Blog: Taxing health – market access for medical products under COVID-19

11 June 2020
ITC News

Trade policy responses to COVID-19 include liberalizing products needed to fight the pandemic

Closed borders, limitations to the movement of people, export and import restrictions - many measures taken in response to COVID-19 constrain the exchange of goods and services. However, a closer look at the temporary changes in market access conditions (ITC's Market Access Map: reveals that 48% of measures have actually sought to liberalize trade - thus easing import conditions for critical products to address the pandemic¹.

As of today, 117 countries have adopted temporary measures to ease imports of products in response to COVID-19. These include reducing tariffs and taxes, suspending anti-dumping duties, increasing quotas as well as relaxing regulatory or procedural requirements. For example, Argentina currently suspends anti-dumping duties on syringes from China; Ukraine eliminated customs duties and VAT on medicines and medical equipment; and Indonesia no longer requires an import certificate for masks.

Least developed countries have high tariffs on some COVID-19 related products, yet only 12 of them have cut tariffs on medical products

While 77% of developed countries have cut tariffs on medical products, only 53% of developing countries and only 27% of least developed countries (LDCs) have adopted such measures.

Temporary tariff reductions are least common among least developed countries

Data source: ITC's Market Access Map, 


This is noteworthy, because LDCs often heavily rely on imports for these products - only few are net exporters of medical products. Africa, for example, accounts for less than 0.5% of exports of COVID-19-related products. Almost all (97%) of its textile masks imports come from countries that currently ban or restrict the exports of this product.

At the same time, market access conditions for some of these products are very restrictive, with high tariffs and stringent non-tariff measures.

Almost all least developed countries impose a tariff of 20% or more on at least one COVID-19 related product. The product facing the highest tariff is alcohol (on average, 42% for undenatured ethyl alcohol and 28% for Ethyl alcohol of an alcoholic strength of <80% vol.).

Other products facing high tariffs include disposable hairnets (26%) and different types of soap (around 20%). Textile masks are subject to average import tariffs of 18% in least developed countries, and of up to 35% in the most restrictive markets. A similar pattern exists for internal taxes, which further add to the price of critical products.

In addition to tariffs and taxes, non-tariff measures² and obstacles in bureaucratic processes complicate imports of COVID-19-related products. ITC's business surveys on non-tariff measures ( document that many companies in least developed countries struggle with lengthy and inefficient non-facilitative customs clearance processes, import licencing and registration requirements as well as customs surcharges. Obstacles such as delays, administrative burdens, informal payments and lack of facilities further add to time and cost of trade³. Here, a full implementation of the WTO Trade Facilitation Agreement could help.

Key products are highly taxed in countries relying on imports

Key products needed during the crisis are therefore not only short in supply, given the high demand worldwide, but also highly taxed and subject to additional trade costs due to these obstacles, making them even less accessible for people in developing countries where the goods are not produced.

Customs revenue from tariffs on medical products is limited

For many least developed countries, tariffs are an important source of government revenue. However, customs proceeds from key medical products are limited⁴. Reducing or eliminating tariffs on COVID-19 related products may therefore only slightly reduce tax revenues, but the benefit of better access to these products may be worth the cost. This is particularly true in view of the significant amounts governments are spending on the fight against the pandemic.

Options for facilitating market access for critical products during the COVID-19 crisis and beyond

Least developed countries can facilitate market access for critical products during health crises while limiting fiscal revenue losses at the same time. They can do so through specific measures that reduce trade costs and contribute to higher competitiveness and efficiency.  

To fight COVID-19 and be prepared for future health crises, governments should:

  • Critically review the tariffs and taxes imposed. Consider their temporary removal in times of health crises.
  • Review import regulations, e.g. licencing and registration requirements. Consider their temporary lifting (or easing) where feasible.
  • Review import procedures for critical products. Consider a 'fast lane' with quick customs clearance similar to the ones used for perishable products⁵.
  • Improve efficiency in the import (and export) processing, including implementing the WTO Trade Facilitation Agreement.

¹ Critical products as defined by the WHO/WCO classification list.

² Non-tariff measures are policy measures other than customs tariffs that affect international trade. Examples include regulations on food   or health safety, rules of origin, quantitative restrictions (e.g. sanctions or quotas) and mandatory inspection of imported or exported products. See the classification of non-tariff measures at:

³ See also: ITC (2011), Non-tariff measures and the fight against malaria Obstacles to trade in anti-malarial commodities, available at

⁴ ITC (2011), Taxing health: The relevance of tariff revenue from anti-malarial commodities, available at