The African Tax Administration Forum (ATAF) has stepped up efforts to support African countries in implementing effective health taxes and strengthening excise tax administration, as part of a broader strategy to enhance domestic revenue mobilization and improve public health outcomes.
In 2023, ATAF launched a dedicated health taxes project, initially focusing on tobacco taxation, to help countries tackle one of the world’s leading preventable causes of death while also addressing the continent’s growing fiscal challenges.
Tobacco taxation has emerged as a central focus of ATAF’s intervention because of its dual impact on both public health and government revenue.
According to the World Health Organization (WHO), tobacco use is responsible for over eight million deaths every year globally, making it one of the most pressing public health crises of our time. It is highlighted that increasing tobacco prices through taxation is the most effective way to reduce consumption.
By prioritizing tobacco tax reforms, ATAF aims to not only curb smoking-related illnesses and prevent avoidable deaths but also provide African governments with an underutilized source of much-needed revenue.
The urgency of these reforms is underscored by Africa’s significant funding gap for achieving the United Nations Sustainable Development Goals (SDGs) by 2030. The continent faces an estimated USD 1.6 trillion financing gap, requiring an additional USD 194 billion annually.
According to the United Nations’ 2023 assessment, progress on several SDGs, including Goal 3 on good health and well-being, remains weak and insufficient.
Increasing investment in health systems has become critical to strengthen resilience against current and future health threats. However, domestic health spending remains below the 15% target set by the Abuja Declaration, averaging only 7.3% in 2020.
At the same time, many African countries are struggling with rising debt burdens, which are crowding out investments in critical sectors such as health and education. The World Bank reports that developing countries spent a record USD 1.4 trillion on foreign debt servicing in 2023, with interest costs reaching a 20-year high.
In several countries, debt repayments have now surpassed spending on essential public services, leaving governments with limited fiscal space to address pressing social needs.
This is compounded by persistent donor dependency, constrained external funding, and relatively low domestic tax collection. Africa’s average tax-to-GDP ratio stands at just 15%, significantly below the OECD average of 34%, underscoring the importance of innovative approaches like health taxes to bridge revenue gaps.
Recognizing these challenges, ATAF is working closely with its 44 member countries to strengthen their capacity to design and implement effective health tax policies. The organization believes that tackling tobacco taxation requires more than just policy reforms; it demands evidence-based approaches, robust administrative systems, and sustained political will.
Through a combination of research, capacity building, technical assistance, and multistakeholder engagement, ATAF is helping countries establish stronger frameworks for excise tax administration.
One of ATAF’s key contributions has been through its flagship publication, the African Tax Outlook (ATO), which provides actionable research and data to inform tax policy formulation across the continent. The 2023 edition of the ATO included a dedicated segment on tobacco taxation, offering insights to help governments make informed decisions, while the 2024 edition is expected to expand this analysis further.
Complementing this research, ATAF has also launched specialized training programs through its Tax Academy, equipping African tax officials with the technical skills needed to manage excise taxes effectively. By October 2023, the first cohort of trainees had completed the program, with the second cohort scheduled for September 2024.
In addition, ATAF has organized numerous workshops and technical discussions at continental, regional, and national levels, reaching more than 400 officials from over 30 countries.
These sessions have addressed key aspects of tax policy design, administration, and measures to combat illicit trade, which remains a significant challenge in the tobacco sector. The momentum from these initiatives culminated in the 3rd Continental Workshop on health taxes, which took place on August 26-27, 2025.
ATAF has also developed a comprehensive Policy and Administrative Guide on tobacco and excise taxation, designed to assist governments in strengthening their frameworks and improving implementation.
This resource, which will be officially launched during ATAF’s Annual Meetings in November, builds on collaborative efforts with global partners such as the World Bank and the United Nations Subcommittee on Health Taxes.
Alongside this, ATAF has supported the development of additional guides and toolkits to help countries refine their excise tax systems and improve administrative efficiency.
Furthermore, ATAF continues to provide tailored technical assistance to individual member countries. For example, Zambia is currently receiving targeted support to strengthen its excise tax administration, with similar engagements planned for other countries.
This assistance covers a range of areas, including policy development, institutional capacity building, and the digitalization of tax administration systems to improve efficiency and compliance. Beyond national interventions, ATAF has played a key role in advancing the African voice in global tax policy discussions.
As a member of the African Tobacco Tax Consortium (ATTC), the organization collaborates with regional and international stakeholders, including the United Nations, World Bank, OECD, and WHO, to ensure that Africa’s perspectives are effectively represented in shaping global health tax frameworks.
By fostering these partnerships, ATAF is working to promote inclusive and impactful policymaking that balances fiscal sustainability with public health objectives.
As Africa strives to achieve the SDGs and strengthen its health systems, ATAF’s leadership in driving evidence-based health tax reforms has positioned the organization as a central player in the continent’s efforts to raise domestic revenues and protect public health.
By combining technical expertise, policy innovation, and strategic collaboration, ATAF is helping African countries turn health taxes into powerful tools for saving lives, reducing inequalities, and advancing sustainable development.