Raising taxes on alcohol and tobacco is a viable financing model to combat lifestyle diseases, as the high cost of treatment continues to burden low-income individuals suffering from non-communicable diseases like kidney disease, diabetes, breast cancer, and heart conditions, experts say. They made the observation following the introduction of new tax reforms by the government. As part of the reforms, excise duty on beer has been increased from 60 per cent to 65 per cent of the factory price, while the fixed fee charged on cigarettes will increase from the current Rwf130 to Rwf230 per pack, in addition to the existing 36 per cent excise duty paid on the retail price. François Uwinkindi, Division Manager for Non-Communicable Diseases at the Rwanda Biomedical Center (RBC), told The New Times that the increase of taxes on beer and tobacco could help subsidise the cost of treating lifestyle diseases. Treatment of these diseases currently remains out of reach for many patients. ALSO READ: Rwanda to increase taxes on beers, tobacco For some patients, for instance, dialysis treatment is required three times per week, costing Rwf100,000 per session, totaling almost Rwf1 million per month. Patients with transplanted kidneys need about Rwf150,000 per month to buy necessary medications. “As part of the Tunyweless campaign, the taxes could discourage consumption of beer and tobacco, reducing the risk factors for non-communicable diseases, while helping to cut the cost of treating these diseases,” Uwinkindi said. Non-communicable diseases (NCDs) account for 46 per cent of all deaths in Rwanda, and tobacco and alcohol are among the major risk factors. ALSO: 10 ways alcohol is destroying your life “Ten years ago, the prevalence of tobacco smoking was 13 per cent among Rwandans. Currently, it is at 7 per cent, marking a 5 per cent decrease,” he said. However, despite the decrease in tobacco consumers, those exposed to tobacco smoke remain high. According to a 2023 study, 29.3 per cent of adult Rwandans reported exposure to tobacco smoke at home, while 13 per cent reported exposure at work. “Ten years ago, excessive alcohol consumption , drinking five bottles at once, was at 23 per cent, and currently, it is at 15 per cent,” he explained. In the same period, two in five people (41.9 per cent) reported alcohol consumption in the past year, and 12.5 per cent reported daily use, according to the survey findings. ALSO READ: No alcohol is the best choice, warns UN health agency Approximately one in three adult Rwandans (30.8 per cent) reported consuming alcohol in the past 30 days. Less than 6 per cent of adult Rwandans reported drinking six or more drinks in one occasion. One of the well-documented impacts of harmful alcohol use is its link to liver diseases, especially cirrhosis. Alcohol consumption is classified as carcinogenic by the International Agency for Research on Cancer (IARC), as it increases the risk of several types of cancer, including liver, breast, mouth, and throat cancers. Excessive alcohol consumption also increases the risk of high blood pressure, stroke, diabetes, and heart disease. “Blood pressure cases have increased over the past 10 years. Currently, 16.8% of the population in Rwanda have high blood pressure, while diabetes is at 3%,” Uwinkindi said. “We recognize NCDs as a priority health issue in Rwanda and across sub-Saharan Africa, where NCDs now account for more than a third of total deaths, a jump from 24% in 2000, he added. In just five years, NCDs will surpass HIV/AIDS, tuberclosis, and maternal mortality as the leading causes of death, meaning health systems must be prepared now. Joseph Mucumbitsi, a cardiologist, said there is a need for innovative financing to treat NCDs, especially given the Trump administration’s recent freeze on development aid and the potential dismantling of USAID, which has sent a shockwave through the global health community. “It is paralysing health programmes that provide lifesaving medication and treatment to people, and it turns the global health financing landscape upside down. Any hit to global health financing is a hit for all health issues, including NCDs.” Today, NCDs – such as cancer, heart diseases, chronic respiratory diseases, diabetes, and mental health conditions like depression and anxiety – account for 74 percent of deaths globally.
