As debates concerning global sustainable development goals intensify, there is one policy that seems to unite all development agencies: the reduction or elimination of energy subsidies – especially those for fossil fuels. It has been estimated that the world’s governments spend approximately half a trillion United States dollars (US$) each year on subsidizing fossil fuels. This subsidy – of commodities that appear to be the major cause of climate change – has recently been described as a reckless use of public funds.

With the Millennium Development Goals (MDGs) expiring in 2015, the world awaits a new, ambitious framework for improving lives. This framework must pass the vital test of reducing inequalities, especially gender-related ones, as a critical step towards the improvement of women's health. Measurably improving women's health throughout the life course will contribute to other post-2015 goals. Conversely, women's social empowerment through education, participation in the labor market, and political representation will improve health.

Pakistan’s enormous macroeconomic, internal, and human security challenges coexist alongside the opportunity created by a huge desire for change. With democracy taking root and a new constitutionally ushered era in state governance, The Lancet Series about Pakistan and health focuses on health as a nation-building and social-welfare agenda at a time of unprecedented social upheaval and economic hardships in the country. We call for a unified vision for the goal of universal and equitable health access. We provide recommendations for six objectives for policy and action.

Nigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country’s NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care.