Germany has slashed its tax on tampons. Many other countries still tax them as ‘luxury’ items.

The German parliament is still discussing the exact details of the reduction, which will then be introduced as part of the 2020 tax amendments, according to the German news agency DW.

The Reichstag had previously maintained that the tax did not discriminate against women. Rather, lawmakers argued, tampons were just one of a number of items the state needed to tax for revenue. In response, campaigners became increasingly creative, publishing a Tampon Book filled with 15 tampons. Why? Books — considered an essential item in Germany — are only taxed at 7 percent.

The basic debate is over how much tax should be levied on menstrual products. Many tax codes distinguish between luxury or nonessential items, which are taxed more and serve as a revenue source for the government, and essential consumer goods, which the state taxes at a lower rate to ensure affordability.

But it’s also about something bigger: Taking on the “tampon tax” has become a major issue worldwide in recent years as women’s activists have collectively begun in on different countries to challenge the practice.

Perhaps less visibly, this issue has also become a field for debate over the role of the government — or, in the case of Europe, the European Union — in shaping taxation and states’ rights.

Campaigners say women have no choice whether to get their period or not and therefore shouldn’t have to pay a high tax on menstrual items. Activists say this particularly burdens poor women, creating a phenomenon known as “period poverty,” in which women can’t afford sanitary items. Studies have also shown that around the world, the United States included, lack of access to menstrual pads or tampons is one reason girls miss out on school.

“The fathers of the tampon tax never had a period,” German journalist Jule Schulte, who started the successful petition, told DW when asked why she thought it took so long to change.

Kenya led the way in 2004 when it abolished its VAT on menstrual pads and tampons,though many other barriers to accessing sanitary items there remain, such as access to clean sanitation in impoverished areas.

Canada was also relatively ahead of the curve when it repealed its 5 percent tax in 2015. The previous year, the government had made around $36 million from the tax on feminine hygiene products, according to Statistics Canada.

In 2018, India repealed its 12 percent tax on “nonessential” menstrual items, such as tampons and sanitary pads, which had only been introduced into the tax code the year before. Women’s activists there were particularly enraged when the tax was first announced, as around four out of five women already lacked access to sanitary pads, according to the BBC.

Australia followed suit in 2018, scrapping its 10 percent tax.

Taxes on menstrual items in the 28 E.U.-member states range from as little as zero in Ireland to as high as 27 percent in Hungary. Denmark, Croatia and Sweden are also high taxers, each with a 25 percent VAT.

Since 1992, E.U. member states have had to apply a minimum 15 percent VAT on consumer goods and services, with the option to apply a reduced rate of as low as 5 percent on certain “essential” items. (This was to ensure a steady rate of tax flows within E.U. countries.)

Consequently, some countries such as the United Kingdom, Lithuania and Czech Republic only have a 5 percent VAT as they’ve requested and received an E.U. reduction on sanitary items by labeling them as essential items. In contrast, indebted Greece raised its tax on tampons from 13 percent to 23 percent in 2015 as part of austerity measures imposed by its European creditors. As Ireland didn’t have a consumer goods tax on menstrual items before 1991, it was grandfathered in and allowed to keep the items tax free. In 2015, France reduced its tax from 20 to 5.5 percent. That same year the British government announced it would donate proceeds from the tax to women’s charities in response to pressure to scrap the country’s 5 percent tax altogether.

The E.U.’s control over tax codes was one issue spurring supporters of the 2016 “Leave” campaign and the U.K.’s ultimate vote in favor of Brexit.

As Quartz reported, “The tampon tax has generated heated debate in the UK among supporters both for and against the proposed exit of Britain from the EU.”

Amid the Brexit campaigning, in March 2016 the E.U. unanimously agreed to allow members states to remove all sales taxes on female hygiene products starting in 2022. The move followed years of protests and petitions in the U.K., as well as France.

“While the euroskeptics describe it as a perfect example of the relatively small decisions the UK government is forced to negotiate with the EU, those in favor of remaining in the EU highlighted the approved resolution as promising for future negotiations,” Quartz’s report from the time continued.

It remains to be seen which will happen first: The E.U.’s 2022 proposed VAT change, or the U.K.’s Brexit from the union. In the meantime, women’s rights activists are eyeing which country will remove its tax next.