06/10/2025
*Silent Killers!* ..Choosing Life Over Profit: Zambia on Crossroad in the NCDs Batlle
By Hellen Bwalya
Zambia is grappling with a rapidly escalating public health crisis fueled by Non-Communicable Diseases (NCDs), often described as “silent killers.”
In a unified call to action, Centre for Primary Care Research (CPCR) Executive Director, Professor Fastone Mathew Goma, and Centre for Trade Policy and Development (CTPD) Executive Director, Isaac Able Mwaipopo, are championing the introduction of health taxes. They argue that such taxes can ease the burden on the national treasury, reduce NCD-related deaths, and mitigate the environmental harms of to***co.
With just eight months before the Fifth Session of the Thirteenth National Assembly of Zambia rises on Friday 15th May, 2026, the two leaders have urged parliamentarians to support the long-delayed To***co Control Bill (TCB) 2025. They describe the bill as a crucial bulwark against indiscriminate to***co consumption.
When asked whether President Hakainde Hichilema’s UPND administration would deliver where the previous Patriotic Front (PF) administration failed, Chief Government Spokesperson Cornelius Mweetwa hesitated, only promising a formal response during the Ministry of Information and Media press briefing on Thursday 18th September, 2025.
Despite the anticipation, the To***co Control Bill was missing from Cabinet’s legislative agenda earlier this week, raising concerns about government commitment.
*A Call to Action*
Civil society groups, including CPCR, CTPD, and the Zambia Media Network Against To***co (ZAMNAT), are urging lawmakers to fast-track the bill once it is tabled before Speaker, State Counsel (SC) Ms. Nelly Butete Kashumba-Mutti. They emphasize that this would align Zambia with its international obligations under the United Nations World Health Organisation Framework Convention on To***co Control (UN.WHO.FCTC), which the country ratified on Friday, 23rd May, 2008.
“The evidence is clear: health taxes deliver three wins—they save lives, reduce healthcare costs, and provide sustainable revenue,” reads a joint statement by CPCR and CTPD.
The UN-WHO’s MPOWER strategy highlights raising taxes on harmful products as one of the most effective demand-reduction measures. Zambia has already taken bold steps in this direction. In the 2025 Supplementary Budget, government raised excise duty on ci******es by 66%, increased duties on beer, spirits, and wine up to 80%, and doubled the tax on sugary drinks. These measures are expected to generate ZMW 3.9 billion—resources that can strengthen health systems, expand access to care, and reduce the burden of NCDs.
More than Revenue
Health experts stress that these measures are not about punishment but protection. “When prices go up, consumption goes down. Young people are less likely to start, and families are nudged toward healthier choices,” explained Prof. Goma and Mr. Mwaipopo, praising Finance Minister Dr. Situmbeko Musokotwane’s decision to fund part of Zambia’s K33.6 billion supplementary budget through health taxes rather than borrowing.
They argue that taxing to***co, alcohol, and sugar-sweetened beverages is an act of care: “These products may be marketed as pleasure, but their long-term impact is pain.”
*The Human Toll*
The human cost of inaction is staggering. According to WHO, to***co use alone kills more than 7,000 Zambians annually, while alcohol abuse and sugary drinks drive rising cases of diabetes, liver disease, and cardiovascular problems. The combined use of alcohol and to***co significantly increases the risk of cancers, heart failure, and mental health disorders.
The Kidney Foundation of Zambia has also raised alarm over the surge in chronic kidney disease (CKD), largely linked to untreated hypertension and diabetes. Secretary General Augustine Mukuka described dialysis as unaffordable for most patients, costing up to K4,000 per session. With more than 1,000 patients in Lusaka alone in need of treatment, he urged government to expand kidney care services and secure NHIMA’s sustainability.
*A Kidney Transplant Survivor’s Story:* William Ng’andu Jr. on Living with NCDs
Sharing his lived experience with a non-communicable disease (NCD), William Ng’andu Jr. recounted his journey with chronic kidney disease (CKD) and the second chance at life he received through a transplant.
“I owe a lot of gratitude to the whole team at Dr. Javias Dialysis Center in Rhodes Park, as well as Griffins Pharmacy, for always ensuring I had access to the necessary medications and consumables. I am also grateful to NHIMA for the financial support that allowed me to undergo twelve dialysis sessions a month and covered the cost of consumables and lab tests,” he said.
Ng’andu Jr. explained that post-transplant care has been a critical part of his recovery. “The University Teaching Hospital (UTH) has been exceptional in providing aftercare services. We have dedicated clinics twice a week where doctors monitor our progress and provide much-needed advice. UTH now also has a pharmacy solely for renal patients, allowing us to access our medications without enduring long queues.”
His survival was made possible through the selfless act of his younger brother, Chipo Ng’andu, who donated a kidney. He also expressed deep appreciation for a Californian surgeon who travelled to Zambia to perform the transplant procedure.
Non-communicable diseases (NCDs) such as cardiovascular illnesses, cancers, chronic respiratory conditions, and diabetes remain a growing health challenge in Zambia, accounting for a significant proportion of deaths nationwide.
Amid this crisis, recent breakthroughs in local kidney transplants at Ndola Teaching Hospital offer hope, cutting costs by more than half compared to overseas procedures.
Why Zambia Must Act Now
Across Africa, health taxes are proving effective. Rwanda’s to***co tax cut smoking rates from 13% to 7% since 2014. South Africa’s sugary drink levy reduced consumption by nearly a quarter among children, while Kenya’s alcohol taxes raised $400 million in 2023 for public services.
“Every Kwacha raised through health taxes doubles its value by cutting future healthcare costs,” Prof. Goma and Mr. Mwaipopo noted. They further recommend closing loopholes, such as untaxed loose-leaf to***co, which currently undermines Zambia’s revenue potential.
As Zambia joins the rest of the world in commemorating World Heart Day on September 29, themed “Don’t Miss a Beat,” CPCR and CTPD are urging leaders to seize this moment.
“Let this be the time we choose life. Enough is enough,” the two leaders declared.
The World Heart Federation estimates that up to 80% of premature cardiovascular deaths are preventable through affordable care, early screening, and healthy lifestyle choices. For Zambia, decisive action on health taxes and the enactment of the To***co Control Bill could mark the turning point.
*Health First: Zambia’s bold move on 'Sin Taxes'*
Zambia is significantly raising health taxes on to***co, alcohol, and sugary drinks in a bid to tackle a growing public health crisis while also increasing government revenue.
The 2025 Supplementary Estimates, released by the Ministry of Finance and National Planning, propose excise duty hikes expected to generate ZMW 3.9 billion.
Key measures include a 66 percent increase in cigarette excise duty, raising it to K750 per mille. Excise duty on alcohol will rise to 50 percent for clear beer and 80 percent for spirits and wine. The import duty on sugar-sweetened beverages (SSBs) will double to K 2.00 per liter.
According to the World Health Organization (WHO), to***co use kills an estimated 7,100 Zambians annually and contributes heavily to the burden of non-communicable diseases (NCDs), which account for nearly one-third of all deaths in the country.
Experts argue that a stronger tax increase on to***co alone could generate more than K2.3 billion annually, compared to the current K160 million, while also discouraging consumption.
However, enforcement remains a challenge, with a loophole allowing untaxed loose-leaf to***co—accounting for about 40 percent of the market.
Alongside the tax measures, the government is considering the long-delayed To***co Products and Ni****ne Products Control Bill.
If enacted, the legislation would align Zambia with the WHO Framework Convention on To***co Control and address loopholes, including tax incentives for to***co firms in Special Economic Zones.
International evidence underscores the effectiveness of such policies. South Africa’s 2018 Health Promotion Levy reduced sugary drink purchases, while Mexico’s 2014 SSB tax led to sustained declines, especially among low-income households.
Studies show consumers often switch to healthier alternatives such as water.
To strengthen tax collection, experts recommend adopting secure digital tax stamps, already used successfully in Kenya and Tanzania, to improve compliance and boost revenue at minimal fiscal cost.
The Africa CDC estimates that a 20 percent price increase on these products across Sub-Saharan Africa could double public healthcare funding.
Supporters argue that the revenue raised could finance critical health services, including medicines and clean water in schools, ensuring visible public benefits.
Despite industry resistance, global studies suggest health taxes do not significantly harm economies, and illicit trade is more linked to weak enforcement than to high tax levels...final ends
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