改革健康税以提高墨西哥的健康水平

A series onFiscalpolicyPublic Disclosure Authorized &Health Knowledge Note #8 ReforminghealthtaxestoimproveMexico’shealthPublic Disclosure Authorized Reforming health taxes to improve Mexico’s health Knowledge Note on Health Taxes #8 August 2025 Health taxes are excise taxes on products that have a negative public health impact: tobacco, alcoholicbeverages, and sugar-sweetened beverages. TheHealth Taxes Knowledge Notesare a series of papers onfiscal policy and health. They address key questions about health taxes and the main issues that come upduring health tax reforms. The series draws on global best practices, scientific evidence, and the World Bank’sexperience supporting countries in designing and implementing health tax reforms. It is produced under theGlobal Tax Program’s Health Tax Project. This note was prepared by Norman Maldonado, Ceren Ozer and Jeremy Veillard, based on technical workby the World Bank and three background papers independently developed for the Bank by the Mexico’sNational Institute of Public Health–INSP (INSP 2025a, INSP 2025b, INSP 2025c). Authors are grateful toTruman Packard, Gisela García, Julie Ruel Bergeron, Gabriel Aguirre, Claudia Macías and Danielle Bloom fromthe World Bank for their review and valuable comments. The authors are grateful for the comments andfeedback from the following peer reviewers: Evan Blecher, Rafael Muñoz, Roberto Iunes and Kate Mandevillefrom World Bank, and Rosa Sandoval from the Pan American Health Organization.Authors also thankthe technical inputs and feedback provided by INSP: Tonatiunh Barrientos, Arantxa Colchero, Luz MiriamReynales, and Belen Saenz-de-Miera from Universidad de Baja California. For questions or comments, contactNorman Maldonado (normanmv@worldbank.org) or Ceren Ozer (cozer@worldbank.org). The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. Theydo not necessarily represent the views of the International Bank for Reconstruction and Development/WorldBank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governmentsthey represent. Attribution.Suggested citation: Maldonado, Norman, Ceren Ozer and Jeremy Veillard (2025).Reforminghealth taxes to improve Mexico’s health. Health Taxes Knowledge Note # 8. Global Tax Program, World Bank.Washington, DC. Cover photo: Beautiful streets and colorful facades of San Miguel de Allende in Guanajuato, Mexico ©Adobestock. REFORMING HEALTH TAXES TO IMPROVEMEXICO’S HEALTH Tobacco, alcoholic beverages and Sugar-Sweetened Beverages (SSBs) are significant contributors to poorhealth in Mexico.These products generate both internalities and externalities1, resulting in premature andpreventable deaths. The individual and societal costs from these externalities and internalities are not reflec-ted in their market price, representing a market failure. In Mexico, 125,350 people lose their lives annually dueto the use of these products. In addition to preventable deaths, there are years of life lost due to prematuremortality and years of healthy life lost due to disability; these two effects are measured by the Disability-Adjusted Life Years (DALYs).When considering the broader perspective of DALYs, the negative effect ofthese products on health is much higher: the country has an annual loss of 2,842 DALYs per 100,000 peopledue to the use of these products. Figure 1 shows the change of burden of disease over time for tobaccoand alcohol. Burden of disease in tobacco has decreased, but progress has stalled, and the burden is stillhigh. Meanwhile, the burden from alcohol is similar in magnitude to the one from tobacco, and it has beensteadily growing since 2006. Alongside their health impact, these products also carry significant fiscal costs.Tobacco alone imposesdirect costs for the treatment of cardiovascular disease, cancer, and Chronic Obstructive Pulmonary Disease,along with indirect costs such as labor productivity losses and informal care. The total costs imposed bytobacco in Mexico amount to 0.8 % of GDP each year, yet tobacco tax revenues, at 0.16 % of GDP, are only afraction of these costs. Mexico has a successful track record of using health taxes to improve health and raise revenues.Healthtaxes are excise taxes targeting use of tobacco, alcohol and SSBs. They are an effective policy instrumentto correct market failures (World Bank 2022) and represent the most effective population-level interventionfor the prevention of noncommunicable diseases (Galea et al. 2025). Mexico currently has excise taxes onall three products2. The country successfully introduced changes in tax structures and rates in tobacco in 2007-2010 and 2019, and in SSBs in 2014. These reforms triggered shocks in real prices (Figure 2), which inturn reduced consumption and improved health (see Box 1). However, structure and rates of alcohol taxeshave not been improved, and tobacco and SSBs taxes require reforms to further