States Urged To Increase Health Budgets As Donor Support Declines

Special Adviser to the President on Health, Dr Salma Ibrahim Anas, has urged state governments to scale up their health budgets as global donor support continues to decline, warning that the sustainability of essential services now rests heavily on domestic financing.

Dr. Anas said most states are not investing enough in healthcare despite being the primary drivers of service delivery at the grassroots.

She expressed concern that many states still allocate far below the 15 per cent budget benchmark recommended under the Abuja Declaration, a gap that undermines the country’s progress toward Universal Health Coverage (UHC).

“States must take radical ownership of their health systems. Without increased investment at the state level, our efforts at the federal level will not translate into improved outcomes for citizens,” she said.

Dr. Anas warned that Nigeria faces a 15–20 per cent reduction in donor funding, a shift that poses serious risks to programmes heavily supported by development partners, including HIV, tuberculosis, malaria and routine immunisation.

She noted that once donors scale down, state and local governments, where PHC services are delivered  will be the first to feel the impact.

“Dwindling donor aid means states must fill the financing gaps immediately to prevent stockouts, service disruptions and increased disease burden,” she said.

Dr. Anas outlined several federal initiatives aimed at strengthening health financing:

Expansion of the Basic Health Care Provision Fund (BHCPF), with support from the National Assembly to double funding from 1% to 2% of the Consolidated Revenue Fund.

She said state governments must expand and adequately fund their State Social Health Insurance Schemes (SSHIS) to protect vulnerable populations from financial hardship.

“Health insurance cannot succeed if states delay counterpart funding or fail to enrol citizens. UHC is impossible without strong state-led insurance schemes,” she added.