In August 2025, Guyana’s President Irfaan Ali removed all taxes and customs duties on feminine hygiene products. Now, Guyana’s Ambassador to the UN in Geneva calls on other countries to follow suit.   

In most developing countries male condoms are distributed freely. Free access to condoms is a globally recognized harm reduction strategy in public health. 

And yet, in those same  countries, and even in some developed  countries, menstrual hygiene products are often inaccessible and largely unaffordable to women and girls. 

Altogether, more than 500 million girls and women around the world are estimated to lack access to sanitary pads or tampons or other menstrual products. 

The unaffordability of menstrual hygiene products is exacerbated by both customs duties and VAT taxes that governments commonly place on menstrual hygiene products. These taxes are discriminatory – part of the gender divide and an assault on the dignity and the Right to Health for women and girls.  And they are regressive taxes, hitting the poor much harder than other groups.  

Guyana’s Menstrual Hygiene Initiative 

Even prior to 2025, tampons and menstrual pads  were VAT-free in Guyana. Then in mid-August, President Ali announced that the government would remove all remaining taxes on those products. 

The country is now in the process of adding these products to the public sector medical supplies list for free distribution to girls and women through public health clinics and  centers. 

While it is a work in progress, a free menstrual packages program is also being rolled out for all girls in both public and private sector schools as part of a Guyana Menstrual Hygiene Initiative, launched in 2021. The initiative was launched following a Ministry of Education showing that one-third of female secondary school students struggle to afford or access sanitary pads – leading to missed classes and educational setbacks. 

Guyana’s First Lady, Arya Ali, has meanwhile been championing feminine hygiene products as a human rights issue since 2020. For Guyana, making menstrual health affordable falls under the government’s harm reduction initiatives. Guyana has taken a lead in ensuring that menstrual health packages are treated as public good and as a fundamental human right. It is a bold move. 

Movement is catching on worldwide 

But the movement is catching on regionally and worldwide.  

A 2024 Lancet Review found that menstrual product taxes were applied in more than 63.2% of the locations in the Americas, with a tax averaging about 10%.   

At the same time, nine countries and one territory have eliminated taxes over the past decade, thanks in part to civil society advocacy – with VAT-free products now available in Barbados, Canada, Colombia, Ecuador, Jamaica, Nicaragua, Mexico, Puerto Rico, Saint Kitts & Nevis, and Trinidad & Tobago, as well as Guyana.  

Elsewhere in the world, other nations, including Australia, Bhutan, the United Kingdom, India, Ireland, Kenya, Lebanon, Lesotho, the Maldives, Malaysia, Mauritius, Namibia, Nigeria, Rwanda, South Africa, and Uganda, are among a growing list that have removed VAT from pads and other female hygiene products.  In the United States, which has no national VAT, 28 states have eliminated sales taxes on the products.   

In 2021, Scotland became the first country in the world to offer tampons and sanitary pads for free “to anyone who needs them,” – setting a precedent for which countries such as Guyana are now poised to advocate more widely.   

Challenges elsewhere

But the picture is hardly uniform. 

In Pakistan, a young female lawyer, Mahnoor Omer, has gained international fame for her campaign to lower the tax on pads. Omer’s argument is that menstrual products should be placed into Pakistan’s tax-exempt  “essential goods” list, which includes items ranging from milk and cheese to agro inputs like cattle semen.  

Currently, Pakistan’s tax can add up to 40% to the price of hygiene products, according to a 2023 report by UNICEF, which has been campaigning on the issue for a number of years. As a result, only about 16% of women and girls in rural Pakistan use appropriate sanitary products, homemade or purchased, according to one peer-reviewed journal study by a team of researchers from Agha Khan University in Karachi.  Others use unhygienic materials or none at all. 

According to UNICEF, the high tax is a factor in Pakistan, which in 2018 had the lowest uptake of the products among four countries in the region. 

From tax free to entirely free

Even without taxation, in most developing countries, sanitary pads are unaffordable for most girls and women who represent about one-half of the global population – and will require such products for about 40 years of their lives.

Non-access to sanitary products affects women’s and girls’ dignity, access to health, education, and workplaces, as well as participation in public activities. It is a good example of systematic gender subordination, gender segregation and economic prejudice through taxation applied solely against women. 

Increasingly, civil society groups led by women and girls around the world are rising up and rejecting this unequivocal assault on women’s rights. These groups see the elimination of taxation on menstrual products as critical to promote gender equity, female empowerment, human rights, and menstrual justice. In Colombia, for instance, A civil society  campaign called Menstruacion Libre (free menstruation) advocated for the elimination of menstrual product taxes. In response, the Supreme Court of Colombia exempted taxes on menstrual pads and tampons in 2018. Other examples of political activism leading to removal of taxes for sanitary pads are #MenstruaciónDignaMéxico (Menstruation with dignity) in Mexico, Inua Dada and Days for Girls in Kenya, Free Periods in the United Kingdom, Qrate in South Africa, We Need to Talk in Turkiye, She for She Pads in Uganda, Myna Mahila in India, Herself in Brazil, With Red in Taiwan and many more.   

Rallying around ‘Menstruation Health Day’ 

The Right to Health has centrality in the fight for freedom and democracy around the world. Menstrual justice is another frontline in the wider battle. While this commentary highlights the issue of affordability and access to menstrual pads, menstruation justice is much more than access to pads. It also is about access to facilities, education and awareness, sound environmental management of hygiene waste products, and support. It is also about elimination of stigma. Moreover there is the issue of women in vulnerable circumstances, such as women prisoners, who have no access to menstruation pads.  

Governments and other stakeholders must craft a comprehensive approach to combat period poverty. This is a “best buy” in the fight for Health for All. Recognition of this, as part of an action plan crafted by WHO member states, for instance, could help amplify the issue and solutions. 

On Wednesday, I will be appearing on a panel of Ambassadors to the UN in Geneva at a hybrid event co-sponsored by Barbados, Canada and Malawi to kick off discussions on the intersection of menstrual health with trade policies.  

We can further scale up our campaigns  by ensuring that the annual Menstruation Health Day, May 28, is incorporated into national public health education and awareness calendars. 

Access to period pads, soap, cups, facilities, education and awareness, fighting stigma and discrimination and access to environmentally safe and dignified disposal must be central in the gender equality agenda, not only for the Ministers of Health, but also for Ministers of Education, Social Welfare, Women and for the Human Rights organs of governments.  

In our polarized world, social progressives and conservatives should all be able to unite around one single truth: Menstruation is a God-given biological activity. It should be safe, hygienic…and  tax-free. 

Dr Leslie Ramsammy is Guyana’s Ambassador to the UN in Geneva and a former Minister of Health.         

Editor’s note: An earlier version of this oped appeared in DemocracyGuyana.com on 5 November. 

Image Credits: News Room , #MenstruaciónDignaMéxico, Free Periods , We Need to Talk , She for She pads. , Myna Mahila .