Special Adviser to the President on Health, Dr Salma Ibrahim Anas, said the health and prosperity of Nigeria must no longer be predicated on external benevolence, but on robust domestic ownership and accountability.
She stated this on Thursday in Abuja, during the 9th Annual Health Conference of the Association of Nigeria Health Journalists (ANHEJ).
Speaking on the conference theme; ‘Domestic Resource Mobilization in the face of Dwindling Foreign Grants and Aids’, she said under the Renewed Hope Agenda of President Bola Ahmed Tinubu, their mission is to build a resilient, equitable, and integrated health system.
“The cornerstone of this mission is Domestic Resource Mobilization (DRM). We must turn this necessity into our greatest opportunity for self-reliance.
“Ladies and gentlemen, if you look into our current health financing situation, you will see that the data only illuminates the fragility of our current financing model. Over the last three years, we have seen marginal growth in our health spending, yet it remains fundamentally insufficient.
“While Nigeria’s healthcare spending per capita has moved from approximately $67.91 in 2020 to $90.92 in 2022, this increase masks a critical, systemic flaw: the overwhelming majority of our Total Health Expenditure (THE) is financed by high Out-of-Pocket (OOP) payments, trapping millions of Nigerians in poverty every year.
“Furthermore, a significant portion of the remaining financing comes from external grants. This precarious balance creates a severe vulnerability of risks and how it affects our aspiration for attaining Universal Health Coverage in Nigeria.”
While looking at the risk of the dwindling donor aid, she said experts project 15% to 20% reduction in foreign grants to Nigeria—“a scenario we face, which immediately creates a financial chasm that threatens to unravel decades of progress. Donor funds typically target key vertical programs: HIV, Tuberculosis, Malaria, and routine immunisation. The moment this funding stream slows, services break down, stock-outs occur, and the most vulnerable communities suffer immediate and catastrophic consequences.
“On the side of Universal Health Coverage, dwindling aid directly sabotages our drive towards Universal Health Coverage, considering the vast quantities of preventive commodities and services that are made possible with donor aid at the PHC level.”
She added that the UHC is not possible if basic services are not free at the point of need for the poor. “Without filling the gap through DRM, our Primary Health Care (PHC) facilities—the very foundation of UHC—will stagnate.
“Ladies and gentlemen, it is gratifying to note that the Renewed Hope Agenda of President Bola Ahmed Tinubu, from the onset, has been proactive and set in motion mechanisms that will ensure that Nigeria is in a position to take its destiny in its own hands.
“The first priority area of the Renewed Hope Agenda, which is about sustained economic growth, aims to ensure adequate resources for the growth of the Nigerian economy across all sectors, including health. To ensure that the health sector has the financial resources it needs to deliver on the UHC aspirations for the Nigerian people as promised in the Renewed Hope Agenda, the Federal Ministry of Health and Social Welfare, in concert with the Legislature and our agencies, had focused on mobilizing and increasing the finding available to the health sector as the bedrock of the Nigeria Health Sector Renewal Investment Initiative (NHSRII). “
While commending the National Assembly, she said the Legislature has been instrumental in advocating for the increase of the BHCPF from the statutory one percent (1%) to two percent (2%) of the Consolidated Revenue Fund (CRF). This single legislative commitment, when fully enacted and funded, will instantly double the fiscal space for health for our poorest citizens.
“We have also reformed the mechanism through BHCPF 2.0 , focusing on; deploying digital platforms to track every Naira disbursed to the National Health Insurance Authority (NHIA) and the Primary Health Care Development Agency (NPHCDA) gateways.
“We are also expanding coverage to over 13,000 PHC facilities nationwide, using performance-based metrics to ensure resources yield measurable results, such as reduced maternal mortality and increased vaccination coverage.
“The expansion of financial protection under the NHIA is FMOHSW’s second DRM strategy, built around pooling resources through mandatory health insurance. The new NHIA Act aims to drastically reduce OOP payments by bringing over 50 million new enrollees under financial protection within the next four years.“
