Reported by: Ijeoma G | Edited by: Oravbiere Osayomore Promise.
In a broad and sharply worded assessment released on April 7, 2026, World Health Day, Corporate Accountability and Public Participation Africa (CAPPA), a respected Nigerian advocacy organisation, condemned successive governments for what it describes as “chronic” underfunding and policy failures that continue to undermine the nation’s health sector. CAPPA’s critique highlights the persistent gap between official commitments to health financing and the lived reality of millions of Nigerians, calling for urgent reforms to strengthen health policy, financing, and preventive measures.
In its statement marking the global observance under the theme “Together for Health: Stand with Science,” CAPPA said Nigeria “must move beyond rhetoric and take urgent steps to strengthen health financing and adopt evidence‑based policies.” The organisation’s Executive Director, Akinbode Oluwafemi, emphasised that the Nigerian government at all levels — federal, state, and local — has repeatedly failed to honour its commitment to allocate at least 15 per cent of the annual budget to health, a target the country pledged to meet more than two decades ago under the Abuja Declaration. CAPPA characterised the ongoing shortfall as a structural crisis with deep consequences for healthcare access and quality across the country.
CAPPA’s analysis highlighted that while health sector allocations have sometimes been increased on paper, the funds actually released and spent on essential services remain far below needs. The group pointed to figures showing that the Federal Ministry of Health and Social Welfare struggled to implement its 2025 capital budget after receiving only a small fraction of the funds originally allocated — just N36 million out of the planned N218 billion. Similarly, in 2024, only N26.552 billion was released from N233.656 billion earmarked for capital projects. Such weak budget execution has severely restricted the government’s ability to upgrade infrastructure, purchase medicines, and support frontline facilities.
Oluwafemi said the persistent gap between budget promises and actual releases has tangible human impacts. “This longstanding gap … has weakened the health system and is short‑changing Nigerians,” he said, warning that underfunding has contributed to limited access to essential medicines, overstretched and understaffed facilities, acute shortages of health workers, and rising out‑of‑pocket costs that place heavy financial burdens on households.
CAPPA also drew attention to shifting patterns in Nigeria’s disease burden, noting that non‑communicable diseases such as hypertension, diabetes, obesity and heart conditions now account for around 29 per cent of annual deaths. It warned that without stronger preventive policies and dedicated financing, the health system will continue to struggle with both old and emerging public health challenges.
To address these trends, CAPPA outlined a series of policy recommendations it believes are grounded in scientific evidence. Among these, the group urged a significant boost to the sugar‑sweetened beverage tax — proposing a levy of at least 50 per cent of the retail price to discourage excessive consumption and generate revenue for health promotion. It also called for mandatory sodium reduction targets, clearer front‑of‑pack nutritional labelling on processed foods, and tighter restrictions on marketing unhealthy foods to children. On tobacco control, CAPPA described the current N13 million allocation to the Tobacco Control Fund as grossly inadequate and advocated raising it to at least N300 million. Such measures, the organisation said, are essential to addressing risk factors driving the rise in lifestyle‑related illnesses.
CAPPA’s statement did not focus solely on fiscal targets but also on broader policy and implementation gaps that have limited progress. It stressed that health financing should be aligned with evidence‑based priorities that reflect the real needs of Nigerians, rather than political bargaining or arbitrary allocation decisions. This critique resonates against a backdrop where overall government health spending in Nigeria has consistently lagged behind the Abuja Declaration target of 15 per cent, with independent analyses showing allocations generally falling below 6 per cent of total government expenditure. In practice, this has meant that much of the health financing burden falls on individuals through out‑of‑pocket payments, which are among the highest in the region and can push families into poverty.
The timing of CAPPA’s critique coincides with wider debates in Nigeria about the state of the health sector. The same World Health Day observances have featured concerns about shortages of health workers, strikes by resident doctors over pay and welfare issues, and repeated calls by labour unions and professional bodies for sustained investment and structural reform. These discussions highlight the deep systemic challenges facing the sector, from manpower shortages and infrastructure deficits to financing gaps and weak policy enforcement.
Government responses to these concerns have varied. Officials, including the Minister of State for Health and Social Welfare, have reiterated commitments to improve access to affordable healthcare and expand programmes that seek to strengthen service delivery. Broader initiatives, such as the Basic Health Care Provision Fund established under the National Health Act, aim to provide a more sustainable financing mechanism for primary health services and reduce dependence on direct payments by patients. Advocates of Universal Health Coverage continue to press for greater collaboration between public and private sectors, improved insurance coverage, and enhanced accountability mechanisms to ensure that resources are used effectively.
Despite these efforts, CAPPA’s assessment underscores that the country remains far from meeting its own targets or addressing the deep financing and policy deficiencies that hinder the delivery of quality health services. The group reiterated that meeting global and regional commitments like the Abuja Declaration would require not just budgetary adjustments but sustained political will, transparent execution of appropriations, and a shift towards preventive and equitable health strategies. Such a transformation, CAPPA argues, is essential if Nigeria is to build a resilient health system capable of meeting the needs of its growing population and reducing avoidable illness and deaths.
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