The National Health Insurance Authority and the Senate have called for stronger health tax reforms in Nigeria to promote sustainable healthcare financing, expand health insurance coverage and reduce the growing burden of non-communicable diseases.

They made the call at a National Stakeholder Co-creation Workshop on Realising Health Taxes for Sustainable Health Financing and Curbing Non-Communicable Diseases, held in Abuja on Wednesday.

The NHIA Director-General, Dr Kelechi Ohiri, said health tax reform required collaboration among government ministries, lawmakers, the private sector, civil society organisations, the media and other stakeholders.

“Health-tax reform is not the mandate of any single sector or ministry. It has to involve the leadership of the Ministry of Finance, Budget and Planning, the private sector, civil society, the media and all stakeholders,” he said.

Ohiri said Nigeria was grappling with infectious diseases and maternal mortality while facing an increasing burden of non-communicable diseases associated with the consumption of sugar-sweetened beverages, tobacco and alcohol.

He added that the country also needed predictable domestic financing to strengthen its healthcare system and improve access to essential services.

“Health taxes offer a promising strategy for addressing both challenges,” he said, describing them as public health interventions capable of influencing consumption patterns and generating domestic resources for healthcare.

He said Nigeria was building on existing international commitments, including World Health Assembly resolutions, and the Federal Government’s commitment to mobilising domestic resources for healthcare.

Ohiri disclosed that the Senate had passed the Sugar-Sweetened Beverage Tax Bill sponsored by the Senate Committee on Health, adding that it was awaiting concurrence by the House of Representatives.

He said the chairman of the House Committee on Health had indicated a commitment to attend to the bill.

“The proposed reforms seek to strengthen the existing SSB tax framework and allocate a portion of resources directly to health promotion, disease prevention and primary healthcare,” the NHIA boss said.

According to him, the major challenge is to translate proposed reforms into effective implementation through appropriate policy, legal, fiscal and administrative arrangements.

He said stakeholders must identify the political leadership, institutional capacity and public financial management mechanisms required to ensure transparency and accountability in the collection and utilisation of the revenue.

Citing the Philippines as an example of a country that used health taxes to expand health insurance coverage, Ohiri said Nigeria could adopt similar approaches to reduce the disease burden and extend coverage to more vulnerable populations.

“Healthcare should be accessible, but it is not cheap. We need to build a workable roadmap so that this does not remain theoretical,” he said.

In a goodwill message, the Chairman of the Senate Committee on Health, Senator Ipalibo Banigo, said health taxes should not be viewed solely as a revenue-generation measure but also as a public health intervention aimed at discouraging the consumption of harmful products.

Banigo said particular attention should be given to how the revenue would be allocated, stressing the need for a transparent and accountable system that connects tax collection to measurable health benefits, particularly for vulnerable populations.

She said the implementation framework should clearly demonstrate how the resources would support health promotion, disease prevention and access to healthcare.

Also speaking, the World Health Organisation Country Representative in Nigeria, Dr Pavel Ursu, said scientific evidence alone would not be sufficient to secure the adoption and implementation of health tax reforms.
Ursu said policymakers needed to understand Nigeria’s political economy, institutional arrangements and the interests of stakeholders capable of influencing the reform process.

He said the Ministries of Health and Finance, lawmakers, civil society organisations, the media, non-governmental organisations and other influential groups must be involved in developing and implementing the reforms.

According to him, research should be demand-driven and structured to inform policy discussions while reflecting Nigeria’s local realities.
The Executive Director of the Alliance for Health Policy and Systems Research, Dr Kumanan Rasanathan, said the organisation supported health policy research and reform initiatives in 16 countries.
Rasanathan expressed hope that the workshop would help participants move beyond developing strategies to changing the way health tax reforms were understood, developed and implemented.

He said collaboration among researchers, policymakers and other stakeholders was necessary to ensure that evidence translated into practical policy action.

The Chief Executive Officer of the International Society for Media in Public Health and Chair of Nigeria Universal Health Coverage, Chief Moji Makanjuola, emphasised the importance of public communication in securing citizens’ understanding of health tax reforms.

Makanjuola said Nigerians needed clear explanations about why the taxes were being introduced, the health problems they were intended to address, how the proceeds would be utilised and how implementation would be monitored.

She said effective communication and public accountability would be essential to building understanding and confidence in the proposed reforms.

Health taxes are levies imposed on products such as tobacco, alcohol and sugar-sweetened beverages, which are associated with non-communicable diseases, including cardiovascular diseases, diabetes and certain cancers. The World Health Organisation identifies such taxes as instruments that can discourage harmful consumption while generating revenue for public services and health interventions.

Nigeria introduced a N10-per-litre excise duty on sugar-sweetened beverages through the Finance Act 2021. However, discussions on strengthening the tax framework have continued amid concerns about the country’s growing disease burden and the need to improve domestic health financing. 

The need for additional financing is particularly relevant to Nigeria’s health system, where out-of-pocket payments remain a major source of healthcare funding, exposing households to financial hardship when they need medical treatment. The WHO’s African Health Observatory health-system profile identifies limited health insurance coverage and high out-of-pocket spending as significant challenges to financial protection. 

The workshop, organised in collaboration with Development Governance International Consult, the Health Strategy and Delivery Foundation, WHO and other partners, seeks to move health tax reform discussions from assessment to joint planning and implementation.

It is also intended to establish clear short-term and long-term responsibilities for stakeholders and develop practical mechanisms for linking health tax revenues to sustainable health financing, disease prevention and expanded health insurance coverage.