Nigeria’s public health system has endured decades of underperformance, despite countless reforms, policies, and international partnerships. The truth is stark: the country does not lack ideas — it lacks political will.
The COVID-19 pandemic made this painfully clear. While emergency funds were released, once the spotlight faded, health budgets shrank and systemic weaknesses resurfaced. This pattern — a burst of activity in times of crisis followed by neglect — exposes the gap between political promises and real commitment.
The Budget Problem
Nigeria committed in the 2001 Abuja Declaration to allocate 15% of national budgets to health. Nearly 25 years later, the country rarely crosses 6%. In 2024, for instance, the federal budget allotted less than 5% to health — a figure grossly inadequate for a population of over 220 million.
This chronic underfunding cascades into poor infrastructure, shortage of health workers, limited access in rural areas, and preventable deaths. For many citizens, the “public” in public health feels like a broken promise.
Political Will as the Missing Link
Policy frameworks exist — from the National Health Act (2014) to the Basic Health Care Provision Fund. But without strong political will, implementation lags. Leaders routinely emphasize health in campaign speeches, yet once in office, attention shifts elsewhere.
Meanwhile, Rwanda — with far fewer resources — shows what consistent political will can achieve. Its universal community-based health insurance has expanded access and reduced inequality. Nigeria’s failure to replicate such success is not about capacity, but about leadership choices.
Why Health Should Be a Political Priority
Strong health systems are not charity projects; they are engines of economic growth. A healthy workforce drives productivity, reduces poverty, and improves governance trust. Neglecting health, on the other hand, perpetuates inequality and fuels cycles of disease and poverty.
Nigeria cannot achieve sustainable development goals or economic transformation without putting health at the center of its political agenda.
The Way Forward
Nigeria needs bold steps, not recycled promises:
- Prioritize health in governance: Treat health as central to national security and economic progress, not a token sector.
- Meet funding commitments: Allocate at least 15% of the national budget to health and enforce transparent spending.
- Strengthen accountability: Civil society, media, and citizens must hold leaders responsible for unmet health commitments.
- Think beyond election cycles: Reforms must survive political turnover; health must become a national project, not a partisan tool.
Conclusion
Nigeria’s public health crisis is not primarily a question of knowledge or resources. It is a test of political will. Unless leaders demonstrate genuine commitment, policies will remain on paper while citizens continue to pay the price with their health and lives.
The way forward is clear. The real question is: will Nigeria’s leaders finally rise to the occasion?
