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As part of the federal government’s plans to achieve the Universal Health Coverage (UHC) by 2030, Nigeria and 14 other countries recently introduced National Health Compacts. The other countries include Bangladesh, Egypt, Ethiopia, Fiji, Indonesia, Mexico, Morocco, Philippines, Sierra Leone, Syria, Tajikistan, Uganda, Uzbekistan, and Zambia. The programme is tailored to achieve the World Bank’s 2024 goal of delivering affordable, quality health services to 1.5 billion people by 2030.
The 2025 Global Monitoring Report released last year at the Tokyo Universal Health Coverage High-Level Forum showed that 4.6 billion people lack access to essential health services and 2.1 billion people face financial services due to health expenses. According to the World Bank Group release, “these challenges underscore the need for long-term, coordinated reforms that help countries build more resilient and equitable health systems.”
Under the initiative, the 15 countries unveiled practical, five-year reforms that will expand primary health care, improve affordability, and support job-rich economic growth. According to World Bank Group President, Ajay Banga, “strong primary health systems do more than safeguard health—they support jobs and economic opportunity.” He further affirmed that “countries are stepping forward with clear priorities, and we are working alongside them to deliver practical solutions at scale. When efforts align behind what works, impact grows.”
To boost affordable health care, Nigeria will train 10,000 pharmaceutical and biotech professionals, create Centres of Excellence, and offer tax incentives to expand local production of vaccines, medicines, diagnostics, and health technologies. At the same time, Morocco will extend mandatory health insurance to an additional 22 million people. Under the scheme, Kenya will double public health spending over five years to reach five per cent of Gross Domestic Product (GDP) and expand social health insurance coverage from 26 per cent to 85 per cent, with full subsidies for vulnerable populations.
In the same vein, Ethiopia will equip at least 40 per cent of primary health centres with digital tools to support clinical care and workforce management. Similarly, Sierra Leone plans for every citizen to access quality primary care within five kilometers. It is also constructing 300 new facilities and equipping 1,800 with solar power and digital connectivity.
While Bangladesh is expanding multi-platform primary care models supported by updated regulation and digital tools, Indonesia is scaling digital primary care, connecting over 600 facilities to hospitals through telemedicine to bring services closer to patients’ homes.
Since the goal was announced, the World Bank Group and partners have helped countries reach 375 million people with quality and affordable care. Also, the bank is working with about 45 countries to scale proven primary care approaches that strengthen health outcomes while generating employment across health workforces, local supply chains, and supporting industries.
It is laudable that Nigeria is among the 15 countries that have embraced the National Health Compacts that will boost affordable health care and help the country to achieve the Universal Health Coverage by 2030. It is also commendable that Nigeria is committed to train 10,000 pharmaceutical and biotech professionals and implement other interventions to increase access to affordable health care in the country.
However, there are obstacles on the way of achieving the lofty goal. Since affordable health care and Universal Health Coverage depend so much on primary health care, Nigeria must intentionally expand its primary healthcare (PHC) facilities throughout the country. Available figures show that Nigeria has numerous primary healthcare facilities with about 34,000 centres. While 80 per cent of the centres are under-funded and lack essential services due to poor infrastructure, staffing and drug shortage, only about 20 per cent are said to be fully functional.
The government must address shortage of health workers. Most of our doctors and nurses now work in hospitals in United Kingdom (UK), United States (US) and Canada. Approximately 16,000 to over 19,000 Nigerian-trained doctors have left the country over the last five to seven years due to brain drain. It has been reported that about 2,000 to 3,000 Nigerian medical personnel, including doctors, leave the country annually. In 2024 alone, over 4,193 doctors and dentists left for foreign practices.
Similarly, about 42,000 Nigerian nurses and midwives to the US, UK and Canada between 2022 and 2024. This has caused serious shortage of nurses and midwives in the health sector. Let the government address the brain drain in this sector as well. Most of these primary health facilities lack power, clean water and proper facilities for vaccines, forcing reliance on basic tools like lanterns, torchlight and wells.
For Nigeria to achieve affordable health care and UHC goals, the health budget must go beyond the annual ritual of five per cent. It must reach the 15 per cent agreed in 2001 by African leaders in Abuja. The government cannot achieve these health goals if our health budget keeps hovering between five and seven per cent annually.
