ABSTRACT
Governments generally provide the services that allow people to access the critical determinants of health: water, sanitation, and education. These are also Sustainable Development Goals and fundamental economic and social human rights. Studies show that governments spend more on public services and health determinants with more revenue. However, governments in low and lower-middle-income countries have small budgets, and tax abuse (avoidance and evasion) contributes to revenue leaks. Researchers have estimated that four countries enable more than half of global tax abuse. We used estimates on tax abuse with a model of the relationship between government revenue and the determinants of health to quantify the potential for progress towards the Sustainable Development Goals 3, 4, 5, and 6. The increase in government revenue equivalent to global tax abuses is associated with 36 million people having access to basic sanitation and 18 million having access to basic drinking water. Additionally, over a ten year period, this increase would be associated with over 600,000 children and almost 80,000 mothers surviving. Thus, curtailing tax abuses would significantly contribute to progress towards the Sustainable Development Goals. Countries that enable tax abuses must review and modify policies to ensure progress towards these goals.