Sub-Saharan African health systems face critical funding challenges due to declining foreign aid, mounting debt and increasing disease burdens. Traditional financing mechanisms have proven inadequate, necessitating the exploration of innovative domestic revenue mobilization (DRM) strategies. This paper contributes to the health economics literature by examining the use of innovative tax models as DRM strategies for sustainable health financing in Sub-Saharan Africa, using the fiscal space for health framework. This narrative review synthesizes peer-reviewed articles, policy documents, and grey literature published between 2010 and 2025. The review identifies four promising innovative models: health taxes (tobacco, alcohol, sugar-sweetened beverages), environmental levies (pollution, carbon, plastic), digital taxation (digital services taxes, mobile money taxes, Value Added Tax (VAT) on digital services) and resource extraction taxes. The evidence demonstrates significant revenue generation potential while achieving public health and environmental co-benefits. However, critical implementation challenges persist: weak administrative capacity, poor governance quality, equity concerns and extensive informality and economic diversity. The paper recommends strengthening tax administration through digital infrastructure investment and capacity building, implementing progressive tax design with targeted exemptions, enhancing transparency and linking tax revenue to health service delivery, and tailoring reforms to country-specific contexts while learning from regional experience.
Mpofu et al. (2026) studied this question.