Financing Public Health In Nigeria: The Need For Urgent Action Amidst Global Uncertainty— By Dr Sam Ikoku

The sudden and total withdrawal of U.S. funding for global health programs, announced recently under former President Donald Trump’s renewed influence, has sent shockwaves across the world—and nowhere is the impact more acutely felt than in Africa. For Nigeria, this development threatens to unravel decades of progress in combating communicable diseases and improving public health outcomes. With no clear timeline or alternative support mechanisms in sight, the need for urgent action has never been greater.

This is not just a crisis—it’s an opportunity for Nigeria to rethink its approach to public health financing and build systems that are resilient, sustainable, and independent of external aid.

The Context: What Just Happened?

In a dramatic move, the U.S.—historically the largest contributor to global health initiatives—has abruptly pulled out of funding key programs through agencies like the World Health Organization (WHO) and the United States Agency for International Development (USAID). This decision comes at a time when many African nations, including Nigeria, rely heavily on these funds to address critical health challenges such as HIV/AIDS, malaria, tuberculosis, and maternal health.

To put this into perspective:

• Programs like PEPFAR (President’s Emergency Plan for AIDS Relief) have provided life-saving antiretroviral therapy to millions of Nigerians living with HIV.

• The Global Fund, largely financed by the U.S., disbursed over $1 billion to Nigeria between 2003 and 2022 to combat malaria, TB, and HIV/AIDS.

• USAID’s support for routine immunization and disease surveillance has been instrumental in preventing outbreaks of preventable diseases.

Now, with this sudden withdrawal, Nigeria faces a potential funding vacuum that could cripple its already fragile healthcare system. Without immediate intervention, the consequences could be catastrophic.

Why Nigeria Must Act Now

Nigeria’s public health landscape is fraught with challenges:

• Malaria: Nigeria accounts for nearly 27% of all malaria cases globally, according to the WHO.

• HIV/AIDS: Approximately 1.9 million Nigerians live with HIV, making it one of the highest-burden countries in the world.

• Maternal Mortality: At 512 deaths per 100,000 live births, Nigeria’s maternal mortality rate remains among the worst globally.

These figures highlight the urgency of the situation. Without alternative funding sources, millions of lives are at risk. The clock is ticking, and Nigeria must act decisively to fill the gap left by the U.S. withdrawal.

A New Framework for Public Health Financing

To mitigate the fallout from this unprecedented move, Nigeria needs bold, innovative strategies to secure its public health future. Here are some actionable steps:

1. Streamlining Public Health Institutions

• Fragmentation within Nigeria’s public health sector often leads to inefficiencies and wastage. By consolidating agencies such as the National Primary Health Care Development Agency (NPHCDA), the Federal Ministry of Health, and state-level entities, administrative costs can be reduced, freeing up resources for frontline services.

• Centralized oversight will also improve accountability and ensure that limited funds are allocated effectively.

2. Engaging the Private Sector Through Tax Incentives

• Nigerian corporations must step up to bridge the funding gap. Offering tax incentives to businesses that invest in public health initiatives could unlock billions of naira annually.

• For example, if Nigeria’s top 100 companies each committed just 1% of their annual profits to a national health fund, it would generate significant revenue to sustain essential programs.

3. Boosting Local Manufacturing of Health Products

• Reducing dependency on imported medical supplies is critical. Nigeria has the capacity to produce everything from mosquito nets and syringes to generic drugs locally.

• While compliance with WHO Good Manufacturing Practices (GMP) is ideal, prioritizing affordable, quality-controlled products tailored to local needs can save lives immediately.

• A thriving local manufacturing sector would not only meet domestic demand but also position Nigeria as a regional hub for pharmaceuticals and medical supplies.

4. Strengthening Public-Private Partnerships (PPPs)

• Collaborations between government and private entities have proven successful in other areas of healthcare delivery. Expanding these partnerships can attract additional investment and expertise.

• Models like Lagos State’s LASHMA program, which integrates private insurers into public health schemes, offer valuable lessons for scaling up nationwide.

An Opportunity for Regional Leadership

Other African countries facing similar challenges can benefit from Nigeria’s leadership in navigating this crisis. Platforms like the African Union (AU) and the African Medicines Agency (AMA) provide opportunities for collaboration and knowledge-sharing.

For instance:

• Rwanda’s community-based health insurance model demonstrates how universal health coverage can be achieved even in resource-constrained settings.

• Ethiopia’s focus on local production of pharmaceuticals shows the potential for self-reliance in meeting health needs.

By taking decisive action now, Nigeria can set an example for the continent—and potentially inspire a wave of innovation across Africa.

Let’s Have an Open Dialogue

The stakes couldn’t be higher. How should Nigeria respond to this sudden withdrawal of U.S. funding? What role can technology play in optimizing resource allocation? And how do we balance short-term emergency measures with long-term systemic reforms?

We invite you to join this critical conversation. Share your thoughts, experiences, and ideas using #RethinkPublicHealthNG. Together, let’s chart a new course for public health financing—not just for Nigeria, but for the entire African continent.

Dr Sam Ikoku is a Productivity Consultant based in Abuja, Nigeria.

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