Nigeria is facing a looming 15–20% decline in foreign health aide—a development government officials warn could erase decades of progress and deepen existing gaps in healthcare delivery.
The Special Adviser to the President on Health, Dr. Salma Ibrahim Anas, issued the warning in Abuja at the 9th Annual Health Conference of the Association of Nigerian Health Journalists (ANHeJ). She said the country must urgently scale up domestic health financing as donor support, which has sustained critical disease-control programmes for years, continues to shrink.
Dr. Anas noted that foreign assistance remains heavily concentrated in HIV, tuberculosis, malaria and routine immunisation programmes. A significant reduction in such funding, she said, risks service disruptions, drug stock-outs, and widening health inequalities.
“Nigeria’s health system has been sustained for years by the goodwill of partners,” she said. “But donor fatigue is real, and we must confront the truth that sustainable health financing must come from within.”
Although Nigeria’s per capita health spending increased from $67.91 in 2020 to $90.92 in 2022, Dr. Anas stressed that the system remains fragile due to high out-of-pocket payments that continue to push millions into poverty.
She highlighted President Bola Ahmed Tinubu’s Renewed Hope Agenda and the Nigeria Health Sector Renewal Investment Initiative (NHSRII) as key government efforts to close financing gaps. The initiative focuses on strengthening primary healthcare, boosting governance and accountability, expanding the healthcare value chain through local production, and improving health security and epidemic preparedness.
Minister of State for Health and Social Welfare, Dr. Iziaq Adekunle Salako, represented by his Special Adviser on Health System Strengthening, Babatunde Akinyemi, underscored the scale of Nigeria’s reliance on external funding. He disclosed that the country has received more than $6 billion from PEPFAR, $2.5 billion from the Global Fund, $1.5 billion from the World Bank, $1.2 billion from Gavi, and $1.6 billion from the Bill & Melinda Gates Foundation over the years.
He warned that shifting global priorities and donor transitions are already creating financing gaps that Nigeria must fill through strategic domestic mobilisation, fiscal discipline, and innovative public-private partnerships.
Salako highlighted existing government efforts, including the Basic Health Care Provision Fund (BHCPF), which has disbursed over N260 billion to states and the FCT since 2018, and the implementation of the National Health Insurance Authority (NHIA) Act, which mandates health insurance for all Nigerians.
He also pointed to domestic innovations across states and the private sector: Lagos State’s allocation of more than 12% of its annual budget to health; Kaduna’s 1.6 million enrollees under its contributory health scheme; and Abia State’s new diaspora health investment fund. Additionally, the Private Sector Health Alliance of Nigeria and the Nigeria Sovereign Investment Authority have contributed over N50 billion and $200 million, respectively, to health sector improvements.
The Minister urged state governments to raise their health budgets, expand insurance coverage, and adopt transparent, performance-based financing mechanisms. He further called on journalists to track funding flows, implementation outcomes, and gaps to strengthen accountability.
Earlier, ANHeJ President Joseph Kadiri said the conference theme—“Domestic Resource Mobilisation in the Face of Dwindling Foreign Grants and Aid”—reflects the urgent need to build internal financing resilience. He encouraged journalists to monitor government promises, expose gaps in the system, and highlight the real-life challenges confronting Nigerian families.
Kadiri also outlined sub-themes including cancer research funding, maternal and newborn health advocacy, media response in public health emergencies, and efforts to combat substandard and counterfeit medications.