Health taxes in Indonesia: A review of policy debates on the tobacco, alcoholic beverages and sugar-sweetened beverage taxes in the media

Abdillah Ahsan, Nadira Amalia, Krisna Puji Rahmayanti, Nadhila Adani, Nur Hadi Wiyono, Althof Endawansa, Maulida Gadis Utami, Adela Miranti Yuniar

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction One of the WHO's € best buys' in controlling non-communicable diseases and their risk factors is to impose health taxes. While the Indonesian political process inhibits the implementation of health tax policy, studies to discuss the issue remain limited. Methods We employed media analysis to document health tax policy dynamics, for example, the changes in policy timeline and key actors' statements. We conducted an article search in the Open-Source Intelligence database using appropriate terminology on three commodities, for example, tobacco, alcoholic beverages and sugar-sweetened beverages (SSB). Results Throughout the 15 years of implementation (2007-2022), tobacco has received the most policy attention compared with the other two commodities. This is mainly related to the increasing tariff and reforming the tax structure. As Indonesia is a Muslim-majority country, alcohol consumption is low, and a tax on alcoholic beverages was nearly unchanging and lacked media coverage. Ministry of Finance (MoF) officials are key opinion leaders often cited in the media for health taxes. MoF's support for health taxes is important to pass and implement health taxes. While SSB taxation is emerging, key opinion leaders' media statements imply policy contestation, leading to delayed implementation. The policy debates on tobacco taxation implied election years as a major challenge for health tax passages. During the political years, anti-health tax arguments emerged from politicians. While the political contestation on SSB concluded that accentuating the health tax arguments in favour of public health generates the strongest opposition against taxation from the industry. Conclusions Politics of tobacco tax implementation are complex - compared with the other two commodities. The political context drives the divided views among policy-makers. Policy recommendations include generating public allies with key religious opinion leaders, continuing capacity building for politicians and Ministry of Health, and generating evidence-based arguments in favour of public health for MoF.

Original languageEnglish
Article numbere012042
JournalBMJ Global Health
Volume8
DOIs
Publication statusPublished - 9 Oct 2023

Keywords

  • health economics
  • health policy
  • public health

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