Don’t tax menstrual pads as luxury goods, says activist : NPR
Bushra Mahnoor, pictured at her home in Attock, Pakistan, advocates for girls’ menstrual health in Pakistan. “It was a big taboo to mention that you were on your period. But mentioning that you were on your period without access to a sanitary napkin was even more humiliating,” she says. Last year, her nonprofit Mahwari Justice filed a lawsuit to reclassify menstrual products as essential goods. Currently, sanitary napkins are taxed as luxury products.
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Growing up, Bushra Mahnoor dreaded her period. This meant shame, stigma and, often, missing school.
As a teenager in Pakistan with four sisters, she says there were never enough menstrual supplies in her home. They rationed towels – regularly using those designed for eight hours for well over 24 hours – and sometimes had to use a spare cloth or cloth that could easily leak. Others face a similar situation. According to a UNICEF reportreleased in 2025, only one in 10 girls and women in Pakistan uses commercially manufactured products.
“When I knew I might not have a napkin and would have to rely on a cloth, it was at that time I couldn’t even imagine going to school,” recalls Mahnoor, who is now 25.
Her school uniform was pure white, and she remembers a teacher ordering a classmate to stand near the back wall of the classroom so others wouldn’t see a period stain on her uniform.
“It was a big taboo to mention that you were on your period. But mentioning that you were on your period without access to a sanitary napkin was even more humiliating,” she says.
Mahnoor has therefore become a pro at finding excuses to stay at home: a vague illness. A stomach ache.
“I grew up with a lot of shame,” she says.
Mahnoor is now trying to change the reality for girls in Pakistan. She is the executive director of Mahwari Justice, a non-profit organization in Pakistan that advocates for menstrual health. In September 2025, she filed a lawsuit seeking to reclassify menstrual products from luxury goods to essential goods. The aim is to eliminate taxes placed on products – which she hopes will lower prices to make sanitary items more affordable.
None of Mahnoor’s experiences come as a surprise to Marni Sommerprofessor of sociomedical sciences at Columbia University’s Mailman School of Public Health, who has studied menstrual health for more than 20 years.
“Access [menstrual] products is a problem almost everywhere,” she says.
Historically, she says this issue has fallen through the cracks of global health and development efforts because it does not fit neatly into one of the priority areas like education, water sanitation, gender and health and because it is an often stigmatized topic. “It’s everyone’s business and no one’s business at the same time,” Sommer says. “This has made it quite difficult to get funding and resources, because the question arises: Who owns it? And who should fund it?”
However, over the past five years, Emily Cruz – who works on menstrual health for the non-profit Splash – says there has been more attention to the issue and changes in each country, “especially in the last five years, to remove these different types of taxes and import duties.” For example, in Malawi, women’s sanctuary products were reclassified as essential goods rather than luxury goods. And Ethiopia saw the surcharge and import duties on products removed.
In Pakistan, the UNICEF report states that there is no national policy, plan or strategy for menstrual health and hygiene. NPR spoke with Mahnoor to learn more about her work in the country, her personal experience and that of other Pakistani women.
The interview has been edited for clarity and length. NPR contacted Pakistani officials at the Ministry of National Health Services, Regulation and Coordination and the Ministry of Law and Justice for comment but did not receive a response.
How did you come to care about this problem?
When I got my first period — I was just 10 years old at the time — and I was given a sanitary napkin to use, I didn’t know how to use it. I stuck it upside down, so the sticky surface was touching my body and it was itchy all day. I continued to use the pads this way. I didn’t know and, of course, I couldn’t ask anyone.
I have seen many mothers who, even after their daughters have had their period, ask them to act as if they have not… [in Islam] it is forbidden to pray five times a day when you have your period but they ask their daughters to pretend to pray so that the men in the family, especially the husband or brothers of this child, do not know that she is of childbearing age now. Because as soon as they know that the girl has started menstruating, they will take her out of school, if she goes, and they will marry her off to a man who is two or three times her age. And that’s something we’ve seen so often. This breaks my heart. Mothers are usually very helpless in these situations. The connection to child marriage contributes to the secrecy around periods and makes it an extremely isolating experience.
No one forced my mother to do [child marriage] but there was always this secret. I remember being told to hide it from my siblings and anyone else in the house.
What got you started talking about menstrual health?
In 2022, when I was in college, we experienced massive flooding that drowned a third of our country. Something that [some friends and I] We saw that the needs of the period were neglected, both on the left and on the right. [The neglect is not new but] relief efforts ignored the needs of the times. And we started campaigning on social media.
We realized that there was a lot of backlash to talking openly about the rules, which changed our focus and made us realize that we have the power to raise funds and actively do something on our own, on the ground.
I went to Balochistan with the medical team – I just hitchhiked with them – and I was handing out towels. I met some people who lived in a relief camp, and they had a cloth and the sisters used it interchangeably. They would wash it in the flood water and give it to the other sister to use. This shook me to my core.
What do women do when they don’t have access to sanitary napkins?
The most common method – which I’ve also used a lot – is to use a cotton pad. So you just take a piece of fabric and [make it into a pouch, then] you put cotton on it. The main problem is that when you wash it, you can’t dry it in the sun. [which is a natural disinfectant]because then everyone would know you’re on your period and there’s a huge stigma. So what people do is they dry it inside the rooms [and] this can lead to heavy bacterial growth inside because it cannot be completely dried. This can cause [vaginal problems, including irritation and reproductive tract infections].
Many people can’t even afford to put cotton inside the fabric, so they just wrap the fabric several times or sometimes fill it with mud or sand to make it absorbent. This is something they do in many tribal areas.
Other people said to us: We don’t even wear panties, can you give us girdles? It’s like a rubber band that you can tie around their waist so they can take a piece of fabric and use it during their period.
Tell us about the lawsuit you are defending.
Like many countries around the world, Pakistan imposes a luxury tax on vintage products. They are not taxed like normal sales items and do not benefit from the essential items exemption.
We have a section in our Constitution — it’s called section six — that provides an exemption on many products that are considered essential items, like medical supplies, and for the cattle industry, bovine semen is considered essential — and menstrual products are not. Instead, there is almost 40% tax on wafers.
The goal of the lawsuit is therefore very simple: the lawsuit challenges the fact that period products are taxed as luxury items. He says the tax is discriminatory because most men don’t use them, and therefore places an unfair burden on women and people who can’t afford them. We want taxes removed and products classified as essential items.
It was filed in September. But due to the unstable political and judicial nature of our country, we are waiting to receive a court date to proceed. But at the same time, we are preparing for a very long battle. In Nepal, they simply removed this tax, but it took them four years.
If the trial is successful, what would happen? Are you optimistic?
We’re also realistic because this doesn’t automatically make menstrual products cheaper. So when India got rid of this tax in 2019, some studies indicate that menstrual products did not ultimately become cheaper. So we are not considering an immediate massive reduction in price, but hopefully it will have some impact and also have symbolic value.
He [would be] a big step but, I would say at the same time, it’s a very, very long journey.
