Fiscal space analysis 4 non-communicable diseases & increased domestic resource

The assignment will develop an analytical and quantitative modelling framework to assess the revenue generation potential, health gains, consumption effects, fiscal space implications, and broader economic and human development outcomes of increased excise taxation on tobacco, alcohol, and sugar-sweetened beverages in Sierra Leone. Throughout, the analysis will place explicit emphasis on non-communicable diseases (NCDs), ensuring that projected revenue, consumption, and fiscal space outcomes are directly linked to measurable reductions in the national NCD context.

 

The assignment is delivered in four interconnected output phases: 

·        Conduct fiscal space analysis and modelling for increased health taxation in Sierra Leone over the short to medium term.

·        Review the health financing, tax policy, legislative, and regulatory framework and develop recommendations for policy and legal reform.

·        Facilitate national stakeholder engagement and policy dialogue on the analysis, findings, and proposed reforms.

·        Deliver capacity building and technical support for health tax modelling, legislative reform, revenue forecasting, monitoring, and oversight mechanisms.

·        Draft a new excise law in line with the policy recommendations.

1)      Conduct fiscal space analysis and modelling for increasing health taxation in Sierra Leone for the next five years:

·        Review and validate the existing fiscal space analysis for health taxation in Sierra Leone, identifying updates required, and confirming current excise tax rates and structures with MoF and NRA.

·        Conduct a targeted desk review to fill gaps not addressed by the existing fiscal space analysis, focused on quantitative revenue and consumption modelling for alcohol and sugar-sweetened beverages (including price elasticity estimates by product), and updated tobacco tax revenue projections reflecting changes introduced under the Finance Act 2024/2025.

·        Collect and analyse current fiscal and health data related to alcohol, sugar-sweetened beverages, and tobacco

o   Update, for alcohol, SSBs, and tobacco, the comparative tax structure, rate, and revenue-trend benchmarking against WHO, IMF, ECOWAS, WAEMU, and World Bank recommendations. Review prior studies and relevant policies, legislation and regulatory framework, relative to health taxation in Sierra Leone, benchmarking against regional and global best practices

·        Assess revenue and health impacts from the Finance Act 2024 and 2025 sin taxes and prior instruments engaging MoF and NRA as primary institutional counterparts.

o   Assess the contribution of increased excise taxes on domestic revenue mobilisation objectives

o   Map health tax revenue within the country’s revenue architecture and determine how the health taxes can help bridge the existing financing gaps

·        Develop a quantitative fiscal model to ascertain the increased revenue generation and health benefits achievable through increased taxation of alcohol and sugar-sweetened beverages, including price elasticity estimates, revenue projections, and health outcome indicators.

 

·        Model multiple tax scenarios to determine revenue impact of increases at low, moderate and high level

o   Estimate incremental revenue from the increased tax under each tax scenario,

o   In Sierra Leone’s economic context, project short-to medium term revenue for up to 5 years

o   Assess the impact on fiscal space for health financing at all levels, based on the prevailing regulatory frameworks

·        Analyse the health impact and implications for human development of increased health financing:

o   Collect and analyse trade and consumption data to assess reductions in alcohol consumptions, tobaccos and SSBs

o   Identify behaviour of drivers and incentives across different population groups

o   Model associated reductions on risk factors and estimate potential health outcomes with particular attention to reductions in NCD incidence, morbidity, and mortality attributable to tobacco, alcohol, and SSB consumption

o   Assess distributional and equity impacts, including related fiscal, social, and political economy implications.

§  Provide actionable policy recommendations, ensuring linkages to the PFM provisions, with:

o   Institutional arrangement required to strengthen health financing

o   Phased action plan for implementation of the proposed action plan 

2)      Review of Excise Tax Laws and Policy Brief Development:

·        Review all existing excise tax laws, regulations, guidelines, and associated tools governing tobacco, alcohol, and sugar-sweetened beverages in Sierra Leone, including the Finance Acts and the NRA Act.

·        In engagement with the national stakeholders, conduct a comparative legal analysis against regional and international best practices, including WHO Framework Convention on Tobacco Control (FCTC) obligations.

·        Identify legislative gaps, inconsistencies, and reform priorities; prepare a Legislative Gap Analysis and updated recommendations aligned to WHO guidelines and consistent to Sierra Leone PFM regulatory frameworks, development and financing objectives.

·        Produce a policy brief on the financing, development benefits, and costs of health taxes for government and parliamentary audiences, framed around its contribution to NCD prevention and control

·        Prepare a model legislative language and a legislative reform roadmap for review in consultation with the NRA, MOF and related drafting institutions

·        Recommend an institutional mechanism to operationalise the new health tax reforms through guidelines, instruments, and standard operating procedures for the Ministry of Finance and the National Revenue Authority on monitoring, enforcement, and budget oversight.

 

3)      National Stakeholder Dialogue on Excise Tax Policy Reforms

·        Develop and execute a comprehensive Stakeholder Engagement and Consultation Plan at the outset of the assignment, covering all government, civil society, private sector, and development partner actors relevant to health tax reform.

·        Facilitate stakeholder consultations across all project outputs, ensuring an inclusive and consultative process for key national stakeholders.

·        In collaboration with UNDP, WHO, UNICEF, the Ministry of Finance, and the National Revenue Authority, design and facilitate a policy dialogue on the financing, development benefits, costs, and proposed reforms of health taxes, bringing together line ministries, parliamentary committees, and development partners.

·        Map and document emerging recommendations for policy reforms to the excise tax act, ensuring inclusive participation from MoF, NRA, relevant line ministries, parliamentary committees, and civil society

4)      Technical support and capacity building for Designing and Enacting Health Taxes:

·        Facilitate high-level engagement, including with Cabinet and policymakers, to build support for excise policy reform aligned with WHO guidelines and identify priority capacity-building needs.

·        Deliver capacity building for policy makers and law makers on monitoring the implementation of NCD policy and legal reforms, including facilitation of parliamentary debates and communication.

·        Support MoF and NRA in developing internal procedures for ongoing health tax revenue forecasting and monitoring.