Time to fix Nigeria’s failing health system

This year’s World Health Day came with sober reflection for Nigeria. It coincided with yet another industrial action by resident doctors, who briefly downed tools over unresolved welfare issues and systemic failures in the health sector. That the Global Day of Reflection was marked amid another disruption of services in public hospitals speaks volumes about […]

This year’s World Health Day came with sober reflection for Nigeria. It coincided with yet another industrial action by resident doctors, who briefly downed tools over unresolved welfare issues and systemic failures in the health sector. That the Global Day of Reflection was marked amid another disruption of services in public hospitals speaks volumes about the fragile state of healthcare delivery in the country.

The day, marked on April 7 with the theme “Together for Health: Stand with Science,” offered another opportunity to spotlight the state of Nigeria’s health sector.

At the heart of the crisis lies a deeper, long-standing problem: the failure to build a functional and accessible primary healthcare system. Across rural and semi-urban Nigeria, where the majority of citizens reside, basic health protocols are either weak or entirely absent. Primary healthcare centres (PHCs), which should serve as the first line of care, have largely collapsed. In many communities, they exist more in name than in function as they are poorly staffed, ill-equipped, and unable to provide even the most basic services.

The consequences are dire. Millions of Nigerians continue to lose their lives to preventable and treatable conditions such as malaria, diarrhoea and complications arising from inadequate antenatal care. For many, access to even the most basic healthcare remains a mirage. This is not merely a failure of infrastructure; it is a failure of governance across all tiers.

Successive governments appear to have abdicated responsibility for primary healthcare, leaving it to international organisations such as the World Health Organisation, non-governmental organisations and, in some cases, local communities to sustain what should be a core public service. The result is a distorted system where patients bypass PHCs and flock to secondary and tertiary institutions, overwhelming facilities that are themselves under-resourced.

This imbalance has contributed significantly to the ongoing brain drain in the health sector. Faced with poor working conditions, inadequate infrastructure and irregular remuneration, many Nigerian health professionals have sought opportunities abroad, further weakening an already strained system.

Globally, healthcare is recognised as a critical social service that governments must provide or heavily subsidise. Even in many developing countries, access to healthcare is prioritised as essential to national development and social stability. In Nigeria, however, this commitment appears largely rhetorical.

When President Bola Ahmed Tinubu announced the removal of petrol subsidy in 2023, part of the justification was that the savings would be channelled into critical sectors such as health. Years on, there is little tangible evidence to suggest that the health sector has benefitted meaningfully from that policy shift.

Instead, the sector continues to be plagued by recurring industrial disputes. These disputes have become a recurring decimal, frequently paralysing services in public hospitals that serve the majority of Nigerians.

Yet, beyond these immediate triggers lies a more fundamental issue: chronic underinvestment. In 2001, Nigeria joined other African nations in adopting the Abuja Declaration on Health Financing, pledging to allocate at least 15 per cent of its national budget to health. More than two decades later, that target remains unmet.

Recent budgetary figures tell a troubling story. In 2023, about N1.17 trillion was allocated to health, representing roughly five to six per cent of the national budget. This rose to N1.33 trillion in 2024, still below six per cent. By 2025, the allocation increased to N2.48 trillion, representing a little over five per cent.

Experts have consistently warned that such levels of funding are inadequate, especially when adjusted for inflation, population growth and the country’s rising disease burden. The implication is clear: Nigeria is not investing enough in the health of its people.

Against this backdrop, reports of government officials travelling abroad to procure air ambulances raise legitimate concerns about priorities. While such assets may have their place, they do little to address the immediate and pressing needs of ordinary Nigerians who struggle to access basic care. In many parts of the country, even standard motor ambulances are unavailable, with communities forced to rely on self-help initiatives to equip their health centres.

This disconnect reinforces a long-standing perception that health policies in Nigeria are often elitist; designed to serve a privileged few, while the majority grapple with inadequate and inaccessible services. It is a perception that the government must urgently work to change.

At Daily Trust, we believe that the way forward is neither complicated nor unattainable. It requires deliberate and sustained investment in primary and secondary healthcare. PHCs must be revitalised, properly staffed and equipped to handle common ailments and preventive care. Secondary facilities must be strengthened to provide more advanced services without being overwhelmed. This does not preclude investment in tertiary institutions; rather, it calls for a balanced approach that recognises the interdependence of all levels of care.

Above all, healthcare must be made affordable. A system where citizens cannot treat basic illnesses without financial hardship is neither sustainable nor just. Ensuring universal access to quality healthcare is not merely a policy choice; it is a moral and developmental imperative.

As Nigeria joined the rest of the world to mark this year’s World Health Day, the message should be clear: the health of the people must take precedence over grand projects and policy pronouncements. The time for rhetoric has passed; what is required now is decisive, sustained and people-centred action.