By Michael Chiemeka
If you are a Nigerian, you have most likely experienced our healthcare system not as you hear it in policy statements, but in the reality of long queues, empty drug shelves, and anxious journeys to distant hospitals. For millions of Nigerians, especially in rural communities, healthcare had become a matter of improvisation.
A mother in a village will most likely travel miles for antenatal care; a child misses routine immunisation because vaccines are unavailable; a family confronted with cancer must choose between treatment and financial ruin. These had over the years become the lived realities of a system long strained by underinvestment, fragmentation, and neglect.
The challenges are well known. Nigeria carries a heavy burden of infectious diseases—malaria, tuberculosis, HIV, and respiratory infections remain leading causes of illness and death. Primary healthcare, the backbone of any effective system, has historically been weak: facilities under-equipped, medicines frequently out of stock, and service quality uneven. Public health funding has been insufficient, leaving households to shoulder costs directly, often catastrophically. Meanwhile, a persistent exodus of doctors and nurses has hollowed out the workforce, while poor sanitation and weak preventive systems continue to fuel avoidable disease outbreaks.
Yet, to conclude that Nigeria’s health sector is doomed would be misleading. Under President Bola Ahmed Tinubu’s Renewed Hope Health Agenda, a series of targeted reforms is beginning to address these structural weaknesses through incremental, system-focused interventions. The logic of President Tinubu’s team is clear: to rebuild primary healthcare which seats at the heart of healthcare delivery to the majority of the country’s population, to strengthen the workforce that is tasked with delivering on this healthcare, to expand specialised care, enforce accountability, and secure the supply of medicines.
These touch on every aspect of the challenges that the country’s healthcare sector faces.
At the foundation of this effort is a renewed emphasis on primary healthcare. The Federal Government’s release of N68 billion to strengthen vaccine procurement and primary care services signals a shift towards prevention and early intervention. By financing tens of millions of vaccine doses—including those for measles, polio, HPV, and malaria—the programme directly targets diseases that disproportionately affect children.
Crucially, it prioritises the 7.4 million “zero-dose” children who have never received routine immunisation. Through mobile teams and house-to-house campaigns, the government intends to reach those it has historically missed.
This investment sits within a broader expansion of the Basic Health Care Provision Fund, now exceeding N130 billion. These measures aim to reduce the financial barriers that have long defined access to care. If sustained, they could gradually shift Nigeria away from its reliance on out-of-pocket spending towards a more pooled and predictable financing model.
However, infrastructure without personnel is futile. Nigeria’s health workforce crisis—exacerbated by migration—has left many facilities understaffed. The training of over 60,000 frontline health workers by the President Tinubu administration, with plans to double that number, is therefore a critical intervention.
By strengthening the cadre of community health practitioners, midwives, and primary care staff, the President Tinubu administration is reinforcing the first line of defence in our health system. In practical terms, this means more skilled birth attendants, better immunisation coverage, and improved management of common illnesses at the community level. It also represents a pragmatic response to brain drain: if specialists leave, the system must at least ensure that basic care remains accessible.
Beyond primary care, the reforms recognise the growing burden of non-communicable diseases. Cancer, once a relatively neglected area, is receiving new attention through the establishment of six federal oncology centres, three of which are already operational in Katsina, Enugu and Edo states. In a country of over 200 million people, access to cancer diagnosis and treatment has been severely limited, often requiring costly travel or treatment abroad. There centres now promise earlier detection, more affordable care, and improved survival rates for cancer patients. Just as importantly, they serve as hubs for training and research, helping to build a pipeline of specialists in this field that Nigeria urgently needs.
Yet reforms in funding, infrastructure, and workforce risk being undermined without accountability. Here, the deployment of National Health Fellows across all 774 local government areas introduces an innovative layer of oversight. These fellows act as the system’s eyes and ears, tracking the flow of funds, monitoring facility performance, and generating real-time data. In a sector where leakages and inefficiencies have often diluted impact, such granular monitoring could prove transformative. It signals a recognition that governance—not just spending—is central to health outcomes.
The physical state of healthcare facilities, long a symbol of systemic decay, is also being addressed. The revitalisation of over 4,000 primary health centres, alongside the upgrade of thousands more, is gradually restoring confidence in public healthcare. Functional facilities—with electricity, water, equipment, and medicines—change the calculus for patients. They bring care closer to communities, reduce pressure on overcrowded hospitals in our cities, and improve maternal and child health outcomes.
Perhaps the most forward-looking element of President Tinubu’s health reforms lies in the push to localise pharmaceutical production. Nigeria’s dependence on imported medicines has long exposed it to supply shocks and high costs. Over $2 billion has been mobilized so far in partnerships and financing—spanning institutions such as Afreximbank and European partners. With this, the government is attempting to build a domestic healthcare value chain that includes manufacturing plants, diagnostic centres, and large-scale projects such as the African Medical Centre of Excellence. It indeed has the potential to enhance medicine security, create skilled jobs, and position Nigeria as a regional hub for healthcare production.
These initiatives reflect a coherent—and still evolving—strategy. Nigeria’s health challenges deep-rooted but they are being tackled with President Tinubu’s healthcare reforms. They are a shift in approach: from episodic interventions to system-building; from urban-centric care to community-level access; from dependence on imports to domestic capability.
Nigeria does not merely need more hospitals or more doctors—it needs a health system that works predictably, equitably, and sustainably. The President Tinubu administration’s reforms, while far from complete, represent a step in that direction. In a country where the absence of care has long been normalised, even incremental progress carries profound significance.
Michael Chiemeka is a medical researcher.
