THE RIGHT TO HEALTH AND ITS FINANCING
 Article 2.1 ICESCR (Governments to take steps to progressively realise the right to
health through maximum available resources by all appropriate means including
adoption of laws)
 The Kenyan approach under Article 43 of the Constitution (separated socio
economic rights from human rights; financing through social security and insurance
schemes)
 Tax Justice Network Perspective: Linking tax to human rights
 Missing factor in debates on the attainment of the right to health (MDGs context):
is the issues of finance
 Rights require resources!

3. The upholding of rights requires finance and without financial
resources, then it would be a fallacy to talk of rights. To
achieve all the components that are said to comprise the right to
health, infrastructure is needed and for such infrastructure to be
availed, then financing is vital.
– Dr. Attiya Waris, University of Nairobi, School of Law

4. Why Does Health Financing Matter?
 Enormous mismatch between countries health financing needs and
their current health spending
 Low income countries carry 90% of the world’s health burden yet
only 12% of global health spending occurs in these countries
 Mere increase in resource and spending is not enough to fully
realise the right to health

5. WHAT CAN BE DONE?
 There is a need to restructure and reform the health systems –
social insurance financing program as well as private insurance
financing: looking to Islamic taxation as an option in Kenya
 Larger portions of national budget to be assigned to the health
sector
 Implement legal domestic enforcement of health policy initiatives
and funding

6. SUGGESTED MODEL ON
FINANCING HEALTH
Reference: Dr Attiya Waris, Tax and Development

7. SUGGESTED MODEL ON
FINANCING HEALTH (2)
Reference: Dr Attiya Waris, Tax and MDGs

8. SUGGESTED MODEL ON
FINANCING HEALTH (3)
Reference: Dr Attiya Waris, Tax and MDGs

9. SUGGESTED MODEL ON
FINANCING HEALTH (4)
Reference: Dr Attiya Waris, Tax and MDGs

10. WHY IS IT IMPORTANT TO LINK TAXATION TO THE REALISATION OF
HUMAN RIGHTS?
 Broad tax base ensures that all income and wealth is taxed
 A narrow tax base is vulnerable to fiscal crisis, and narrow interest group
All Things Must Pass: October 2002
capture of the state
 Tax per GDP ratio is a key measure of governance and welfare
 Need to understand its dynamics of components, and not confuse with total
government revenue / expenditure.
 Tax expenditure estimates are crucial, need much more research; See the tables
next…

11. All Things Must Pass: October 2002 11
Tax per
GDP
<10%
(n=16)
10%-15%
(n=19)
15%-20%
(n=9)
>20%
(n=7)
Country Algeria, Angola,
Central African
Republic, Chad,
Comoros,
Democratic
Republic of
Congo, Republic
of Congo,
Equatorial
Guinea, Guinea-
Bissau, Liberia,
Libya,
Madagascar,
Niger, Nigeria,
Sudan,
Sao Tome and
Principe
Botswana,
Burkina
Faso,
Cameroon,
Côte
d’Ivoire,
Egypt,
Eritrea,
Ethiopia,
Gabon,
Gambia,
Guinea,
Malawi,
Mali,
Mozambique
, Rwanda,
Sierra
Leone,
Tanzania,
Togo,
Tunisia,
Uganda
Benin, Burundi,
Cape Verde,
Ghana, Kenya,
Mauritius,
Morocco,
Senegal, Zambia
Djibouti,
Lesotho,
Mauritania,
Namibia,
Seychelles,
South Africa,
Swaziland

12. All Things Must Pass: October 2002
Tax and Development
 Tax per GDP includes:
 Direct tax
 Indirect tax
 Trade tax
 Resource revenues are
not included
 Non-tax revenues not
studied
 Tax revenue has
strongest relationship

13. Tax and Development
 The lesser taxation
contributes to a
country’s GDP the
higher the rate of
mortality
 The more taxation
contributes to a
country’s GDP the
lesser mortality

14. THE END