Nigeria’s 2024 budget shows that the health of Nigerians is not a priority. Only 5 percent of Nigeria’s 2024 “Renewed Hope” budget of $31.9 billion was appropriated for the health of over 220 million people. $7 for every Nigerian. This is embarrassing and irresponsible, especially when President Bola Ahmed Tinubu promised 10 percent for the sector and is Nigeria’s “Chief Medical Tourist.”
Nigeria failed to commit to the Abuja 2001 Declaration of 15 percent of all African countries’s budgets for health. This could only mean one thing: the health sector is grossly depressed. There is heavy dependence on development institutions and partners, especially at the primary care, subnational, and displaced communities levels. But there is only a little that they can do.
The COVID-19 pandemic exposed Nigeria’s weak health resilience. According to Health Minister Dr. Ali Pate, 90 percent of Nigeria’s population (over 200 million) is not covered by health insurance. Health-insured Nigerians are not assured of quality service due to poor budgetary allocation. Out-of-pocket expenditure is too expensive for a nation with nearly 50 percent of its population living below the poverty threshold of $1.9 daily.
“There is heavy dependence on development institutions and partners, especially at the primary care, subnational, and displaced communities levels. But there is only a little that they can do.”
In 2022, former President Muhammadu Buhari signed the National Health Insurance Act Bill into law, making health insurance compulsory for all, but only on paper. Nearly all Nigerians are on the verge of poverty if an ailment comes knocking. Life and family savings and assets are being lost daily to keep loved ones alive. This is for those who are financially “alive.”
Many have resorted to debt. When funds were available, lack of access or poor quality of service for a dilapidated health sector could spell death. For instance, Nigeria’s National Hospital (Nigeria’s poster hospital) does not have an arthroscopy machine for orthopaedic surgery. Colossal embarrassment!
Nigeria’s health sector is weak. Depleting human resources and a lack of modern health technologies are features of public hospitals at all levels. There is nearly no support for research, innovation, and development in the sector. These challenges have led to many health professionals migrating to Europe, America, and other African countries for better remuneration, benefits, and career advancements. Attacks, kidnappings, and killings of health professionals have exacerbated this trend.
According to the Nigerian Medical Association, Nigeria has a ratio of one doctor to 10,000 Nigerians, with less than 24,000 doctors left to cater for over 220 million Nigerians. The available health professionals are overworked and left to battle with burnout and mental health issues. There is no health talent strategy to compensate for the loss of personnel through the brain drain after effect. The impact is telling on the sector. More quacks are emerging, and self-medication is leading to increased death rates, especially for children and women.
Nigeria’s economy offers no hope. The exit of major pharmaceutical giants from Nigeria in 2023 due to a harsh business environment worsens the plight of many Nigerians. Inflation and foreign exchange fluctuations mean the cost of import-dependent pharmaceutical products and services surges with the depleted disposable income and purchasing power of Nigerians.
Millions of Nigerians are running out of resources daily to meet their expensive health needs, mostly in rural and internally displaced communities, vulnerable citizens, and those living with disabilities. Millions of Nigerians are in a debt crisis to survive, and some are at risk of death. The economic planners have dealt a huge blow to the sector that could have a catastrophic effect in the short and long term.
Urgent action is required to turn the tide. President Bola Ahmed Tinubu must urgently correct this financing shortfall through a supplementary budget. Nigeria’s budgetary allocation in 2025 and subsequent years must comply with the 2001 Abuja Declaration. Innovative strategies must be employed to pull millions of Nigerians into the National Health Insurance Act.
The Ministries of Health at federal and sub-national levels must develop a health talent strategy to train more health professionals and retain them to compensate for the human resources shortfall. The employment benefits and safety of health professionals must be given top priority. Special intervention funds should be provided for innovation, research, and development. Public-private partnerships, technology, and knowledge transfer are required to transform the sector.
Foreign investors, local industries, and manufacturers in the health sector should be wooed, incentivized, and encouraged. The economy, especially inflation and foreign exchange turbulence, requires stability and better management.
The government must display its commitment to the health sector not in mere words and pages of papers but through committed political will and action evident in funding and support.
In the words of Martin Luther King Jr., “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”
Victor Alikor is a development economist, public analyst and Oxford Foundry Fellow.
