Only 15 percent of the Sustainable Development Goal indicators for gender equality (SDG 5) are on track, and at the current pace, full equality is more than 134 years away. How can progress be accelerated? One promising approach lies in health taxes.

A new UNDP policy brief, Empowering Women through Health Taxes: A powerful fiscal tool for accelerating just, equitable and sustainable development, explores how excise taxes on tobacco, alcohol and sugar-sweetened beverage (SSB) products can act as a catalyst for advancing women’s empowerment and equitable development.  

The differential burden of tobacco, alcohol and SSB products on women

Men are the primary consumer base for tobacco, alcohol and SSB products and face higher mortality rates from related non-communicable diseases. However, women experience distinct and disproportionate harms, as these products contribute to a complex web of challenges that deepen existing gender inequities. This includes: 

• Secondhand smoke: Nearly 700,000 women globally die from secondhand smoke exposure every year, surpassing male deaths from the same cause. Secondhand smoke exposure also increases the risk of diseases such as asthma.
• Violence against women: A strong correlation exists between alcohol consumption and intimate partner violence (IPV) inflicting physical harm and severe emotional and mental trauma on women.
• Road safety risks: While most drunk drivers and individuals injured in road crashes are men, women’s risk to injury or death if in an accident is higher. A woman is 47 percent more likely than a male counterpart to sustain serious injuries if in a car crash, and 17 percent more likely to be killed, even after accounting for variables such as height, weight, seatbelt usage and crash intensity. These disparities primarily stem from vehicle designs and safety tests tailored to the male physique.
• The hidden costs of caregiving: Women predominantly bear the caring responsibility for family members with diseases and disabilities linked to tobacco, alcohol and SSB product use. Often unrecognized and undervalued, this unpaid caregiving burden severely limits women’s ability to engage in education, employment and other crucial aspects of human development, including caring for their own health. Evidence shows that caregiving women are over twice as likely to experience poverty compared with women without caregiving responsibilities.
• Economic hardship: The financial strain imposed by household spending on tobacco, alcohol, and SSB products can be substantial. A non-negligible portion of the household budget may be diverted to these products, limiting the availability of money for necessities such as food, education and healthcare. This economic burden undermines women's financial security and well-being.

These examples illustrate that tobacco, alcohol and SSB product use amplifies women’s disempowerment and gender inequities. UNDP’s new policy brief describes further examples of differential gender impacts in depth, including greater risks for women tobacco farmers, concurrent use of tobacco and alcohol and its association with gambling.

Health taxes and their gendered impacts

Health taxes, which are excise taxes levied on products harmful to health, offer a potent tool for mitigating these harms and contributing to women’s empowerment.

Health taxes are not just about promoting health; they also create opportunities to raise government revenue to fund initiatives empowering women. The revenue generated can be reinvested into programmes that empower women such as social protection, universal health coverage, support for domestic violence victims and promoting economic opportunities, which ultimately benefit all. Research indicates that health taxes have a progressive impact, especially benefiting lower-income populations. 

Countries such as the Philippines have demonstrated that substantial development gains can be achieved through bold health tax reforms. Increased taxation has led to increased funding for expanding universal health coverage, significantly benefiting low-income and elderly populations, which include a higher proportion of women. Alongside the rapid expansion of universal health coverage, women's health has improved and their poverty rates have dropped.

Yet, despite these benefits, health taxes remain underutilized in low- and middle-income countries (LMICs). While the WHO recommends that tobacco excise taxes comprise at least 70 percent of the retail price, cigarette excise taxes average less than 22 percent of the retail price in lower-income countries and 41 percent in middle-income countries. This represents a significant missed opportunity, particularly given that health taxes are relatively easy to implement and can mobilize revenue quickly – an especially valuable advantage for LMICs with limited tax administration capacity and fiscal space. Moreover, health taxes enjoy considerable public support and carry lower political risks compared to other forms of taxation.

Health taxes align perfectly with the theme for International Women’s Day 2025: “For ALL women and girls: Rights. Equality. Empowerment.” As stressed by the UN’s Pact for the Future, gender equality and the empowerment of women are indispensable to sustainable development. Harnessing the transformative potential of health taxes can accelerate societal change for an equitable and sustainable future for women, and for all. It is time to embrace health taxes not merely as a fiscal or health promoting instrument, but as a vital force accelerating efforts toward realizing SDG 5 and beyond – ensuring that gender equality is not just an aspiration, but a tangible reality.