Imaan Kanji Lalji, LLB student Technology Law, University of Groningen, i.a.kanji.lalji student.rug.nl

Non-communicable diseases are a burden on Tanzania’s health care system with the major diseases being cancers, chronic respiratory diseases, cardiovascular diseases and diabetes.¹ These big four contribute to around 40% of the non communicable diseases within Tanzania, and to around 30% of the deaths with approximately 559.9 deaths per 100,000.² Non-communicable diseases are caused by 5 major risk factors, including the use of tobacco, an unhealthy diet, a lack of physical activity, drinking alcohol and air pollution.³ However, with habits such as smoking and drinking continuing to be activities of choice, these diseases are on the rise. With this, Tanzania faces a heavy burden on the country’s health care system, hospitals and revenue. It is in the best interests of the government to attempt to curb such harmful practices. Governments often combat this through such methods such as fiscal measures, strict advertising standards and implementing prohibitions. This paper will view the commitments of Tanzania to tackle the rise of non-communicable diseases as per international treaties. While there are various methods to achieve tobacco control, this paper focuses on the tax requirements of the WHO Framework on the Convention of Tobacco Control (FCTC) and whether Tanzania’s current policies align with this treaty and the country’s other international obligations.

The FCTC aims to develop a regulatory strategy for handling tobacco as an addictive substance, with the aim of improving public health.⁴ Two key aspects of the convention include strategies for a targeted decrease in demand, and a decrease in supply.⁵ In an attempt to reduce demand, the convention includes articles on price and tax measures, non-price measures, regulating the content of tobacco products, packaging and labelling requirements, education and public awareness along with advertising requirements.⁶ Measures to reduce the supply of tobacco include those that prohibit its illicit trade, sale to and by minors along with the promotion of alternative activities.⁷ In an attempt to reduce tobacco and cigarette consumption, Tanzania has imposed a tax on such products of 14.7%.⁸ This excise duty, imposed by the Tanzania Revenue Authority is a step towards Tanzania’s commitment to the FCTC, a treaty signed on the 27th of January 2004 and ratified on the 30th of April 2007.⁹ Despite these strategies, Tanzania’s measures have fallen short, not only of the WHO FCTC tax requirements but also of their obligations under the African Charter on Human and Peoples’ Rights.

As per Article 16 the African Charter on Human and Peoples’ Rights (ACHPR), which Tanzania has both signed and ratified, health care is considered a fundamental right. Article 16(2), requires that “State Parties to the present Charter shall take the necessary measures to protect the health of their people”.¹⁰ This creates a positive obligation upon states to do everything in their ability to protect the health of their people. While this does refer to health care in the broader application, tackling non-communicable diseases is a crucial aspect. This complements the fiscal obligations outlined in the WHO FCTC including the Convention’s primary objective as per Article 3, which is to protect from the health, social, environmental and economic consequences of tobacco consumption and exposure through the creation of measures implemented by parties.¹¹ Together, these two treaties ensure the fulfilment of each other's obligations and goals. However, as seen in the Final Technical Report on Cigarette Taxation in Tanzania by the American Cancer Society, Tanzania falls immensely short of the WHO’s recommendation for a 70% tax on tobacco products with the country instead implementing a 14.7% tax.¹² In fact, Tanzania is known to have the lowest tax on tobacco products in Africa.¹³ It is important to note that this blog does not consider additional measures taken by the government of Tanzania towards reducing tobacco consumption such as advertising requirements and prohibitions. As such, Tanzania may have more progress in ensuring their alignment with their international obligations as per the ACHPR.

Despite the country’s obligations to reduce tobacco consumption as per the WHO FCTC and to ensure the fundamental right of health care as per ACHPR, Tanzania falls short of its responsibilities and lacks the necessary measures to limit tobacco and tobacco products. Considering the situation of Tanzania’s health care systems, with the majority of the population struggling to access basic health care assistance, stronger tax policies to target long term non-communicable diseases are essential to ensuring a thriving population; both in terms of health and the economy. I believe that the measures and treaties currently implemented at international and regional levels are actionable and that the responsibility now falls upon the government and their steps to ensure effective implementation.

 ^1. Ndumwa HP and others, ‘Mitigating the Rising Burden of Non-Communicable Diseases through Locally Generated Evidence-Lessons from Tanzania’ (2023) Annals of Global Health <https://doi.org/10.5334/aogh.4111> accessed 23 April 2025.

^2. Ibid. Leonard E. G. Mboera and others, ‘Patterns and trends of in-hospital mortality due to non-communicable diseases and injuries in Tanzania, 2006–2015’ (2024) 3(7) PLOS Glob Public Health <https://doi.org/10.1371/journal.pgph.0000281> accessed 23 April 2025. Leonard E. G. Mboera and others, ‘Patterns and trends of in-hospital mortality due to non-communicable diseases and injuries in Tanzania, 2006–2015’ (2024) 3(7) PLOS Glob Public Health <https://doi.org/10.1371/journal.pgph.0000281> accessed 23 April 2025.

^3. ‘Noncommunicable diseases’ (World Health Organisations, 2025) <https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1> accessed 23 April 2025.

^4. WHO Framework Convention on Tobacco Control, (2003), 2302 UNTS 166.

^5. Ibid, Part III, Part IV.

^6. Ibid, Article 6, 7, 9, 11, 12 and 13.

^7. Ibid, Article 15, 16 and 17.

^8. Blecher E, ‘Cigarette Taxation in Tanzania, Final Technical Report’ (American Cancer Society , September 2011) <https://idl-bnc-idrc.dspacedirect.org/server/api/core/bitstreams/942b8db7-aa3a-4ba2-990b-040d 998bde84/content>

^9. FCTC.

^10. African Charter on Human and Peoples’ Rights (adopted 27 June 1981, entered into force 21 October 1986) (1982) 21 ILM 58 (African Charter), Article 16(2).

^11.  FCTC, Article 3.

^12. Blecher E, ‘Cigarette Taxation in Tanzania, Final Technical Report’ (American Cancer Society , September 2011)
<https://idl-bnc-idrc.dspacedirect.org/server/api/core/bitstreams/942b8db7-aa3a-4ba2-990b-040d 998bde84/content>

^13. Ibid.