The year 2025 proved to be a critical test for Nigeria's healthcare system, navigating a complex web of public health crises, financial instability, and workforce challenges while simultaneously pushing forward with significant policy reforms. The sector experienced one of its most demanding periods, balancing emergencies with long-term restructuring efforts aimed at a more resilient future by 2026.
Public Health Emergencies and Global Funding Shocks
The year began with intense disease surveillance as the Nigeria Centre for Disease Control and Prevention (NCDC) reported a worrying increase in Lassa fever cases. By late January, the agency had recorded 290 confirmed infections and 53 deaths. The situation worsened as the year progressed, with the tally rising to 1,069 confirmed cases across 21 states and 195 deaths by December 7. This represented a case fatality rate of approximately 18.2%, higher than the 16.5% recorded in the same period of 2024.
Other infectious diseases also posed major threats. Between January and November, the NCDC confirmed 19,213 measles cases with 153 fatalities. Additionally, there were 10,353 suspected cholera cases and 244 deaths across 37 states. The agency consistently warned that these outbreaks were spreading and called for enhanced surveillance and community engagement to curb their transmission.
Beyond domestic outbreaks, a global political decision created immediate uncertainty. On January 20, an executive order from United States President Donald Trump halted foreign aid for 90 days. This move temporarily froze funding for key global health programmes, including HIV/AIDS interventions under the President’s Emergency Plan for AIDS Relief (PEPFAR). Given that PEPFAR supports about 90% of HIV treatment in Nigeria, stakeholders feared severe disruptions to treatment and prevention services for millions.
In a swift response to cushion this impact, the Federal Government in February approved an additional N200 billion allocation specifically for the health sector, focusing on TB, HIV, and malaria services. This action highlighted the sector's heavy reliance on donor funds while underscoring a growing urgency to bolster domestic health financing.
Policy Gains Amidst a Crippling Workforce Crisis
On the policy front, 2025 saw the launch of initiatives designed to improve governance and service delivery. In March, President Bola Tinubu inaugurated the National Health Fellows Programme. The first cohort saw 774 fellows deployed across all local government areas to monitor the performance of primary healthcare centres (PHCs), with a second group scheduled for early 2026.
However, these gains were overshadowed by a profound and ongoing human resource disaster. The brain drain of medical professionals reached alarming levels. In April, the Minister of Health and Social Welfare, Prof. Muhammad Pate, revealed that over 16,000 doctors had left Nigeria in the past five to seven years. He labelled the trend a "silent but serious emergency," warning that many communities were being left without adequate care and advocating for better working conditions and ethical international recruitment practices.
Industrial unrest further strained the already fragile system. The Nigerian Association of Resident Doctors (NARD) began a warning strike in September over unpaid salaries, which escalated into an indefinite strike from November 1 to 29, disrupting services nationwide. Similarly, the Joint Health Sector Unions (JOHESU) and the Assembly of Healthcare Professional Associations (AHPA) started an indefinite strike on November 15 over the non-implementation of the adjusted Consolidated Health Salary Structure, paralyzing many tertiary and general hospitals.
Infrastructure and Preventive Health as Beacons of Hope
Despite the turmoil, there were notable advancements in infrastructure and public health campaigns. In July, the Federal Government commissioned three state-of-the-art oncology centres in Katsina, Enugu, and Edo states to improve access to cancer care.
A major preventive health milestone was achieved in October with the launch of Nigeria's most ambitious integrated vaccination campaign. The initiative aimed to reach over 106 million children nationwide, targeting measles, rubella, HPV, polio, routine immunisation, and neglected tropical diseases in a single coordinated effort.
Concurrently, health financing reforms gained momentum. The National Health Insurance Authority (NHIA) intensified its drive to expand insurance coverage across the population, a critical step towards reducing the high out-of-pocket spending that burdens many Nigerians.
As the year closed, the Nigerian health sector stood at a crossroads, shaped by the severe pressures of 2025 but actively restructuring its approach to funding, workforce retention, and primary care delivery for the challenges of 2026 and beyond.
