Featured, Health
From policy reforms and improved health insurance coverage to introduction of malaria vaccine, the Nigerian health sector in 2024 experienced notable progress in some areas, while it grappled with persistent challenges of disease outbreaks and the emigration of health professionals. Overall, the year was characterized by a mix of highs and lows.
By Anthony Isibor
IN 2024, Nigeria’s health sector experienced some measure of progress and dealt with persistent challenges. On one side, there were significant advancements in health policy reforms, health insurance, and the roll out of the malaria vaccine. However, the long-standing issues such as health tourism, inadequate infrastructure and the weak state of primary healthcare, PHC, centers continued to hinder the country’s overall healthcare outcomes.
Although the year 2024 began with a National Health Budget allocation of 4.8%, about ₦1.4 trillion of the country’s total budget, a significant increase from the previous year, it was still below the World Health Organization’s recommended 15% of national budgets for health.
With the launch of the Health Sector Strategic Blueprint (2023-2027), a new chapter in addressing Nigeria’s healthcare gaps was launched. The plan emphasized better healthcare financing, improved quality of care, and addressing systemic inefficiencies.
As stated by Dr. Muhammad Ali Pate, Minister of Health and Social Welfare, the aim was to provide affordable, equitable and sustainable healthcare for every Nigerian. “This blueprint will tackle longstanding challenges like human resources, infrastructure and financing.”
There was also Expansion in Health Insurance from 17.4 million in 2023 to 19.4 million as announced by Dr. Nasir Sambo, Executive Secretary, National Health Insurance Authority, NHIA.
However, the National Bureau of Statistics, NBS, had also reported that the healthcare insurance penetration rate in Nigeria was still below 5% of the population, compared to countries like Kenya, where health insurance coverage stands at 20%. The expansion of NHIA is seen as a positive move, but achieving UHC remains a long-term goal.
The commencement of Malaria Vaccine Rollout in the country was also a huge achievement as it would be the first time Nigeria would receive the vaccine since it was approved and because Malaria has been listed as one of Africa’s deadliest diseases, killing nearly half a million children under the age of 5, and accounting for approximately 95% of global malaria cases and 96% of deaths in 2021.
It is also worthy of note that since 2019, Ghana, Kenya and Malawi had been delivering the malaria vaccine through the Malaria Vaccine Implementation Programme, MVIP, coordinated by WHO and funded by Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid. The RTS,S/AS01 vaccine had been administered to more than 1.7 million children in Ghana, Kenya and Malawi since 2019 and had been shown to be safe and effective, resulting in both a substantial reduction in severe malaria and a fall in child deaths. At least 28 African countries have expressed interest in receiving the malaria vaccine.
“This vaccine has the potential to be very impactful in the fight against malaria, and when broadly deployed alongside other interventions, it can prevent tens of thousands of future deaths every year,” said Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi, the Vaccine Alliance.
“While we work with manufacturers to help ramp up supply, we need to make sure the doses that we do have are used as effectively as possible, which means applying all the learnings from our pilot programmes as we broaden out to a new total of 12 countries.”
“Nearly every minute, a child under 5 years old dies of malaria,” said UNICEF Associate Director of Immunization, Ephrem T Lemango. “For a long time, these deaths have been preventable and treatable; but the roll-out of this vaccine will give children, especially in Africa, an even better chance at surviving. As supply increases, we hope even more children can benefit from this life-saving advancement.”
“The malaria vaccine is a breakthrough to improve child health and child survival; and families and communities, rightly, want this vaccine for their children. This first allocation of malaria vaccine doses is prioritised for children at highest risk of dying of malaria,” said Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals. “The high demand for the vaccine and the strong reach of childhood immunisation will increase equity in access to malaria prevention and save many young lives. We will work tirelessly to increase supply until all children at risk have access.”
According WHO, malaria remains one of the top causes of morbidity and mortality in the country, with over 200,000 deaths annually. Therefor celebrating the launch of the Oxford R21 malaria vaccine, Dr. Ali Pate had this to say:
“The malaria vaccine represents a significant shift in how we can tackle diseases that have plagued Nigeria for decades. With 75% efficacy, this vaccine is expected to save tens of thousands of lives annually, particularly children under five.”
By October 2024, Nigeria had already vaccinated over 500,000 children in Kebbi and Bayelsa states as part of a pilot programme and the Ministry of Health has projected that, over the next few years, 100,000 lives could be saved annually if the vaccine is fully rolled out. The Global Fund estimates that malaria-related deaths could be reduced by 30% once the vaccine is scaled nationwide.
However, as lofty as the achievements are, the sector has not been without its share of challenges.
One of such challenges that have continued to bedevil the industry is Health Tourism. This has remained a persistent drain on the nation’s resources.
According to the Central Bank of Nigeria, CBN, the nation loses over $1 billion annually to medical tourism, with an estimated 70,000 Nigerians travelling abroad for medical treatment each year. This figure remains high, despite efforts to improve the local healthcare system. The majority of medical tourists head to countries like India, the United Kingdom and the United States.
Condemning the trend, Dr. Ayoade Alabi, a Nigerian consultant said: “While medical tourism may be the norm for Nigeria’s political elite and wealthy citizens, it reinforces inequality in access to healthcare. The resources spent abroad should be invested in improving our healthcare infrastructure to benefit all Nigerians.”
Also, President Bola Tinubu’s administration had acknowledged that reducing medical tourism would require drastic improvement in the quality of domestic healthcare facilities.
Another challenge faced in the sector is the issue of Limited Emergency Response to Disease Outbreaks.
Despite improvements in early detection and disease surveillance, Nigeria continues to grapple with recurring outbreaks of diseases like Lassa fever, cholera and mpox. In 2024, the Nigeria Centre for Disease Control, NCDC, reported that the country had experienced 116 confirmed cases of Lassa fever, with 23 deaths as of September 2024. In response, Nigeria received 10,000 doses of the mpox vaccine from USAID to control the spread of the disease.
Dr. Ifedayo Adetifa, Director-General of NCDC, commented: “We are improving in terms of surveillance, but there is still much work to be done in strengthening our response mechanisms and ensuring the rapid deployment of resources during outbreaks.”
Additionally, the World Bank reports that Nigeria’s health emergency preparedness index is at 53.5%, which is considered suboptimal, especially in the face of recurring outbreaks and natural disasters.
Similarly, Brain drain in the medical sector has also remained unfazed, especially with numerous government efforts to curtail it, Brain drain continues to be a critical challenge in Nigeria’s health sector.
According to a 2024 report by the WHO, more than 7,000 doctors have migrated from Nigeria in the last five years, with a significant number choosing to work in countries like the UK, the US, and Canada. Dr. Emmanuel Abanida, a health policy expert, pointed out that this migration of highly trained healthcare professionals deprives Nigeria of essential skills and expertise. “We need to retain these professionals by improving their working conditions and offering incentives for them to stay,” he said.
The Nigerian Medical Association, NMA also estimated in early 2024 that Nigeria was short of 150,000 doctors, contributing to the heavy burden on the country’s healthcare system.
There is also the challenge with the state of Primary Healthcare Centres, PHCs, across the country. These centres remain one of the most pressing issues in the health sector.
According to a 2024 assessment by the WHO, more than 70% of PHCs in Nigeria are either non-functional or operate below optimal standards. The World Bank reports that 60% of PHCs do not have basic medical supplies, while 30% lack essential drugs.
This is particularly alarming given that PHCs are the first point of contact for most Nigerians, especially in rural areas. Dr. Fatima Kyari, a public health expert, stated that many PHCs are under-resourced and understaffed, which severely impacts the quality of care they provide. Strengthening PHCs is essential for improving health outcomes, particularly in rural areas where they are the only healthcare facilities available.”
In a 2024 statement, the Federal Ministry of Health acknowledged that PHCs have been neglected for years and require urgent investment. A report from the National Primary Health Care Development Agency, NPHCDA, noted that over 3,000 PHCs across the country need complete rehabilitation or reconstruction.
In rural states like Kano, Yobe, and Zamfara, PHCs are often the only healthcare option available, yet they remain under-equipped to handle even basic healthcare needs. According to Dr. Abiodun Egbeyemi:
“PHCs are the backbone of Nigeria’s health system, but they are often overlooked. If we improve these centers, we can reduce preventable deaths, ease the burden on secondary and tertiary hospitals, and ensure that Nigerians have access to essential health services.”
While these challenges remain, experts agree that revitalizing PHCs is one of the most cost-effective ways to improve health outcomes and reduce healthcare inequalities in Nigeria.
One of such experts, Dr. Kyari emphasized that PHCs are at the heart of an equitable health system. Strengthening them will reduce the financial burden on secondary and tertiary care, improve maternal and child health, and make basic healthcare accessible to all Nigerians.”
Although the government has allocated a portion of the health budget to PHC revitalization, with a focus on providing adequate staffing, medical supplies, and infrastructure, experts still emphasize that continued political will, transparent management, and sustained funding are critical to making these reforms successful.
A.I
Jan. 7, 2025
Tags: Dr Kate O’Brien Dr. Ayoade Alabi Dr. Ifedayo Adetifa Dr. Muhammad Ali Pate UNICEF WHO
