Director of the Abuja School of Social and Political Thought, Dr. Sam Amadi, has warned that Nigeria’s failure to release appropriated health funds is pushing the country toward a national health emergency and jeopardising progress toward global health targets.
Speaking during an interview on ARISE News, on Sunday Amadi said the current situation could derail Nigeria’s ability to meet the targets of the United Nations Sustainable Development Goals (SDGs) by 2030.
“This situation at hand deserves a state of emergency, because the truth of the matter is that the 2030 Sustainable Development Goals regarding achieving the health indices will become a pipe dream if we continue on this trajectory,” he said.
According to him, the major problem is not the absence of funds but the failure to release money already appropriated in the national budget.
“A situation whereby both the capital budget on health and the one per cent Consolidated Basic Healthcare Provision Fund is made unavailable is unacceptable. The problem is not that the funds are not there. No, the funds have been budgeted. You don’t budget what you don’t have,” Amadi said.
“As a matter of fact, the National Assembly also does supplementary budgets when the need arises. The issue is at the point of releasing these funds. That is where we need to focus attention.”
Amadi called for scrutiny of the government agencies responsible for releasing budgeted funds, particularly the Office of the Accountant General.
“We need to focus attention on the governmental agency at the level of the Accountant General and begin to ask questions there: why are these funds being withheld?” he asked.
“Is it that you don’t understand what health service delivery means, or that you’re using some strategy you call a bottom-to-top approach which really should not apply in the health sector?”
He argued that health funding should be treated with the same urgency as defence or legislative spending.
“If it doesn’t apply in the military on issues related to defence budget, it should not apply in the health industry. Even in the National Assembly, running costs and capital expenditures are released fully. Why should it be different for healthcare?”
Amadi warned that withholding funds could cripple efforts to revitalise Nigeria’s struggling primary healthcare system, particularly in rural communities where most Nigerians live.
“The four thematic areas designed by the current Ministry of Health to improve healthcare delivery will become a pipe dream,” he said.
“We need funds to penetrate rural areas. That is where you have the primary health centres, and about 70 per cent of Nigerians reside in those rural areas.”
He cited data from the National Primary Health Care Development Agency showing that a significant number of primary health centres across the country are no longer functioning.
“In 2022, the agency published data showing that out of about 34,000 primary healthcare centres across the country, less than 10 to 15 per cent are still in existence — not even working, but still physically existing,” he said.
He noted that the federal government had set a target to reactivate about 17,000 centres by 2027, a plan that depends heavily on the release of appropriated funds and donor support.
“The ministry must have these funds in order to attract counterpart funding from donor agencies. Some international NGOs have agreements with the Nigerian government that they will provide support if Nigeria contributes its share,” he said.
“The person who is withholding these funds is also withholding the counterpart funding that should have been attracted to support primary healthcare.”
Amadi expressed concern over declining releases of health sector allocations in recent years despite rising budgetary provisions.
“It is very troubling. The releases have dropped from about 45 per cent to 30 per cent and currently to about 15 per cent,” he said.
“Which means every year from 2022 till now, it keeps dropping by roughly 15 per cent. If you project this trend forward, it means that by 2026 there may be nothing released — even though the funds have been allocated.”
The policy analyst warned that inadequate funding could worsen maternal and child mortality and weaken disease prevention programmes.
“The impact is huge. You need to travel to rural areas and see what is going on,” he said.
“One of the core responsibilities of primary healthcare is disease prevention — reducing maternal and child mortality. The ministry is already struggling and bending over backwards just to maintain immunisation programmes.”
He stressed that gaps in immunisation coverage threaten public safety nationwide.
“Until that one person in the most rural area of Nigeria is immunised and protected from infectious diseases, none of us in the cities is safe,” Amadi said.
“Do not forget that COVID started in Wuhan, a remote area of China, yet it caused a global pandemic that locked down the entire world.”
Amadi argued that Nigeria must dramatically increase health spending and ensure full release of approved funds to prevent further deterioration in the sector.
“What we should do is release 100 per cent of the funds that have been appropriated. No discussion,” he said.
“In fact, what we should be discussing is that the funds currently allocated are not enough.”
He noted that Nigeria’s health spending still falls far short of the benchmark set by the African Union under the Abuja Declaration.
“We are supposed to allocate about 15 per cent of the national budget to health, yet we are hovering around five per cent,” he said.
“Can we push it to 10 per cent, 12.5 per cent, 15 per cent and even go beyond to 20 per cent? It is doable. That is what I mean when I say we must declare an emergency in the health sector.”
Amadi concluded by stressing the link between national prosperity and public health.
“The wealth of any nation depends on the health of its people.”
Boluwatife Enome
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