Several strong messages emerged from the recent health-tax co-creation workshop, all pointing to the same conclusion: evidence is essential, but evidence alone will not deliver reform.
Dr. Pavel Ursu, World Health Organization Representative in Nigeria, described evidence as the starting point. He stressed that progress depends on understanding the national landscape, the actors involved, and the political and institutional realities that shape implementation. He also distinguished between execution and implementation, noting that implementation requires constant attention to changing conditions and stakeholder interests.
Dr. Kumanan Rasanathan, Executive Director of the Alliance for Health Policy and Systems Research, reinforced that point, emphasising that research should not end with publications. Its value lies in whether it contributes to changes in policy and practice. He also highlighted the importance of engaging seriously with industry opposition, public perceptions, fiscal concerns and the interests of actors beyond the health sector.
Bringing the discussion directly into the workshop’s implementation agenda, Dr. Yewande O., Managing Principal – Global Operations Health Strategy and Delivery Foundation and Co-Investigator, focused attention on what it would actually take to make health-tax reform work in Nigeria.
Dr. Yewande O. called for emerging evidence to be translated into practical pathways for action, with clarity on priority interventions, what can happen in the short term versus the longer term, which institutions or individuals should lead, what approvals are required, and what barriers could prevent implementation.
She also stressed that proposals around earmarking or ring-fencing need to explain how revenue would move through Nigeria’s budget and public financial management systems, and that the work should continue beyond the project’s six-month catalytic period.
Together, these contributions underscored a central lesson from the workshop:
The challenge is not only generating evidence for health taxes, but building the institutional, political and operational conditions needed to turn that evidence into action.
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