YELLOW PAD

By Anthony Leachon

Dec. 20, 2023 marks 11 years since the signing of the Sin Tax Reform Law, which, in my opinion, is the greatest health advocacy and the greatest piece of legislation ever signed into law in our country.

In 2012, Republic Act 10351 or the Sin Tax Reform Law raised excise tax rates on tobacco and alcohol with the goal of lowering the number of Filipino smokers and raising revenue for Universal Health Care. The bill had been languishing in Congress for 16 years, but with the joint effort of the medical community, civil society, and our champion legislators, we made this landmark legislation a reality for the benefit of millions of Filipinos, smokers and non-smokers alike, for years to come.

Today, the coalition of passionate doctors and advocates known as the Sin Tax Coalition is still going strong. Despite the changes in the political landscape and through a pandemic, we have remained steadfast in our commitment to upholding public health by raising taxes on tobacco, alcohol, e-cigarettes and heated tobacco products.

I used to work in the corporate world, but some of the people closest to me — my mother, my father, and my sister — all succumbed to non-communicable diseases. I decided to retire from the corporate world and repurpose my skills, energy, and passion to health advocacy work. I became a P1 consultant to Health Secretary Enrique Ona, which was also where I met former Health Undersecretary Ted Herbosa, who is now the Secretary of Health of this administration.

The World Health Organization (WHO) estimates that seven out of 10 deaths in the Philippines are due to non-communicable diseases. That is 500,000 deaths in a year, which is equivalent to about three jumbo jets crashing every day. And yet, the clamor to address this epidemic is almost non-existent because unlike epidemics we have faced before, non-communicable diseases do not exhibit a clear and present danger.

The road towards the passage of the Sin Tax Reform Law in 2012 was strewn with many obstacles. Health advocates put in grueling hours speaking in front of Congress, talking to individual legislators, and demonstrating on the streets, all in the name of a healthier future for the Philippines. We found hard working champions in the government, from the Department of Finance, Department of Health, Department of Budget and Management, and other executive agencies, to the legislators. Everyone involved in the passage of this bill was willing to pull out all the stops because we knew that this reform would save the lives of millions of Filipinos for generations to come. Unfortunately, the person who signed the Sin Tax Reform Bill into law, former President Benigno Aquino III, passed away in 2021 from complications from diabetes, a non-communicable disease. The president himself was a smoker, but in spite, or perhaps because of this, he supported the sin tax reform.

The working paper, “A Performance Review of Sin Tax Reforms in the Philippines from 2012 to 2020,” by Kenneth Isaiah Ibasco Abante, AJ Montesa, Lyonel Tanganco, Viviane Apostol, and Patrick Acupan, published this December, assesses the promises and criticisms of the Sin Tax Reform Law. It tackles how the Sin Tax Law and the succeeding laws have affected revenues, smoking and alcohol prevalence, tobacco-growing regions, and our health system.

Despite the gains from the sin tax reforms, no piece of legislation is without room for improvement. The COVID-19 pandemic showed us that our healthcare system, despite the skyrocketing health budget, is still weak and fragile. There are large gaps in our healthcare service delivery and the implementation of the Universal Health Care Law, and it is our most vulnerable countrymen that fall through these cracks. We must make sure our gains are furthered and felt by every Filipino, just as the law intended.

Further, we must always be on our guard, knowing that tides can turn at any moment. The sin tax reforms must be protected in the face of emerging and greater challenges. We must address the proliferation of new products such as e-cigarettes and heated tobacco products, which are popular among the youth. The number of Filipinos drinking alcohol, which has not been taxed as high as tobacco, remains high, and binge drinking is still prevalent. Lastly, we need to protect the sin taxes from possible attacks.

The horizon for Filipinos at this moment is limited, given that the average lifespan of Filipinos is 72 years. I am passionate about the fight against non-communicable diseases because we should aim to live well into our 80s or 90s, or perhaps even endeavor to live until 100. Through this advocacy, we will be able to prolong the lives of Filipinos, so they have the time and health to pursue their dreams.

As we celebrate the leaps we took and the steps we are yet to take for a healthier Philippines, we may draw inspiration from the story of Diana Nyad. She was a long distance swimmer who crossed from Florida to Cuba at age 64, which set a world record. She was able to achieve this feat after failing to do so five times before. Upon finishing her amazing feat, she gave three important messages.

The first is “Never give up. Never give up. Never give up.” Although we face many obstacles, we must keep going and remember why we have believed in this advocacy since 2012.

The second is that nobody is too old to pursue or chase their dreams.

And the last, and most relevant to us advocates, is that, according to Diana Nyad, although swimming is a solitary effort, nobody can win without collaboration, without teamwork. We have made it this far through the joint efforts of passionate individuals across varied professions and backgrounds. Think of how much further we will be able to take this advocacy through further collaboration. I believe that this is the key to victory.

This article is a revised version of Dr. Anthony Leachon’s opening remarks at “Sin Tax Strategies for a Healthy Philippines: A Forum on the Past, Present, and Future of Sin Tax Reform,” a public launch held by iLEAD on Dec. 11 sharing findings from three outputs: A Performance Review of Sin Tax Reforms in the Philippines from 2012-2020, an Investment Case to Fund the National Tobacco Control Strategy (NTCS), and Local Experiences in Tobacco Control Strategies and implementation.

Dr. Anthony Leachon is an independent health reform advocate who advocated for the passage of sin tax reforms. He is a cardiologist at the Manila Doctors Hospital