With the case for health-tax reform established, the recent co-creation workshop also examined the political, institutional and stakeholder realities that could determine whether implementation moves forward or stalls.
Presenting the project’s political-economy analysis, Dr. Gafar Alawode, CEO of DGI Consult and Co-Investigator, highlighted the importance of understanding who supports reform, where resistance exists, what different institutions need, and how policy opportunities can be used effectively.
His presentation also pointed to the need for stronger country-specific evidence on disease burden, consumption patterns, revenue potential, appropriate tax structures and the basis for any proposed earmarking arrangement. He identified advocacy, legal and policy reform, public financial management, accountability, risk management and capacity building as critical areas for implementation.
Aisha Fodio, Manager, HSDF, then brought in the stakeholder perspective through findings from the perception survey conducted during the August inception workshop.
The findings showed that stakeholders consider the Presidency, National Assembly and Ministry of Finance among the most influential actors in advancing reform. They also identified competing government priorities, weak political support and legislative challenges as major barriers.
The survey further highlighted the importance of stronger evidence on health impact, consumption patterns and revenue projections, alongside clear accountability arrangements and visible benefits for the public, including expanded coverage for vulnerable populations, reduced out-of-pocket spending and transparent reporting. Pasted text
Taken together, the two presentations reinforced an important lesson:
Health-tax reform will depend not only on the strength of the evidence, but on whether the right institutions can act, competing interests can be managed, and implementation can deliver benefits that are visible and credible to the public.
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