Nigeria’s health sector is undergoing a quiet but determined transformation. Over the past two years, a mix of policy reforms, targeted investments, and strategic collaboration has begun to reshape the system. Amid reduced donor funding and evolving global health priorities, gains in primary healthcare, insurance coverage and system resilience are emerging. The country is steadily building the groundwork for a more responsive and self-sustaining health infrastructure, reports DELE ANOFI.
Nigeria’s steady advancement towards achieving Universal Health Coverage (UHC) is increasingly gaining international recognition. Time magazine recently named three Nigerian health professionals among its 100 most influential people in health: the Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate; Dr Ladidi Kuluwa Bako-Aiyegbusi, a senior official at the Ministry; and Dr Abasi Ene-Obong, a private sector innovator in genomics.
Prof Pate was recognised for leading the vaccination of over 12 million girls against the human papillomavirus (HPV), the rehabilitation of more than 900 primary healthcare centres (PHCs), and the launch of the “Know Your Numbers” campaign, which screened 10 million Nigerians for common health risks. Dr Bako-Aiyegbusi received acclaim for her pioneering work in tackling childhood malnutrition by fortifying widely consumed bouillon cubes with vital micronutrients.
By the third quarter of 2024, Nigeria had surpassed its targets on 31 out of 41 key health performance indicators. According to findings from the 2023 Demographic and Health Survey and the People’s Voices Survey, child mortality has declined by 16.7%, with rates dropping from 132 to 110 deaths per 1,000 live births since 2018. The country has also seen notable reductions in disease burden: diarrhoeal diseases have decreased by 40%, respiratory infections by 30%, HIV prevalence by 12%, and malaria incidence by 5%.
These improvements have been largely attributed to sustained public investment in primary healthcare. Since 2019, more than N130 billion has been allocated to the Basic Health Care Provision Fund (BHCPF), including N31 billion disbursed in 2023 and N25.8 billion in 2024. An additional N32.8 billion has already been approved to support primary healthcare programmes in the first quarter of the 2025 fiscal year. The Ministerial Oversight Committee (MOC), which supervises the BHCPF, has held more meetings in the past 18 months than in all preceding years combined—an indication of improved governance and accountability in the sector. A core objective of the government’s health reform agenda is to ensure the presence of at least one fully functional PHC in every political ward, with plans to double PHC coverage by 2027.
There has also been progress in health insurance coverage. Enrolment rose by 11% in the past year, bringing the total number of Nigerians covered to 18.7 million. The long-term ambition remains the achievement of universal health coverage by 2030. While challenges persist, the data suggests that Nigeria is laying the groundwork for a more inclusive and resilient health system. The combination of strategic leadership, increased funding, and multi-sectoral collaboration is yielding measurable results—offering a path forward for sustained health system strengthening.
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Revamping the health system
Under the Renewed Hope Agenda, Nigeria has intensified health sector reforms through a suite of strategic frameworks, including the National Health Renewal and Investment Initiative (NHRII), the Nigeria Health Sector Renewal Compact—signed between the Federal Government, all 36 State Governments, and development partners—and the Sector-Wide Approach (SWAp). These coordinated efforts aim to harmonise previously fragmented interventions and build a more integrated, efficient, and self-reliant health system.
At the tertiary level, 201 hospital projects have been completed and 179 sets of medical equipment procured. Workforce development is another critical area of focus. More than 2,400 new health professionals have been recruited, while 120,000 frontline health workers are undergoing retraining—over half of whom have already completed the process. To address the growing issue of medical brain drain and workforce shortages, enrolment quotas at health training institutions have been expanded.
Health insurance coverage for vulnerable populations is also advancing. Through the National Health Insurance Authority (NHIA), 1.8 million vulnerable Nigerians have been enrolled, providing them with access to essential health services and reducing out-of-pocket expenditure. In parallel, efforts to industrialise the health sector are gathering pace. A landmark $1 billion agreement with Afreximbank is supporting the expansion of local pharmaceutical manufacturing, with backing from five development finance institutions and more than 70 private firms. A beta-lactam antibiotics plant in Lagos is already operational, creating over 700 jobs. Global players such as Abbott and Siemens are planning local production ventures; while a $240 million Brazilian-funded generics manufacturing facility is currently in development.
Regulatory reforms are also underway to strengthen oversight and quality assurance. In a bid to streamline and safeguard organ and tissue transplantation services, the government has introduced new Standards and Guidelines for the Establishment and Coordination of Organ/Tissue Transplantation Services in Nigeria. All facilities involved in such procedures are now required to register and obtain licences from the National Tertiary Health Institutions Standards Committee (NTHISC). Additionally, a National Organ Transplantation Registry is being established to enhance transparency and accountability in the sub-sector.
The game-changing Basic Health Care Provision Fund
The Basic Health Care Provision Fund (BHCPF) continues to play a pivotal role in Nigeria’s pursuit of universal health coverage. With N130.8 billion committed over five years, the fund is strengthening the foundation of primary healthcare by supporting the establishment of at least one functional Primary Healthcare Centre (PHC) in every ward nationwide. In 2024 alone, N25.8 billion was allocated to support 8,809 facilities, with an additional N12.9 billion pending disbursement. The fund is distributed across four key agencies: the National Health Insurance Authority (NHIA) receives 48.75%, the National Primary Health Care Development Agency (NPHCDA) 45%, the National Emergency Medical Treatment Committee 5%, and the Nigeria Centre for Disease Control and Prevention (NCDC) 1.25%.
The results are tangible—higher enrolment in health insurance schemes, a reduction in disease burden, and expanded deployment of health workers in underserved communities. Strategic objectives include doubling the number of PHCs per ward by 2027 and achieving universal health coverage by 2030.
Ending AIDS by 2030: The NACA strategy
Between 2023 and 2025, the National Agency for the Control of AIDS (NACA) made considerable progress despite diminishing donor contributions. More than 1.63 million Nigerians—representing 86% of people living with HIV—are now receiving treatment. Women comprise nearly 60% of those reached, prompting gender-responsive interventions at the community level.
NACA’s strategy is rooted in community leadership, decentralised care, and greater reliance on domestic resources. Public campaigns, including those marking World AIDS Day 2023, underscored the role of civil society and the need to reduce stigma. The launch of the National Strategic Framework (2023–2027) introduced a sustainability model with a business-oriented focus. A key milestone is the establishment of the N62 billion HIV Trust Fund of Nigeria, in collaboration with the Nigerian Business Coalition Against AIDS. The Federal Government further allocated N10 billion for HIV-related commodities in 2025, of which N4.8 billion is earmarked for scaling up treatment.
NACA is also integrating HIV services within broader health systems in 12 states, with plans to extend to 25. By 2025, local manufacturing of HIV commodities—including test kits, condoms, and antiretrovirals—is expected to commence. Notably, efforts to prevent mother-to-child transmission (PMTCT) are gaining ground, with over four million pregnant women screened for HIV in 2023. A newly established Acceleration Plan Committee is leading efforts to close the treatment gap for children.
Drug safety and local manufacturing: NAFDAC’s reform agenda
The National Agency for Food and Drug Administration and Control (NAFDAC) has intensified its reform agenda to enhance public health safeguards and regulatory effectiveness. A major achievement is the World Health Organization’s prequalification of the Central Drug Control Laboratory in Lagos, enabling the certification of Nigerian-made medicines for export.
Crackdowns on counterfeit pharmaceuticals have yielded substantial results, with over N1 trillion worth of fake drugs seized from major markets. To streamline drug distribution and improve oversight, the agency is implementing new regulations—including a ban on alcoholic beverages in sachets, which has faced resistance—and relocating vendors to Coordinated Wholesale Centres, starting in Kano.
As part of efforts to tighten import controls, Cotecna Inspection Services has been appointed as a third-party inspection agent for pharmaceutical imports from India. In parallel, NAFDAC is supporting local pharmaceutical innovation, including regulatory backing for Nigeria’s first glucometer and diagnostic strip production facility. The agency is working towards achieving WHO Maturity Level 4 certification, positioning Nigeria as a regional leader in pharmaceutical regulation and safety.
Health insurance reform: NHIA’s inclusive model
During the period under review, the National Health Insurance Authority (NHIA) undertook significant reforms to expand access and inclusivity within Nigeria’s health insurance landscape. As of early 2025, enrolment figures had risen to 19.2 million Nigerians at both national and sub-national levels—marking a 14% increase from the 16.7 million recorded at the start of the current administration. In February 2025, the NHIA revised key provider reimbursement mechanisms. Capitation payments—fixed annual sums paid to healthcare providers per insured patient—were increased by 93% compared to December 2023. Meanwhile, fee-for-service payments, which reimburse providers for individual medical services, saw a staggering 378% rise over the same period. These adjustments reflect a strategic effort to improve provider incentives and service quality.
To bolster coverage for vulnerable populations, the agency operationalised the Vulnerable Group Fund. This intervention complements the implementation of the 2023 Operational Guidelines, which aim to harmonise insurers under a single regulatory framework. Central to the NHIA’s forward strategy is the ambition to enrol 50 million Nigerians, with a strong focus on the informal sector—where coverage currently remains under 1%. The NHIA has also rolled out impactful access-driven initiatives. Among them is the National Medicine Supply Initiative, launched in partnership with 12 local pharmaceutical manufacturers. The scheme introduced 33 NHIA-branded generic medicines, projected to reduce drug prices by up to 50%. Currently piloted in seven states and the Federal Capital Territory, the initiative is poised to improve the availability of affordable, quality medicines nationwide.
Moreover, NHIA programmes now offer free caesarean sections in 172 high-risk Local Government Areas, have treated 1,600 women under the Fistula-Free Programme, and provided emergency obstetric care to nearly 3,000 women. A N32.8 billion first-quarter allocation is sustaining coverage across 8,000 healthcare facilities.
Strengthening disease preparedness: The NCDC response
The Nigeria Centre for Disease Control and Prevention (NCDC) has continued to reinforce the nation’s capacity to respond to public health emergencies. During recent outbreaks of cerebrospinal meningitis in Jigawa, Yobe, and Katsina States, the agency led a nationwide response effort, which included the delivery of over one million doses of the Men5cv vaccine. The NCDC activated Emergency Operations Centres in response to multiple outbreaks, while deploying expert teams, essential supplies, and technical support to affected regions. In collaboration with international partners including WHO, UNICEF, and Gavi, the agency expanded diagnostic capacity, improved sample collection, and intensified public sensitisation campaigns.
Efforts to improve routine immunisation also gained momentum, with the introduction of vaccines for Human Papillomavirus (HPV) and malaria. Coordinated advocacy and strengthened partnerships with state governments have improved disease surveillance and boosted the resilience of Nigeria’s emergency health infrastructure.
Reinforcing the fight against HIV, TB and Malaria
Despite diminishing international support—particularly from USAID—Nigeria has demonstrated renewed commitment to tackling its most pressing infectious diseases. The Federal Government earmarked an additional N300 billion for the health sector in 2025, including N10 billion for HIV treatment. This investment targets an additional 100,000 individuals and accelerates progress towards achieving the UNAIDS 95-95-95 targets.
In the fight against tuberculosis, focus has shifted to improving early diagnosis and detection, particularly in light of rising drug-resistant strains. Innovative domestic financing mechanisms are being explored to address funding shortfalls. A notable intervention came from the First Lady, Senator Oluremi Tinubu, who, in her role as Global TB Champion, contributed N1 billion through her Renewed Hope Initiative (RHI) in 2024 to bolster national efforts.
On the malaria front—where Nigeria bears 27% of the global disease burden—the government has committed N231.73 billion for 2025, with N41 billion specifically allocated for malaria vaccine procurement. Following successful pilot introductions in Kebbi and Bayelsa States, the vaccine rollout is expected to expand to 17 additional states by year’s end.
Immunisation breakthroughs and vaccine access
Nigeria has made significant progress in immunisation, driven by strong political will and robust international support, particularly through the National Primary Health Care Development Agency (NPHCDA). A major milestone was the phased introduction of the RTS, S malaria vaccine in Bayelsa and Kebbi States—a critical intervention in combating a disease that still claims nearly 200,000 Nigerian lives annually.
Parallel efforts to introduce the HPV vaccine for girls aged 11 to 12 have reached nearly five million children across 15 states, thanks to effective grassroots mobilization and the involvement of traditional institutions and civil society actors. Nigeria also became the first country to receive over one million doses of the MenFive vaccine, which protects against multiple strains of meningitis, marking another immunisation landmark. These efforts are backed by a N303 billion Health System Strengthening (HSS3) grant, aimed at reaching 1.8 million zero-dose children through enhanced routine immunization. Key enablers include solar-powered cold chain equipment and upgraded vaccine distribution infrastructure. On the regulatory front, the revision of the National Vaccine Research and Development Plan signals renewed commitment to local vaccine production.
Collaborations with Gavi, WHO, and UNICEF have further reinforced Nigeria’s immunization ecosystem, enabling access to critical vaccines and fostering long-term resilience. However, a $430 million annual financing gap persists, underscoring the urgent need for sustainable, domestic funding mechanisms.
Preventive care and immunisation
Preventive healthcare is gaining momentum nationwide. Expanded immunization campaigns have delivered millions of doses of measles, tetanus-diphtheria, and HPV vaccines. HIV prevention and treatment services are now offered at over 40,000 health facilities, while cancer care is being scaled through international partnerships, new treatment centres, and the rollout of a national cancer registry.
Through the Sector-Wide Approach (SWAp) framework, donor funds are now more effectively coordinated. Flagship initiatives like HOPE and HOPE-PHC aim to reach over 40 million Nigerians, focusing on improved governance, digital health tools, and evidence-based health interventions.
Strengthening cancer control
In the past two years, Nigeria has intensified its battle against cancer through a multi-pronged strategy centred on prevention, early detection, treatment access, and research. The National Institute for Cancer Research and Treatment (NICRAT), in collaboration with the Federal Government and the Nigeria Sovereign Investment Authority (NSIA), is spearheading the establishment of six Centres of Excellence and six preventive oncology centres—one in each geopolitical zone—to bring screening and diagnosis closer to communities and promote early intervention.
Preventive strategies have expanded, with the HPV and hepatitis B vaccines now integrated into the national immunisation schedule to help reduce cervical and liver cancer cases. Efforts to build a robust national cancer registry are also underway, aimed at strengthening data-driven policy and resource allocation. Support for vulnerable populations is growing. The Cancer Health Fund has been scaled up, with N1 billion allocated for cancer care in the 2025 budget—including childhood cancers. Public-private partnerships are proving transformative, with collaborations involving AstraZeneca, Roche, and Pfizer helping to cut treatment costs and enhance diagnostic access.
Cancer infrastructure is expanding nationwide, with over 1,200 healthcare professionals trained to deliver quality care. NICRAT is also driving forward cancer research through initiatives like the SINCCAR project and partnerships with global health institutions. A $250 million private-sector-led Cyclotron hospital is set to be built in Abuja—poised to revolutionize cancer treatment in Nigeria and across the continent. Meanwhile, advocacy by the Nigerian Cancer Society is increasing public awareness and building momentum for greater investment in cancer control. While challenges remain, the response is gaining traction—anchored by political commitment and multi-sectoral engagement.
Responding to the Japa challenge
Confronted with the wave of health worker emigration—popularly termed the ‘Japa syndrome’—Nigeria has introduced a suite of workforce retention measures. A high-level committee was tasked with resolving industrial disputes, enhancing remuneration, and creating enabling work environments. The National Health Workforce Migration Policy offers a strategic approach to ethical migration management, talent retention, and diaspora engagement. Infrastructure investments—especially in the revitalization of over 8,000 primary healthcare centres—are designed to make workplaces more attractive for medical professionals.
Yet, the challenge endures. Issues such as unpaid allowances, policy inconsistencies, and poor facilities continue to fuel the brain drain. Bridging this gap remains a critical priority if Nigeria is to sustain its healthcare reforms.
Policy and programmatic innovations
Over the past two years, Nigeria has launched a flurry of reforms under the Health Sector Renewal Initiative, which includes the Nigeria Health Sector Renewal Compact and the Four-Point Agenda. The Compact—signed by the Federal Government, 36 state governments, and development partners—marks a unified commitment to systemic transformation.
Among the key reforms: Executive Order on Local Drug Production: Removes tariffs on pharmaceutical machinery and raw materials, streamlining manufacturing. NHIA Expansion Strategy: Health insurance enrolment has grown from 16 million to 18.7 million, supported by capitation reviews and closer collaboration with state schemes. Safe Motherhood Guidelines: New protocols such as the Calibrated Drape and Labour Care Guide are targeting 7 million pregnant women and 6 million new-borns annually. Free Caesarean Section Programme: Offers life-saving surgeries at no cost in NHIA-accredited facilities. Dialysis Cost Reduction: A 20% decrease in dialysis charges across federal hospitals in eight states is easing burdens on kidney patients. Maternal Mortality Initiative (MAMII): Provides free maternal services to reduce pregnancy-related deaths. NCD Strategies: New national strategies for hypertension, tobacco control (2024–2028), and task-sharing in care delivery are being implemented. Infectious Disease Control: Updated strategies for HIV/AIDS, hepatitis, and STIs were introduced in late 2023.
Health governance and transparency
Accountability is emerging as a cornerstone of Nigeria’s health reforms. In October 2024, the government invited global health watchdogs—including the International Atomic Energy Agency (IAEA), WHO, and the International Agency for Research on Cancer (IARC)—to evaluate its response to non-communicable diseases. The Impact Review Mission Team conducted a comprehensive nationwide assessment, yielding recommendations that are already shaping program adjustments.
In addition, new partnerships with institutions such as the Mayo Clinic, Milken Institute, Syndicate Bio, Phillips Foundation, and St. Jude Global have strengthened capacity in research, diagnostics, and service delivery. Importantly, anti-corruption agencies and civil society organizations are now part of monitoring and fund-tracking mechanisms, marking a shift toward greater transparency. A pivotal move came with the inauguration of 774 Health Fellows by President Bola Tinubu—an initiative led by the Coordinating Minister for Health—to oversee the construction and activation of 8,800 new primary healthcare centres nationwide.
While gaps persist in workforce retention, infrastructure, and equitable access, the transformation of Nigeria’s health sector is undeniable. With foundational reforms in motion, expanded service delivery, and enhanced governance, the sector is poised for sustainable growth. Anchored by political resolve, international collaboration, and a commitment to transparency, Nigeria is advancing steadily toward its vision of universal health coverage and global competitiveness in healthcare. The groundwork laid since 2022 could very well define the trajectory of a healthier, more resilient Nigeria.