Nigeria’s Health System Needs Political Courage To Fix – Entrepreneur

A Health Entrepreneur, Dr Richard Ajayi, ha said that Nigeria’s health system requires political courage and systemic reforms to end years of underfunding, weak policies, and overdependence on medical tourism.
Ajayi told the News Agency said in Abuja yesterday that in spite of the country spending just 0.5 per cent of its GDP on health, about four dollars per person annually, fewer than one in 10 Nigerians have health insurance.
He said the consequence is that millions of citizens are forced to choose between treatment and financial ruin, while the country lost about two billion dollars yearly to medical tourism.
“These numbers are not abstract. They reflect the lived reality of families struggling to survive when illness strikes,” he said.
According to him the challenge is further underscored by the World Health Organisation’s Global Health Expenditure Database (2022), which shows Nigeria tops Africa in out-of-pocket health spending.
He said about 76.1 per cent of total health expenditure in the country is paid directly by households, more than in Equatorial Guinea (70.4 per cent), Cameroon (67.7 per cent), or Guinea-Bissau (64.9 per cent).
He said the heavy reliance on personal funds reflected weak insurance coverage and limited government investment in health, leaving citizens vulnerable to catastrophic costs.
He dismissed piecemeal interventions, stressing that fragmented approaches would not heal Nigeria’s ailing health sector.
“Risk pooling does not work without scale. Policy without enforcement is paper. And a workforce without support becomes a revolving door,” he said.
He called for the creation of a single national health funding pool that integrated Federal, state, donor, and private resources, and the introduction of mandatory but incentivised insurance to capture the informal sector.
He also urged stronger collaboration with the private sector to drive efficiency, technology adoption, and patient trust.
He noted that healthcare should be viewed, not just as a moral imperative but as an economic strategy and a national security priority.
“The consensus on what must be done is clear. The real question is whether Nigeria has the political courage to act,” he said.