Hypertension: The Silent Killer Nigeria Is Underfunding

For millions of Nigerians living with hypertension, controlling their blood pressure is becoming more than a health challenge. It is increasingly a financial burden, with the cost of medicines, consultations, tests and other care competing with food, school fees, transport and other household needs.

Despite the growing burden of the disease, only 0.05 per cent of Nigeria’s 2025 health budget was allocated to hypertension prevention and control, against an estimated annual investment requirement of 0.7 per cent.

The figures reveal a wide gap between the scale of the problem and the resources being committed to tackling it.

According to a hypertension financing factsheet by Legislative Initiative for Sustainable Development (LISDEL), more than 20 million Nigerians are estimated to have elevated blood pressure, with about four in 10 adults affected.

The factsheet indicated that only 30 to 37 per cent of people living with the condition have their blood pressure under control, while just four per cent of treated patients achieve the recommended target.

This means that large numbers of Nigerians who have already entered the healthcare system are still not achieving adequate blood pressure control.

For many families, managing hypertension does not end with diagnosis. Patients may require regular medication, consultations and monitoring, often over many years. Where healthcare costs are paid out-of-pocket, the financial pressure can become significant.

The LISDEL factsheet estimated that households spend between $20 and $55 or more every month managing hypertension.

The situation is further complicated by limited health insurance coverage. According to the report, fewer than five per cent of patients receiving primary healthcare have prepaid insurance coverage, leaving most patients to pay directly for their care.

For families already struggling financially, the consequences can extend beyond healthcare expenditure.

LISDEL estimated that 48.2 per cent of households affected by hypertension face a risk of impoverishment, while 63 per cent of Nigerians live below the national poverty line.

The implication is that a condition that can often be detected and managed through regular monitoring and appropriate treatment can also become a source of financial vulnerability for households.

The burden of hypertension is not limited to the patient or the family, the condition is associated with serious cardiovascular complications, including heart disease and stroke, which can require more expensive and intensive care.

The LISDEL factsheet revealed that hypertension contributes to more than 14,000 ischaemic heart disease events and over 13,000 strokes annually.

There is also an economic cost when people become too ill to work or die prematurely.

According to the report, hypertension and other non-communicable diseases are estimated to cause at least $400 million in productivity losses each year.

This places hypertension beyond the category of an individual health problem and into the broader conversation around household welfare, workforce productivity and economic development.

The Policy and Advocacy Officer, LISDEL, Olympus Adebanjo, identified lifestyle, hereditary factors and emotional stress among the major risk factors for hypertension.

The challenge, however, is that many people may not know they have high blood pressure until complications develop.

This makes prevention, early detection, regular screening and sustained treatment particularly important.

For public health experts and advocates, strengthening primary healthcare offers an opportunity to bring hypertension services closer to communities and reduce the complications associated with poorly controlled blood pressure.

The Programme Director of LISDEL, Damilola Ademuyiwa, pointed to the HEARTS programme, piloted in Kano, Ogun State and the Federal Capital Territory, as an example of how primary healthcare can be used to prevent and control hypertension.

The programme focuses on strengthening systems for cardiovascular disease prevention and management at the primary healthcare level.

According to the factsheet, an estimated government investment of $113 million could avert up to 77,500 deaths over the next 15 years.

As the debate over financing continues, stakeholders are also looking towards revenues from the proposed Sugar-Sweetened Beverages (SSB) tax as a possible source of additional funding for NCD prevention and control.

They called for a portion of the revenue to be specifically allocated to health, rather than allowing it to become part of general government revenue without a defined health purpose.

The Multi-Country Coordinator at the Global Health Advocacy Incubator (GHAI), Prof Emmanuel Alhassan, said the SSB tax should operate as a targeted public health intervention.

He called for legislation to specify a meaningful percentage of SSB tax revenue for health, with NCD prevention and control explicitly listed among the areas eligible for funding.

According to him, such funding should support primary healthcare and programmes addressing hypertension, diabetes, cardiovascular diseases, obesity and cancer, while transparent reporting should be used to track how the money is spent.

Alhassan also called on the National Health Insurance Authority (NHIA) to provide free essential hypertension medicines, identifying treatment costs as a major barrier to effective disease control.

He advocated better utilisation of the Basic Health Care Provision Fund (BHCPF) and supported the proposed amendment to the National Health Act seeking to increase the health sector’s Consolidated Revenue Fund allocation from one per cent to two per cent.

The figures paint a picture of a disease affecting millions of Nigerians while receiving a relatively small share of health financing.

For a country where hypertension affects a large proportion of adults, improving prevention, early detection, treatment and blood pressure control could help reduce avoidable complications while protecting families from the financial consequences of prolonged illness.

The Advocacy Partnership for Hypertension Financing and Patient Voice (APH-FiP) project, implemented by LISDEL in partnership with GHAI and Resolve to Save Lives, is seeking to strengthen public financing for NCDs, improve budgetary disbursements, build government capacity and empower patients and the media to demand accountability.

The challenge now is whether the can translate the scale of its hypertension burden into a corresponding level of investment in prevention and control.