Nigeria’s 2026 Appropriation Bill allocates ₦2.48 trillion for health out of ₦58.47 trillion, just 4.2% of the budget. This falls short of the 15% target African governments committed to in the 2001 Abuja Declaration.
The World Health Summit in Berlin emphasized that health spending is an investment, not merely an expense. Khaled Abdel Ghaffar, Egypt’s Minister of Health and Population, highlighted a $240 million early-detection program projected to save $7 billion by 2030, a 688% return.
Nigeria’s Health Spending Gap and Economic Impact
Nigeria’s health budget is less than a third of the Abuja Declaration target. Closing this gap requires treating health as economic infrastructure, similar to roads and power. Martin Seychell of the European Commission cautioned that increased spending alone, without a clear strategy, does not guarantee better outcomes.
High out-of-pocket health expenses in Nigeria burden families. Dr. Githinji Gitahi of Amref Health Africa noted that 71.9% of health spending comes directly from households. 45.5% of households face catastrophic health spending, defined as health costs exceeding 10% of their budget.
Malaria alone reduces Nigeria’s GDP by over $1.1 billion annually, according to the Federal Ministry of Health and Social Welfare. Nigeria accounts for 27% of global malaria cases.
Building Local Health Industries and Workforce
Nigeria aims to produce 70% of essential health products locally by 2030, supported by the Presidential Initiative for Unlocking the Healthcare Value Chain.
The health system also faces workforce challenges. While Nigeria has 95,456 registered doctors, only 60,551 hold active licenses. The 2024 National Policy on Health Workforce Migration requires broader implementation to address these gaps.
Funding must reach intended services. Dr. Gitahi warned that prevention and vaccination budgets are often cut first during fiscal constraints due to their less visible results. In 2025, only ₦36 million of the ₦218 billion allocated for federal health capital projects was released.
Africa’s Health Economy Challenges
Dr. Satoshi Ezoe, Japan’s Assistant Minister for Global Health, stated that Japan achieved universal health coverage in 1961 while still recovering from the Second World War, and argued that this foundation supported socioeconomic development. Meanwhile, Africa struggles to capture value from the health products it uses, as noted by Dr. Obiageli Ezekwesili of Human Capital Africa. She highlighted that Africa’s global manufacturing capacity is less than 5%, and its gains from the health value chain remain insignificant.
Ensuring Funding Reaches Intended Services
To ensure funding reaches intended services, the Office of the Accountant-General and Budget Office should include health infrastructure in quarterly cash plans and publish funding release details. The National Health Insurance Authority (NHIA) and state schemes should automatically enroll eligible beneficiaries and track out-of-pocket spending reductions.
Multi-year purchasing agreements with qualified Nigerian manufacturers, offering clear standards for price, quality, and delivery, could provide reliable demand and encourage investment. Incentives under the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC) and NAFDAC approval pathways should reward verified local production, including ingredient manufacturing and quality standards. Ultimately, recognizing health as an investment in economic growth is key for Nigeria‘s development, as a healthier population can participate more fully in the economy.
