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Saatja: "Sara Bertucci" <[email protected]> Saaja: [email protected], "Info - SOM" <[email protected]>, "Info - RAM" <[email protected]>, "Info - RAM" <[email protected]> Teema: Urgent: Strengthening UN Political Declaration on NCDs & Mental Health – EPHA Input Kuupäev: 2025-08-20 13:19 Tähelepanu! Tegemist on välisvõrgust saabunud kirjaga. Tundmatu saatja korral palume linke ja faile mitte avada. Dear Excellencies, On behalf of the European Public Health Alliance (EPHA), the leading civil society network advocating for better health in Europe, I am reaching out to you ahead of the Fourth UN High-Level Meeting on Non-Communicable Diseases (NCDs) and Mental Health. The upcoming Political Declaration will be a pivotal moment for global NCD prevention. We trust in the leadership of Estonia to help ensure the text sends a strong and unambiguous signal of commitment. The decisions taken now will shape not only the future burden of NCDs, but also public confidence in governments’ resolve to protect health. In the attached letter, we respectfully urge Estonia to: * Strengthen Article 42, point VII, by explicitly recommending tangible fiscal actions to ensure affordability of healthy products, including zero-rating VAT on raw fruits and vegetables; * Strengthen paragraph 43, committing governments to "implement or increase" health taxes; * Explicitly include taxation of sugar-sweetened beverages, alcohol, tobacco, and ultra-processed foods as core measures; * Safeguard against vague language or commercial interference; * Reaffirm governments’ right to implement public health measures free from undue influence. These measures are among the most effective and cost-efficient tools to prevent NCDs, improve population health, and generate revenue for health and social protection. The urgency to act has never been greater, and the Estonia’s role and influence will be critical to a strong outcome. We remain fully available to discuss these recommendations or provide any support that could be useful in your deliberations. With highest consideration, <https://twitter.com/epha_eu> <https://www.linkedin.com/company/european-public-health-alliance/> <https://www.youtube.com/@epha_eu> Sara Bertucci (she/her) Policy Manager - Global Public Health Rue de Trèves 49-51,1040 Brussels, Belgium <mailto:[email protected]> [email protected] | <http://www.epha.org/> www.epha.org Rue de Trèves 49-51 1040 Brussels, Belgium [email protected] | +32 (0) 2 230 30 56 www.epha.org OPEN LETTER – European Public Health Alliance calls to strengthen the High-Level Political Declaration on NCDs and Mental Health through stronger commitment to fiscal policies, to promote equity and well-being Dear Excellencies, As the Fourth UN High-Level Meeting on Non-Communicable Diseases (NCDs) and Mental Health approaches, we, representatives of European public health civil society, urge you to ensure the final Political Declaration unequivocally endorses fiscal policies - specifically taxation of sugar-sweetened beverages (SSBs), alcohol, tobacco, and ultra-processed foods. These are proven levers to reduce the NCD burden, improve physical and mental well-being, and ultimately address the commercial determinants of health. The European Public Health Alliance (EPHA), representing public health civil society, patient groups, health professionals, and disease groups through over 40 members spanning across 20 countries in the WHO European Region. are deeply concerned that the revised text of the Political Declaration significantly weakens commitments to a wide range of proven, cost- effective best-buys in NCDs prevention, from advertisement to labelling and packaging of health-harming products – with taxation standing out as a particularly glaring area where urgent action is needed. There is broad scientific consensus and political recognition that fiscal policies are among the most effective tools available to governments for reducing consumption of harmful products, improving population diets, and tackling the growing burden of NCDs. The World Health Organization (WHO) has consistently highlighted health taxes as a “best buy” intervention, both cost-effective and scalable, recommending that governments design taxes to raise prices and meaningfully change consumption behaviour (1, 2, 3). The WHO’s “3 by 35” Initiative embodies this approach, urging countries to raise real prices on tobacco, alcohol, and sugary drinks by at least 50% by 2035. Such pricing could avert 50 million premature deaths over the next 50 years while generating $1 trillion in revenue by 2035. At the same time, tangible fiscal actions are equally important to ensure the affordability of healthy products, such as fruits and vegetables, to support population-wide dietary shifts. Moreover, such fiscal policies represent smart levers in economic policy, generating critical revenue that can support urgently needed efforts to strengthen universal health coverage and social protection. They are essential to realise the declaration’s goals of reaffirming the right to the highest attainable standard of physical and mental health, leaving no one behind, and reaching the furthest behind first. These measures have already proven successful across diverse contexts, from Latin America to Europe, where countries implementing SSB taxes have seen reductions in consumption and product reformulation.  Rue de Trèves 49-51 1040 Brussels, Belgium [email protected] | +32 (0) 2 230 30 56 www.epha.org Despite this, references to health taxes are one of the clearest examples of how the current draft remain vulnerable to dilution, demanding urgent correction. As noted in a recent BMJ commentary on the draft declaration, vague or aspirational language risks weakening global resolve and emboldening commercial actors that have long sought to undermine effective public health regulation. The commercial determinants of health, including aggressive industry marketing, policy interference, and trade pressures, continue to obstruct national progress (4,5,6). It is therefore vital that the declaration not only acknowledges these forces as partners, but actively equips governments to respond through strong regulatory frameworks, including fiscal policies. Preventing NCDs and promoting mental health and health equity is not anti-business: a whole-of-society approach includes the private sector, and particularly those businesses aligned with public health goals. It requires clear regulatory frameworks oriented towards the advancement of the public good and long-term economic sustainability. The Political Declaration must move beyond rhetorical commitments and voluntary measures. A clear endorsement of fiscal measures would send a powerful message of leadership, accountability, and public interest in NCDs governance. We respectfully urge you to: • Strengthen Article 42, point VII, by explicitly committing to tangible fiscal actions to ensure affordability of healthy products, including the zero-rating of VAT on raw fruits and vegetables as a recommended measure • Strengthen paragraph 43, committing to "implement or increase" health taxes • Explicitly include taxation of SSBs, alcohol, tobacco, and ultra-processed foods as a core target for health-promoting environments • Avoid language that weakens these commitments or opens the door to commercial interference • Reaffirm the right of governments to implement public health measures free from undue influence. With this declaration, the global community has a pivotal opportunity to slash the burden of NCDs, enhancing mental well-being, combat health inequities, saving lives, and improving economies. We ask you to seize it, supporting a declaration that catalyses meaningful and equitable health protection. We thank you for your leadership and remain at your disposal to support your efforts. Sincerely, The European Public Health Alliance (EPHA)