Special Adviser to the President on Health Dr Salma Anas warned that donor fatigue was already affecting essential interventions and could jeopardize progress towards Universal Health Coverage (UHC) if the country does not take charge of its health system.
Dr Anas, who spoke at the 9th Annual Health Conference organized by the Association of Nigerian Health Journalists (ANHEJ) on Friday in Abuja with the theme “Domestic Resource Mobilization in the Face of Decreasing Grants and Foreign Aid”, insisted that Nigeria must urgently move from dependence on foreign donors to sustainable domestic financing.
Describing the media as vital partners in driving public awareness and accountability on health reforms, he urged closer collaboration to promote policies that prioritize sustainable financing, noting that Nigeria must strengthen its capacity to independently finance quality healthcare for all citizens.
According to her, global funding priorities have changed, leaving Nigeria exposed and forcing the country to confront a fundamental truth about the fragility of its donor-dependent system.
He said: “For decades, development partners have been indispensable allies in our fight against infectious diseases, maternal mortality and child survival, yet the global landscape is changing, donor fatigue is real and there is no more speculation.”
Dr. Anas noted that while donor-funded programs, particularly HIV, immunization and maternal health, have saved millions of lives, several partners have scaled down or withdrawn. The consequence, he said, is a dangerous financial imbalance that leaves Nigerians vulnerable as external support declines.
“It’s like we’re planning for resources that don’t belong to us… You can’t plan for someone’s resources and be sure they’ll always be there. When these funding plans close, the system collapses and vulnerable communities suffer.”
Dr. Anas lamented that more than 70% of total health expenditure in Nigeria comes from direct payments, pushing millions into poverty every year. A significant portion of the remaining funding comes from foreign donations, another sign, he said, that the country must “take ownership” of its health destiny.
He added that over the past three years, health allocations have increased marginally but remain “fundamentally insufficient” to meet national needs.
According to her, President Bola Ahmed Tinubu’s Renewed Hope Health Agenda places domestic resource mobilization at the center of reforms aimed at building a resilient, equitable and integrated health system.
“Our mission is clear: build a resilient, equitable and integrated health system. The cornerstone of this mission is the mobilization of internal resources. We must turn this need into our great opportunity for self-sufficiency.”
Dr Anas praised the National Assembly for proposing an increase in the Basic Health Care Provision Fund (BHCPF) from 1% to 2% of the Consolidated Revenue Fund, describing it as a potential game-changer saying: “When it happens, it will instantly double resources for our poorest citizens.”
He also announced ongoing reforms including strengthening BHCPF accountability under BHCPF 2.0, expansion of health insurance (with almost 20 million Nigerians now enrolled) and policy measures to curb waste and improve efficiency. Sugar tax, local production and medical tourism reforms.
The presidential advisor confirmed that efforts have been intensified to increase the tax on sugary drinks in line with WHO recommendations of up to 50%, emphasizing that the tax should be directed strictly at health.
“The link between sugar consumption and non-communicable diseases is clear: diabetes, hypertension, stroke, cardiac arrest. Raising the tax will save lives and generate much-needed health funding.”
He highlighted ongoing investments in local production of medicines, vaccines and consumables, noting that every factory put into operation saves Nigeria foreign exchange and strengthens self-reliance.
On medical tourism, Dr Anas said improved public and private facilities are starting to attract foreigners, saying: “In Abuja, facilities like Nisa Premier and Nizamiye are already attracting patients from outside Nigeria. Much more is happening in Lagos and Sokoto.”
Describing federal reforms, the President’s advisor stressed that real progress depends on state governments, which assume responsibility for primary and secondary health care.
“Each state must allocate at least 15% of its budget to health…The federal government cannot implement it alone. The real delivery of health care happens in the states.”
Additionally, he urged states to expand their own health insurance plans, supplement BHCPF allocations, and deploy innovative financial tools.
Dr Anas urged journalists to collaborate with the government to raise public awareness, support legislative reforms and advocate for domestic resource mobilization.
“You are not just reporters, you are critical analysts for the health sector. You are custodians of accountability. Use your platforms to track the money, demand utilization reports, educate citizens and hold government accountable at the federal, state and local levels.”
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