Progress towards a health surcharge in Bangladesh
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Work for a Better Bangladesh (WBB) Trust, Health Rights and Tobacco Control, Bangladesh
Bangladesh Anti Tobacco Alliance (BATA), Communication and Advocacy - Tobacco Control, Bangladesh
Work for a Better Bangladesh (WBB) Trust, Administration and Management, Bangladesh
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A103
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Background and challenges to implementation:
While Bangladesh has made significant strides on tobacco control, we have been weak on pricing. Tobacco control advocates were less competent in this area than in policy areas such as smokefree places, TAPS, and packet warnings. Intensive industry lobbying contributed to blocking significant progress on taxation. As a result, the other policy areas have not had the anticipated success.

Intervention or response:
Work for a Better Bangladesh Trust has been advocating for higher tobacco taxes virtually since its inception and for a dedicated surcharge since 2005. We did international research on health promotion foundations. We wrote a short book on the issue, including specific suggestions on its use. We carried out a signature campaign. We met with policymakers to discuss the issue. We organized seminars and participated in international discussions on the issue. We found several high-level advocates to push for the issue. We also engaged our extensive network in promoting the surcharge idea.

Results and lessons learnt:
In 2014-15, the Government of Bangladesh introduced a health surcharge on tobacco products of 1% of price. The government did not, however, make a decision at the time as to the use of the collected surcharge. As a result, it went into general revenue. More recently, the government has decided to allocate the surcharge to tobacco control in the following areas: prevention of non-communicable disease, policy implementation, function of the National Tobacco Control Cell, cessation, and treatment of tobacco-related disease. It is hoped that the allocation will begin within the next year.

Conclusions and key recommendations:
Sustainable funding for tobacco control is necessary in order to maintain an effective response to the epidemic. A dedicated surcharge is the best source of sustainable funding. Advocates should not be disappointed if the process requires many years, as the benefits will continue for decades to come.