For millions of Nigerians, the simple act of seeking medical care can spiral into a financial nightmare. As the country’s population surges past 200 million and the climate grows ever more unpredictable, the nation faces not just a healthcare crisis, but a full-blown public health emergency. This dual threat—of a faltering health system and the intensifying impacts of climate change—was thrust into sharp relief at the recent BusinessDay Media health conference in Abuja, held on August 22, 2025, under the theme “Bridging the Gap: Advancing Equitable and Affordable Access to Healthcare in Nigeria.”
According to BusinessDay, the country’s health system is buckling under decades of underinvestment, policy paralysis, and institutional fragmentation. Hospitals are overwhelmed, critical infrastructure is deteriorating, and the remaining health workers—many of whom haven’t joined the ongoing wave of emigration—are underpaid and overstretched. Health insurance, meant to shield the most vulnerable, covers just 9.5 percent of Nigerians as of 2024 and is poorly implemented, leaving millions exposed to catastrophic out-of-pocket expenses.
Brian Deaver, CEO of the Afreximbank-backed Abuja Medical Centre for Excellence, set the tone at the summit with a stark warning: “The pursuit of redefining healthcare delivery could not be more timely or more urgent. If we want to lead, we must demand more of ourselves. Not someday—today.” Deaver argued that reform must start with people—frontline health workers who are, in his words, “the beating heart of any healthcare system.” Yet, in Nigeria, these workers are “chronically underappreciated, inadequately trained, and overwhelmed.” He called for investment in workforce training, supportive environments, and the use of health data to guide decisions. “Healthcare should not be an exercise in lowered expectations,” Deaver insisted.
But the problems run deeper than staffing. Nigeria’s health financing is woefully inadequate. Public spending on health stands at just 0.5 percent of GDP—about $14 per person annually. The 2024 national budget allocated N1.34 trillion to health, just 4.64 percent of the total N28.78 trillion budget. That’s a mere N6,289 per person each year or N524 per month, based on a population estimate of 212 million. Donor contributions are declining, private investment is slow to scale, and out-of-pocket payments account for more than 70 percent of total health expenditure.
“More than half of the Nigerian population is multidimensionally poor and cannot afford healthcare when needed,” said Mustapha Zakari, Executive Vice Chairman of Masslife Healthcare Ltd., at the conference. He advocated for direct financial incentives to boost household purchasing power and reduce the burden on families. Solutions discussed included expanding social health insurance, introducing targeted subsidies for low-income earners, and leveraging technology to efficiently track and deliver entitlements.
Meanwhile, climate change is compounding Nigeria’s health woes. As reported by Vanguard on August 22, 2025, the impacts of climate change—floods, rising temperatures, and erratic weather—are intensifying across the country. Recent flooding in Niger State in late May 2025 claimed over 200 lives, displaced entire communities, contaminated water supplies, and overwhelmed already fragile healthcare facilities. The World Health Organization (WHO) has called climate change the greatest health threat of the 21st century, and Nigeria is living that reality.
Climate-related illnesses—including malaria, cholera, respiratory infections, and malnutrition—are surging, with children and women bearing the brunt. A recent study in Lagos State, cited by Mr. Adeniyi Adeneye of the Nigeria Institute of Medical Research, found that increased heavy and prolonged rainfalls are creating more mosquito breeding sites, raising malaria risks. “Climate change is significantly amplifying the threat of malaria in vulnerable regions like Lagos,” Adeneye explained. The study also revealed that Long-Lasting Insecticidal Nets (LLINs), a core malaria prevention tool, are rarely used because residents find them “inconvenient and heat-causing.” As a result, surveyed households reported “zero ownership and use” of LLINs—far below national averages—leaving communities exposed to mosquito bites and disease.
Rising temperatures are also making it harder to diagnose and treat malaria. Adeneye warned that “rising temperatures can cause fevers, leading to the misdiagnosis of malaria for other febrile cases and the irrational use of antimalarials through presumptive treatment at home.” This not only threatens the effectiveness of treatment but also increases the risk of drug resistance.
The climate crisis doesn’t stop with infectious diseases. Heatwaves in West Africa in February 2024 were made four degrees Celsius hotter by human-induced warming, with Nigeria’s heat indices reaching as high as 50°C. Each 1°C rise in temperature increases the risk of pre-term births by 5 percent, and floods are destroying maternal health centers, disrupting antenatal care, and worsening outcomes for pregnant women and infants. Over 11 million Nigerian children under five are stunted—a crisis that climate-linked food insecurity, heat, and poverty only deepen.
Environmental pollution, driven by rapid industrialization, urbanization, and inadequate waste management, adds yet another layer to the crisis. Research published in the African Journal of Environmental Sciences and Renewable Energy in January 2025 highlights that oil exploration has spilled more than 13 million barrels of crude oil in the Niger Delta over five decades, severely contaminating water, air, and soil. Urban centers like Lagos have seen a 20 percent increase in respiratory illnesses due to vehicular emissions, with particulate matter levels exceeding WHO thresholds by over 300 percent.
Floods—already affecting more than 1.4 million people and killing over 612 in 2022—are expected to cause even greater damage in 2024 and beyond. These disasters fuel outbreaks of cholera, typhoid, and diarrheal diseases by contaminating water sources. Shifting weather patterns are lengthening mosquito breeding seasons, driving up cases of malaria, dengue, and yellow fever. Food insecurity and malnutrition are on the rise as erratic weather disrupts farming cycles and reduces agricultural yields.
Dr. Ozuomba Sixtus, Chair of the Society of Family Physicians of Nigeria’s Lagos Chapter, told Vanguard, “We are no longer dealing with predictions; we are living the consequences.” He described how respiratory diseases, stress-related illnesses, and even pregnancy complications are all on the rise as a result of climate change. “We’re seeing increased cases of asthma and respiratory tract infections because of dry air, dust, and pollutants. The immune system becomes compromised due to environmental stress, making people more susceptible to infections, both viral and bacterial,” he explained.
Policymakers and experts agree that urgent, coordinated reforms are needed. At the Abuja conference, Adetolu Ademujimi of APIN Public Health Initiatives emphasized the need for investment that is “not just supply-driven but based on real-time data and national priorities.” Legal counsel Chineye Ajayi argued that “policy without implementation is paper,” pointing to the 2022 National Health Insurance Authority Act as a framework that still lacks real enforcement. Lekan Ewenla of Ultimate Health Management Services said the failure to fully implement mandatory insurance enrollment has undermined what could have been a transformative reform.
Weibe Boer of JIPA Network suggested that Nigeria could learn from unified funding models in the Caribbean, which have lowered per capita costs by pooling risk and consolidating funding. “When you take 200 million people together, the cost per person becomes quite low,” Boer said, urging Nigeria to create a single national funding pool and to use incentives to increase insurance enrollment rather than relying solely on mandates.
The government, for its part, claims to be taking action. Iziaq Salako, Minister of State for Health and Social Welfare, assured conference attendees, “The government is not just thinking about the supply side but also the demand side. We look forward to deeper partnership with the private sector.” Yet, skepticism remains high after years of unfulfilled promises and underfunded programs.
As Nigeria loses an estimated $2 billion annually to medical tourism, the stakes couldn’t be higher. The opportunity to rewrite the country’s healthcare story is real, but it will require political will, bold reforms, and the courage to break from the status quo. “Let history say that this was the generation that turned the tide for Nigerian healthcare,” Deaver urged. Whether that hope becomes reality depends on what happens next.
