2018 Budget: Again, Nigeria falls short of AU health funding commitment

President Muhammadu Buhari presenting the 2018 Appropriation Bill to lawmakers.
President Muhammadu Buhari presenting the 2018 Appropriation Bill to lawmakers.

Nigeria has again ignored the commitment it made alongside other African countries 16 years ago on funding of health care services for its citizens.

Nigeria hosted the Heads of State of member countries of the African Union (AU) in 2001 who made the “Abuja Declaration” under which the leaders pledged to commit at least 15 percent of their annual budgets to improving their health sector.

Since the declaration, Nigeria has not attained the pledged funding benchmark as the federal government has never voted more than six percent of its annual budget to the health sector.

The highest percentage since the declaration was in 2012 when 5.95% of the budget was allotted to health.

In the 2018 Budget proposal President Muhammadu Buhari presented on Tuesday to the National Assembly, he allocated N340.45 billion, representing 3.9 percent of the N8.6 trillion expenditure plan to the health sector.

The allocation is less than the 4.16 percent and 4.23 percent made to the health sector by the administration in the 2017 and 2016 budgets.

In July 2013, Nigeria again hosted over 50 African Heads of State in a special summit that was tagged ‘The Abuja +12 meeting”, which reviewed the progress made on the promise of the Abuja Declaration on health funding.

Breakdown of the 2018 Health Budget proposal

If the appropriation bill is passed as presented on Tuesday by President Buhari, the N340 billion allocated means that government plans to spend N1,888 on each citizen for the whole year.

It is estimated that Nigerians spend N359.2 billion on medical tourism annually.

The budgetary allocation is against the backdrop of recent outbreaks of Monkey pox, Measles and Lassa fever, and the fight to end polio and high maternal and child deaths.

The country is also beset by poor primary health facilities, lack of functioning cancer machines or treatment centres, poor health emergency responses and low coverage of the health insurance scheme, among other issues.

In the 2018 health budget proposal, N269.34 billion was earmarked for recurrent expenditure which refers mainly to expenditure on operations, wages and salaries, purchases of goods and services, and current grants and subsidies; while N71.11 billion is for capital expenditure.

Though there was a little increase in capital expenditure when compared to the N51.1bn earmarked for it in 2017, in percentage term it was a decline as the 2017 budget was N7.4 trillion while that of 2018 budget is N8.6trillion.

Details of the budget proposal revealed that health came 12th as Power, Works and Housing got the highest capital project proposal with N555.88 billion, almost eight times that of health.

Nigeria’s health situation is of growing concern especially in the insurgency ravaged North Eastern region where access to medical care has diminished.

Various statistics also show that Nigeria has one of the worst health care delivery records in the world.

According to the World Health Organization, Nigeria is rated 187th out of 191 countries in terms of health care delivery.

WHO said one-third of more than 700 health facilities have been destroyed in the country and about 3.7 million people are in need of health assistance.

The health body placed Nigeria at third highest in infant mortality rate in the world.

Medical experts described as worrisome the recent figure released by international agencies which put Nigeria’s maternal mortality rate at 58,000 in 2015. This showed that Nigeria recorded the second highest maternal death rate in the world.

Apart from poor health interventions apparently caused by lack of funds, the sector has also experienced series of industrial actions by its workers over unpaid salaries and other administrative anomalies.

The Joint Health Sector Unions and Assembly of Healthcare Professionals, JOHESU, recently called off its nationwide strike which it embarked on September 20 to protest among other issues, salaries adjustments, promotion arrears, and improved work environment for its members.

“The fact that the Abuja declaration was made in Nigeria, we should be taking the lead, but other smaller countries like Kenya, The Gambia, Rwanda, Lesotho, Swaziland are the ones making bold steps in terms of budgetary allocation for health,” Aremu Fatai, the director, Policy and Legislative Advocacy at Partnership for Advocacy in Child and Family Health, a coalition of non-governmental organisations.

Mr. Fatai, a medical doctor, said the proposal was short of expectation.

“This doesn’t speak well of Nigeria’s image as the Giant leader in Africa and it doesn’t go well for the health sector because what this means is that the government does not prioritize health,” he said.

“Infrastructure, building roads and bridges are bad but then even when you build the road and bridges it’s only a healthy population that can utilize them. When you talk about agriculture, it’s only when the farmer is healthy that he can be more productive in the farm.”

He urged the National Assembly to use its power as it is constitutionally guaranteed to make necessarily adjustment to the appropriation bill and make sure that health gets a better deal in the budget.


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  • thusspokez

    Nigeria has again ignored the commitment it made alongside other African countries 16 years ago on funding of health care services for its citizens.

    This is like someone pleading with a sick person to go to the hospital for their own sake. What could be more important than the health of a nation? If Nigerian governments do not even care about life, how could anyone trust them in other areas of human welfare?

    • Abrupt

      Are u not tired of drawing lines? Is this how you can effect change? When we insisted that an Educated and reasonable person be elected as president you disagreed because u were afraid of Boko haram. We asked for Buhari’s WAEC certificate and none was produced. How can a man who failed 78% of the papers he sat for in final secondary school exams know the value of education?…that education produces Medical Doctors and Lab Scientists, Nurses etc? That education led to the invention of the state of the art equipment he benefits from when he abdicates his office to London for medical attention? You cannot sow Cassava and expect to reap Cocoyam. Cry me a river!

  • North/West Allies

    Giant of Africa my foot, that’s why our leaders rush abroad for medical treatment and ignore our health sector. Very unfortunate! Nigeria is rather the butt of Africa because we are far behind from reality

    • Hillary Egwim

      But yet people like you want Nigeria to remain one nation. If even you can admit that Nigeria is a disgrace, then you should be able to understand where Biafrans are coming from.

      • North/West Allies

        My brother, I am core Igbo man and i believe in Biafra but if one Nigeria will treat every citizen equal and bring development then i have no problem with it

  • Dr Pat Mumuwole Awosan

    We allow these Animals to run wild. After it became public knowledge that the Nigerian Govt has once again presented a budget that is not representative of the people but their pockets, one expected the Nigerian people to hit the streets in protest, especially the YOUTH & UNEMPLOYED. Alas! What you get is youths spending their time on comment sections insulting each other or defending personalities based on ethnic or regional affiliations. Sad. When a government budgets less than 8% of its total budget for Education but defense as one of the highest then you need no seer to tell you where we are heading. What about health? As long as they and their usel.ess children receive treatment abroad – UK, US, Germany etc, they care not whether you die of Malaria or snake bite. In September 253 people died in Nasarawa from snake bites. REASON: There was no antidote in the hospital.

    Napoleon and his Piglets have taken over Manor Farm as it were and turned it into a full-blown Animal farm where the Piglets have become literally above the law and untouchable regardless of their crime of corruption or executive mismanagement. The worst they get is an unceremonious termination of appointment by Napoleon after many months of pressure from other stakeholders in the farm. The rewritten commandments as prescribed by the inner circle of the Piglets is a working document that directs events at the farm…and it doesn’t matter whether Napoleon is having cold or receiving paying a visit to the Veterinary. A sweeping revolution of some sort that will separate the species in Animal farm and confine each to a space inhabited by its own kind is sure the only veritable solution to this seemingly intractable disorder.