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. 2019 Jul 4;97(9):620–630. doi: 10.2471/BLT.18.222638

Table 4. Illustrations of feasibility considerations on revenue-raising mechanisms in Benin, Mali and Togo .

Criterion Increased tax on (imported) alcoholic drinks Newa or increasedb tax on airplane tickets New tax on telephone communications New tax on remittances in financial transactions New tax on the extractive industriesc New tax on national lottery ticketsd
Political feasibility Resistance from the population would be expected, especially for a tax on beer
(–)
Unitaid airline tax was previously rejected by parliament in Togo but is already in force in Mali. Tax for the purpose of UHC may gain more acceptance
(+ –)
Competing interests of ministries
(–)
Resistance from the population would be expected
(–)
Competing interests of ministries. Unclear political situation
(– –)
Popularity of gambling may be an advantage to advocate for UHC. Tax on national lottery tickets already exists to fund social, cultural and sport events
(+)
Sustainability No high consumption rates so far, but increase would be expected
(+)
Growing industry
(+ +)
Growing industry
(+ +)
Growing amount of remittance from migrants
(+)
Growing industry
(+)
Revenues may be unreliable due to irregular consumers
(–)
Stability Stable market
(+)
Stable market
(+)
Stable market
(+)
Stable market
(+)
Revenues would fluctuate due to varying commodity prices
(–)
No stable market
(–)
Progressivity Taxes could be higher for wine and spirits which are consumed by more affluent population groups (compared with beer) to be more progressive
(+ +)
Affects more affluent population groups. Distinction between economic and business class passengers would enhance progressivity
(+ +)
A flat tax rate is more progressive. The tax would be more progressive if differentiated in terms of volume and services
(+ –)
Potential negative impact for people who depend on remittances, as those who receive remittances spend the highest proportion of their income on consumption
(– –)
Not enough information to assess this Potential negative impact for low-income groups
(–)
Administrative efficiency Mechanism to collect taxes already in place
(+ +)
Mechanism to collect taxes already in place
(+ +)
Mechanism to collect taxes already in place
(+ +)
No information available No effective collection mechanism in place. Lack of data on how much is collected (Togo)
(– –)
Mechanism to collect taxes already in place
(++)
Other possible effects and trade-offs Has the potential to reduce alcoholic drinks consumption, which increases health status of the population
(+)
Marginal risk that national airports would lose competitiveness
(+ –)
Investments may slow down, which would affect the rural poor who depend on telephone services
(–)
Informal transactions would benefit.
(– –)
Extractive industries already highly taxed (Mali). This emerging sector still needs to attract investors
(– –)
Current market is competitive, with diverse gambling options. Existing lottery already in place
(–)

UHC: universal health coverage.

a Only in Benin and Togo.

b Only in Mali.

c Only in Mali and Togo.

d Only in Benin.

Note: We graded the criteria from very weak to very strong based on the data from stakeholders’ discussions and interviews: (– –) = very weak; (–) = rather weak; (+–) = neutral; (+) = strong; (+ +) = very strong.

Sources: Based on country studies.57