In Nigeria sufficient funds can be obtained through sin taxe

In Nigeria, sufficient funds can be obtained through sin taxes on products that zip inhibitor pose risk to health, such as tobacco and alcohol, progressive levies on phone calls or mobile phone purchases, and taxes on air tickets, foreign exchange transactions, and luxury goods. Nigeria could also generate substantial fiscal capacity to fund national health reforms by cutting the country\'s enormous budget for fuel subsidies. Additionally, Rwanda\'s exemplary health-system reforms offer important lessons for Nigeria: with a strong stance against corruption, the Buhari-led government can also “assert vision and control” to mobilise and align resources from domestic and external sources, and ensure efficient use of such resources to increase access to high-quality health care for Nigerians. The new government should commit itself to the 2001 Abuja declaration by allocating at least 15% of its budget to health. This is one way the Buhari-led government can demonstrate its political will to achieve the 2014 Presidential Summit Declaration on UHC and secure the crucial public support needed for other reforms. Evidence shows that no country has been able to achieve UHC with voluntary health insurance. Stakeholders therefore agree that the government must make health insurance compulsory by facilitating the amendment of the 1999 National Health Insurance Scheme (NHIS) Act 35. The passage of Law 100 in Colombia to implement a national social security system greatly contributed to universal coverage. President Buhari should sign the amended NHIS Act passed by the Seventh National Assembly and ensure full implementation. Each state government should create its health insurance agency with guidance from the NHIS and implement innovative ways to capture the formal and informal sectors. These steps will greatly increase health insurance penetration across the country. The Commission on Macroeconomics and Health and Commission on Investing in Health show that investments contribute to economic growth and social development. Adequate public investments in health reduce financial impoverishment as a result of catastrophic cost of health care by shifting cost away from out-of-pocket expenditures and facilitating prepayment risk pooling mechanisms. Healthy citizens are productive. They work, earn, and save, and contribute to economic growth. UHC will catalyse a robust health-care market that will create many jobs for the Nigerian people within the public and private sectors. Also, governments that facilitate substantial progress towards or achieve UHC, as in Thailand and Rwanda, are perceived favourably by their citizens and are more likely to be re-elected.
Global health research often needs collaboration between various organisations and oversight from many research ethics committees (RECs), including those from partner institutions, national committees, ministries of health, and funders, which increases administrative burden and time. Maintenance of the highest ethical standards in research is paramount; unfortunately ethics breaches are not uncommon. In view of the real possibility of ethical wrongdoing, worldwide health research must abide by transparent, rigorous, and effective procedures of ethics review. However, although oversight from many RECs might assist with maintenance of ethical principles, this process can result in delays and barriers to research. Usually each REC reviews protocols independently (either sequentially or in parallel), and will often only review protocols after the other committees have already approved them. Modification requests can be quite different. Some RECs might request modifications to increase the cultural appropriateness, relevance of the research, and the availability of intervention during and after the project, whereas others might focus on letters of approval and complexity of consent forms. These competing priorities can mean that previously approved protocols require more amendments, but nerve cord is usually unclear which REC\'s feedback should take precedence. Having to seek various approvals, with no communication between RECs and no plan for which committee\'s decisions take priority, can lead to research bottlenecks. Many RECs, particularly those in low-income and middle-income countries (LMICs), have long turnaround times, perhaps because of infrequent meetings, overworked members, and understaffed councils. These additional demands can make researchers who must show REC approval to apply for grants less competitive for funding. Moreover, the additional administrative burden research teams face to meet the requirements of several RECs might, paradoxically, reduce the time and attention given to the execution of research projects, weakening ethical oversight. One solution might be for RECs to learn about each other\'s procedures, communicate about the proposals, and harmonise processes. If a REC could benefit from additional support and capacity building, then collaborating committees could provide this support. Ideally they could work together to ensure that partner RECs are meeting or exceeding international standards. Collaborative capacity building might be particularly useful for long-term institutional collaborations. If long-term partnership is not possible, communication between RECs regarding their updated guidelines, submission requirements, expected turnaround times, and agreement about the order of REC submissions might still be beneficial. To help efficient communication between these committees and researchers, we suggest that one REC coordinate feedback and respond to submissions on behalf of all RECs. Whenever possible, the lead REC should be an institutional review board from the country in which the research is being done. If the REC of the institution that is implementing the research is internationally accredited then the final word on approval of, or changes to, the research protocol might be advisably done by that REC.