The Coordinating Minister of Health and Social Welfare, Muhammad Pate, on Thursday said that Nigeria must prioritise mobilising domestic resources to sustain health services and protect vulnerable populations.
Mr Pate said this during a panel session on “Reflections on Emerging Challenges in Health Financing” at the National Health Financing Dialogue in Abuja.
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He stressed that while donor funding has been useful, the country must take ownership of its health sector.
He also urged development partners to stop bypassing national institutions with parallel projects, warning that such practices weaken rather than strengthen the country’s health financing systems.
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“We cannot pretend perfection, but we have to work on our institutions so they continue to move from strength to strength,” he said.
“If you bypass them and create separate budgets outside the government, you are allowing waste.”
According to him, partners should align with the government’s sector-wide approach by using national systems, even if weak, to help improve them.
“Over time, there should be no stand-alone delivery units. The funds should go directly through ministries with proper safeguards,” he added.
The four A’s of service delivery
Echoing the minister’s stance, Donald Kaberuka, former African Development Bank president, said Africa’s health financing challenge is not about foreign taxpayers’ money but about mobilising domestic resources responsibly.
“The health of our people is not about money from outside,” Mr Kaberuka said.
“It’s money from us. Nigeria’s tax-to-GDP ratio is still at 11 to 12 per cent three points below the sub-Saharan average. It means there are Nigerians who are not paying their fair share.”
He outlined what he described as the four A’s that must guide health service delivery once resources are raised.
“First is availability. Services must exist in the first place. Second is accessibility. What use is it if you are told care is free, but there are no medicines or doctors at the hospital,” he said.
“Third is affordability. Wasteful subsidies undermine public finances, yet without affordability, health systems collapse. And the fourth is accountability. Every naira and every service must be accounted for.”
He added that any viable financing system must also provide safety nets for the most vulnerable and pool risks across governments, communities, companies, and individuals.
Legislative push for higher allocations
Ipalibo Harry-Banigo, Chairperson of the Senate Committee on Health, said the National Assembly is already considering a bill to raise the Basic Health Care Provision Fund (BHCPF) from the current one per cent of the Consolidated Revenue Fund to two per cent, alongside a dedicated account for immunisation.
Ms Harry-Banigo said this would substantially increase funding for health.
“But it will need cooperation from all stakeholders including civil society, sub-national governments, and the public, because it must pass through hearings before it becomes law,” she said.
She also disclosed that parliament has introduced an infrastructure fund for health, with provisions such as a 50 per cent subsidy on power supply to public hospitals.
According to her, this would ease costs for facilities and improve service delivery.
Beyond public spending, the senator stressed the importance of including the private sector, which she said serves many.
On alternative financing, she said health taxes could be explored but only on the basis of evidence-based frameworks to ensure fairness.
One Health and antimicrobial resistance
The WHO Regional Director for Africa, Mohamed Janabi, responded to questions on the region’s rising burden of non-communicable diseases and antimicrobial resistance.
Mr Janabi warned that Africa’s growing burden of antimicrobial resistance and zoonotic outbreaks requires a coordinated ‘One Health’ approach that brings together human, animal, and environmental health.
“Most of these diseases, Ebola, Marburg, Mpox, even COVID, start in animals before jumping to humans,” he said, recalling recent Marburg cases in Rwanda and Tanzania traced to farmers working near bat colonies.
“That is why outbreaks must be addressed in a multisectoral way. You cannot separate the veterinary part from the human part,” he said.
Mr Janabi noted that only about 40 per cent of African countries currently have reliable data systems to measure its true impact.
“If you ask me today how serious AMR is on the continent, it is difficult to answer, because we don’t yet have the database. That is where WHO is stepping in to provide expertise and help countries establish surveillance.”
He linked the challenge to misuse of antibiotics by both individuals and livestock farmers.
“Most of us don’t complete our prescriptions. Where do the leftovers go? Into water sources, into animals. And in our farms, antibiotics are overused. This cycle is fuelling resistance,” he explained.
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Building social capital
Mr Pate concluded by noting that health financing has implications beyond economic productivity and human capital.
He argued that in a country often divided along ethnic, religious, and political lines, coming together to address collective health needs can help heal fractures and build trust.
“By coming together to address the health needs of our population, in fact we can forge social capital and that itself can help us grow even further,” he said.
Drawing a comparison with Rwanda, he credited part of the country’s post-conflict recovery to social solidarity.
“One of Rwanda’s secrets is not just the technical reforms, but the social capital they rebuilt in the post-conflict period. It helped them to look beyond themselves and preserve the commons,” he explained.
He added that public health spending, when done equitably, serves this collective good.
