Salako, Anas, others push for deeper domestic health financing

The Minister of State for Health and Social Welfare, Dr Adekunle Salako, has stressed that Nigeria must urgently deepen domestic financing to secure the future of its health system as foreign grants decline.

While he noted that Nigeria’s development partners have made enormous investments over the years across HIV, malaria, immunisation, maternal and child health, tuberculosis, and broader health systems strengthening, the Minister emphasized that the landscape of global aid is increasingly unpredictable.

However, acknowledging the support from the United States, Global Fund, World Bank, Gavi, the UK, the EU, Japan, and philanthropic foundations, the Minister noted that Nigeria has also shown commitment through counterpart funding, increasing its co-financing of Gavi programmes and providing in-kind contributions to PEPFAR.

Emergency funds have also been used to protect essential services when donor shifts create financing gaps.

Speaking on Friday in Abuja at the 9th Annual Health Conference of the Association of Health Journalists, themed ‘Domestic Resource Mobilisation in the Face of Dwindling Foreign Grants and Aid’, Salako said global economic pressures and shifting priorities have made donor flows uncertain, and Nigeria had anticipated this shift by implementing domestic financing reforms.

He identified major local financing pillars, including the Basic Healthcare Provision Fund (BHCPF), the National Health Insurance Authority (NHIA) Act, and State-level initiatives such as contributory health insurance schemes and diaspora-backed infrastructure funds.

He also highlighted expanding private-sector investment, with the Private Sector Health Alliance mobilising over ₦50 billion and the Sovereign Wealth Fund investing in hospital infrastructure.

Salako said the government is exploring blended financing, social impact bonds, and deeper capital market engagement, while prioritising continuity of care for vulnerable groups, especially in HIV treatment and immunisation.

He said strategic co-investment with global partners remains critical and urged partners to focus on systems strengthening rather than recurrent costs.

He reminded health journalists that their work is key to shaping public accountability, explaining reforms, identifying gaps, and reporting programme outcomes.

In her presentation, Special Adviser to the President on Health, Dr Salma Anas, warned that Nigeria can no longer depend on increasingly unreliable donor funds.

While acknowledging that external support has helped reduce maternal and child deaths and combat infectious diseases, she noted projected donor reductions of 15–20 percent, calling for urgent domestic financing reforms.

She said over 70 per cent of current health spending comes from out-of-pocket payments, pushing millions into poverty each year, and although national health budgets have risen gradually, they remain far below the recommended 15 per cent.

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She cautioned that heavy reliance on grants for HIV, malaria, and immunisation exposes Nigeria to disruption. With over 30,000 primary healthcare facilities nationwide, declining donor flows without domestic replacement would strain the poorest populations and stall progress toward universal coverage.

She said the Tinubu administration anticipated the challenges in the Renewed Hope Health Agenda and its National Health Sector Renewal Investment Initiative, which unites federal and state governments, development partners, and civil society, adding that all the States have signed up to mobilise domestic resources and align investments.

The BHCPF, she said, remains Nigeria’s strongest tool for universal coverage and now functions with improved transparency and performance indicators.

The National Assembly is working to double its statutory allocation from one to two per cent, she revealed, noting that the fund would benefit over 30,000 PHCs, with performance benchmarks tied to reduced maternal deaths and improved immunization.

Plans, she said, are underway to protect households through mandatory health insurance, targeting 50 million Nigerians in four years, with current enrolment close to 20 million.

Innovative funding streams, especially the sugar-sweetened beverages tax, are being strengthened, with advocacy for higher rates and earmarking proceeds for health.

She stressed that sustainable delivery depends on state and local governments, calling on states to take ownership, scale up social insurance, and approach the Abuja Declaration benchmark of 15 percent budget allocation to health.

NUJ FCT Chairman Comrade Grace Ike, represented by Jide Oyekunle, said Nigeria must confront dwindling donor flows by investing in a self-sustaining system.

She urged governments to protect health budgets, ensure transparency, expand insurance coverage, and strengthen public–private partnerships. She charged journalists to investigate fund use, track commitments, spotlight gaps, and deepen accountability.

Earlier, ANHeJ President Joseph Kadiri said the conference underscores the need for sustainable financing, strong partnerships, and resilient institutions.

He urged journalists to track government commitments and amplify the realities faced by families, noting sub-themes including cancer research, maternal and newborn health, public health emergencies, and combating counterfeit drugs.