Health
Crisis persists in Nigeria’s health sector; brain drain, underfunding, fake drugs to dominate 2025

The year 2024 has witnessed constant challenges in the country’s social investment initiatives. However, the authorities should be commended for their efforts to better the healthcare sector through various initiatives by the government and stakeholders in the past year.
The health sector recorded notable improvements mainly driven by the government ranging from investments to health initiatives aimed at accessible quality health care, regardless of socioeconomic status. One of the notable initiatives is the Nigeria Health Sector Renewal Investment Initiative, NHSRII; unveiled on 13th December 2023, to improve population health outcomes through the Primary Healthcare, PHC, system.
In just one year, the health sector under the Tinubu-led administration recorded a notable budget allocation. The total health budget was ₦1,228,100,390,765, taking 4.47% of the proposed budget expenditure of the 2024 federal budget, which was lower than the 15% recommendation of the 2001 Abuja Declaration. The allocation was aimed at strengthening Primary health care, improving infrastructure, and increasing coverage from 16.7 million to 19.2 million people within a year. Additionally, the government expended ₦37 billion through the Basic Health Care Provision Fund, BHCPF, to designated PHCs. The National Health Insurance Scheme, NHIS, 2024 made additional provisions for the National Youth Service Corps, NYSC, and Military Retirees. The Presidential Initiative for Unlocking the Healthcare Value Chain initiative also achieved a $5 billion project pipeline and $2 billion in foreign investments.
Also, in August 2024, the Nigeria Sovereign Investment Authority, NSIA, overseen by the Federal Ministry of Finance and Coordinating Minister of the Economy, launched the Health-care Expansion Programme, which is aimed at establishing ten world-class healthcare facilities that will specialize in oncology and diagnostics across the country while also retraining 120,000 frontline health workers. This could also mitigate the mass exodus of health practitioners, otherwise known as brain drain.
Speaking on the brain drain syndrome, which has become a parasite eating at the Nigerian Health sector, resulting in a low healthcare density with a ratio of approximately two healthcare practitioners (doctors, Nurses, and midwives) per 1,000 individuals, which is below the recommended density ratio of 4.45 per 1,000 persons by the World Health Organization, WHO. To tackle this issue of brain drain syndrome, the Nigerian government implemented various initiatives to curb the syndrome, and this measure includes the National Policy on Health Workforce Migration, this policy targets increased incentives for health workers, especially those situated in the rural areas of the country, the policy also focuses on capacity development and diaspora engagement.
Another step the government took to curb the brain drain parasite is by proposing a Bill to restrict doctors from leaving Nigeria for five years after completing their studies, although it was criticized by the public and health professionals.
The government’s investments underscore its resolve to transform Nigeria’s healthcare sector and attain universal health coverage by 2030.
However, despite all the efforts by the government to better the health sector, the sector has also suffered notable setbacks in the past year. Ranging from Economic constraints and inflation leading to the exodus of drug pharmaceutical companies resulting in the increased cost of medications, constant strikes by the health workers, continuous record of medical workers and students abduction, delayed disbursement of the Basic Health Care Provision Fund, BHCPF, increased rate of malnutrition and high maternal mortality rate.
The country witnessed the highest economic constraints and inflation which affected pharmaceutical chain supplies in Nigeria leading to the exit of companies like GlaxoSmithKline, GSK, and Sanofi, PZ Cussons which led to the unattainable prizing of drugs and medication in June 2024, the prices of asthma inhaler was reported to have increased as fake inhalers also flooded the market due to the departure of GSK.
Also, the incessant strike by health practitioners was a major challenge for the health sector. For a different reason, the Joint Health Sector Union, JOHESU, has gone on strike some of these reasons include the demand for an upward review in the retirement age from age 60 to 65 for health workers, and in just October 2024, the body went on strike demanding for immediate payment of outstanding salaries to staff of regulatory agencies and threatened a seven-day warning strike over government’s failure to pay COVID-19 inducement hazard allowances to an omitted health worker.
Furthermore, the health sector faced an insecurity crisis in the past year as health workers and students were abducted. In August 2024, 20 medical students and a doctor were kidnapped in Benue State, Nigeria while traveling to a medical convention. In October 2024, In the Mareri area, Gusau City, Zamfara state, a consultant gynecologist of the Federal Medical Centre was kidnapped from his home by a Zamfara militia.
Another challenge in the health sector was the delayed disbursement of the Basic Health Care Provision Fund BHCPF 2024, evaluation found that the BHCPF was implemented sub-optimally in at least one thematic area across six states in Northern Nigeria.
Last but definitely not least is the increased malnutrition rate. 2024 was a year of hunger and malnutrition; different health organizations reported that millions of Nigerian children went through malnutrition in the past year. According to UNICEF’s NutriVision 2024, over 11 million children under 5 in Nigeria are experiencing severe child food poverty, which makes them up to 50% more likely to experience life-threatening forms of malnutrition. Similarly, the Integrated Food Security Phase Classification, IPC’s Acute Malnutrition Situation report states that nearly 5.4 million children in northwest and northeast Nigeria are suffering from acute malnutrition. This includes about 1.8 million cases of Severe Acute Malnutrition (SAM). Also, the most disheartening is the return of kwashiorkor, a kind of malnutrition associated with war when there is severe scarcity of protein and caloric food. According to a report by Dr Foluso Balogun, a pediatrician at the University College Hospital, UCH, Ibadan, for the first time in many years, children with kwashiorkor are seen in the country.
The way forward in 2025
While ruminating on the events of 2024 in the health sector, the government needs to focus on investing in local manufacturing of medical products and prioritization of locally produced drugs over imported medicines, also enhancing the logistics system. Stronger regulatory framework to ensure stable access to healthcare facilities. Compliance by the authorities towards their policies.