Last month, President Bola Tinubu submitted the budget proposal for 2026 to the National Assembly. Out of a total budgetary proposal of N58.47 trillion, the president allocated N2.48 trillion to the health sector, about 4.2 per cent.
This relatively low allocation to health continues a trend.
Despite increases in health allocations under President Bola Tinubu, Nigeria’s health sector remains persistently underfunded, receiving only a fraction of the resources agreed under the Abuja Declaration, a long-standing continental commitment to prioritise public health financing.
An analysis of federal budgets since 2023 shows that while health spending has increased in nominal naira terms, its share of total government expenditure has consistently remained below six per cent, far from the 15 per cent benchmark African leaders agreed to more than two decades ago.
This persistent gap highlights a disconnect between political commitments and fiscal priorities, even as Nigeria struggles with weak primary healthcare, overstretched hospitals, and high out-of-pocket health costs.
Over the years, PREMIUM TIMES has reported extensively on various health conversations, financing summits and policy roundtables where government officials, civil society groups, experts and development partners repeatedly identified inadequate public funding as a central barrier to achieving Universal Health Coverage (UHC).
|
Participants at these forums have consistently warned that without a significant increase in health’s share of the national budget, reforms in health insurance, workforce retention and service delivery will remain limited in impact.
Yet, under successive Nigerian governments, these warnings have largely gone unheeded. While overall government spending has increased, health care has failed to keep pace with competing priorities, such as security, infrastructure, and debt servicing.
Moreover, when inflation, currency depreciation and population growth are considered, the real value of health spending appears even more constrained.
For a country that accounts for a disproportionate share of global maternal deaths, child mortality and deaths from avoidable diseases, the continued failure to approach the Abuja Declaration benchmark raises fundamental questions about Nigeria’s commitment to protecting the health of its citizens.
What the Abuja Declaration requires
Adopted in 2001 by African Union member states, the Abuja Declaration was a landmark political commitment aimed at reversing chronic underinvestment in health systems across the continent.
Signatories, including Nigeria, pledged to allocate at least 15 per cent of their annual national budgets to health, recognising that weak public financing was a major driver of poor health outcomes.
The declaration was designed to ensure predictable funding for primary healthcare, disease prevention, health workforce development and infrastructure, at a time when many African countries were grappling with high maternal mortality, infectious diseases and fragile health systems.
More than 23 years later, Nigeria has never met the target.
Successive federal budgets have allocated between three and six per cent of total spending to health, far below the agreed benchmark.
This persistent shortfall has been a recurring theme in several health dialogues, and the Tinubu administration has continued this pattern.
Proposed health budgets
Under the 2026 budget proposal, the health sector received N2.48 trillion out of a total N58.47 trillion, translating to about 4.2 per cent of federal spending.
Although the National Assembly can increase the allocation while considering the budget, the final approved budget is not expected to be significantly different in percentage terms.
To comply with the Abuja Declaration target, the sector would require approximately N8.7 trillion, assuming the total budget amount remains unchanged, resulting in a funding gap of more than N6 trillion.
In effect, Nigeria is providing less than one-third of the minimum funding level it once committed to, despite rising healthcare costs, rapid population growth and increasing demand for services.
In percentage terms, health’s share of the proposed budget remains below six per cent, less than half of the Abuja benchmark and significantly lower than allocations to sectors such as defence, infrastructure and education.
This imbalance persists despite policymakers acknowledging that a robust health system is crucial for productivity, human capital development, and long-term economic growth.
Health spending under Tinubu
A review of federal budgets since 2023, the first year of President Bola Tinubu’s administration, shows that health allocations have increased in nominal naira terms, but have remained largely stagnant and in some cases declined when measured as a share of total government spending.
In 2023, Nigeria’s health sector was allocated just over N1.07 trillion from a total federal budget of N21.83 trillion, representing about 4.9 per cent. Although this marked a modest increase from previous years, it still fell below the Abuja Declaration benchmark.
The 2024 budget, which expanded significantly following the removal of fuel subsidies and exchange rate reforms, allocated approximately N1.336 trillion to health out of a total budget of N28.78 trillion. In percentage terms, health’s share declined to around 4.6 per cent.
By 2025, total federal expenditure had risen again, driven largely by higher debt servicing, security spending, and capital projects.
The health sector was allocated approximately N2.38 trillion in the approved budget; however, as the total budget climbed to N54.99 trillion, the sector’s share remained below six per cent, according to budget analyses by civil society groups and health financing advocates.
The proposed 2026 allocation of N2.48 trillion continues this trajectory. While it represents the highest nominal health allocation Nigeria has recorded, it accounts for only about 4.2 per cent of the proposed N58.47 trillion budget, a lower proportional allocation than some earlier years under the same administration.
Defence, Security and Education gain priority
Over time, defence and security, infrastructure, debt servicing and education have consistently absorbed much larger shares of the budget.
In the 2023 budget, defence and security received over N2.47 trillion, accounting for nearly 11 per cent of total federal spending, while education was allocated about N1.79 trillion.
The pattern continued in 2024, when security allocations rose above N3.25 trillion amid escalating security challenges across several regions.
Education, on the other hand, also saw an increase to about N2.18 trillion, buoyed by government commitments to human capital development and pressure from education unions.
By 2025, the disparity became even more pronounced. Security spending expanded significantly, driven by military procurement, internal security operations and intelligence services, while education crossed the N3 trillion mark following years of advocacy for improved funding.
Health, although allocated over N2 trillion for the first time, remained a distant third priority, absorbing less than six per cent of total federal expenditure.
This trend shows that while government spending has grown rapidly under the Tinubu administration, health has not been positioned as a core pillar of national development on par with security and education.
Why rising allocations still translate to shrinking value in real terms
On paper, Nigeria’s health allocations have grown steadily under the Tinubu administration.
From N1.07 trillion in 2023 to N1.336 trillion in 2024, and N2.48 trillion in the proposed 2026 budget, the nominal increases suggest progress; although actual budgetary releases can be lower.
Yet a closer look reveals that these gains are largely eroded by inflation, currency fluctuations and rising healthcare costs, meaning the actual purchasing power of health budgets is shrinking.
Nigeria has experienced double-digit inflation over the past three years, with medical supplies, pharmaceuticals and hospital operating costs rising even faster than general consumer prices.
For instance, while health allocations appear higher in naira terms, hospitals and primary healthcare centres face persistent drug shortages, equipment decay, and staffing gaps, reflecting a widening gap between budgetary commitment and real capacity.
Nigeria imports a significant proportion of medical equipment, diagnostic kits and vaccines. With the naira trading around N1,400 to the US dollar in the 2026 budget assumptions, the cost of essential imported medical goods has risen sharply.
This reduces the amount of care that can be delivered for each naira allocated, even if nominal spending rises.
According to the International Centre for Investigative Reporting ICIR, federal health spending translated to roughly N524 per person per month in 2023, an amount insufficient to cover even basic preventive services.
READ ALSO: Resident doctors to resume indefinite strike on 12 January
This low per-capita spending helps explain why out-of-pocket health expenses remain high, public hospitals struggle with drug shortages and equipment failures, health workers continue to migrate abroad, and Nigeria remains heavily dependent on donor funding for essential health services.
As the national budget expands, sectors that are not prioritised lose ground relative to competing demands such as debt servicing, infrastructure and security.
Between 2023 and 2026, Nigeria’s total budget more than doubled, yet the health sector’s share remained below six per cent.
This suggests that health expenditures are not keeping pace with overall government spending, despite increasing population growth and disease burden.
