….Say budget bottlenecks killing public hospitals, fuelling japa
Out of the N218 billion capital project funds appropriated for the health sector in 2025, only a paltry N36 million (barely 0.0165 percent) was released to the Federal Ministry of Health and Social Welfare.
The massive shortfall, combined with delays in the release of counterpart contributions, prevented the Ministry from accessing donor-supported funds and incapacitated it from executing its 2025 capital budget expectations.
The Coordinating Minister of Health and Social Welfare, Prof. Mohammed Ali Pate who made the revelation during the week while presenting the Ministry’s 2026 budget defense before the House Committee on Healthcare Services, said the ministry’s capital component suffered severe shortfalls as a result of the cash planning system operated by the Office of the Accountant-General.
Pate noted that delays in the release of Nigeria’s counterpart contributions to donor-supported programmes compounded the problem, even as he disclosed that cash flow constraints and systemic bottlenecks in the federal budget process are not uncommon.
Pate said that with such non-release of funds, it was practically impossible to implement any meaningful capital project even as the ministry was unable to draw from some counterpart and donor funds.
Demanding an audit of external funds, the Chairman of the House Committee on Healthcare Services, Dr. Amos Magaji, has asked for detailed documentation on donor funds received by the ministry, including disbursements and outcomes, as part of legislative oversight on health sector financing.
Persistent funding gaps
Saturday Vanguard investigations show that the latest funding shortfall reflects a long-standing structural pattern in Nigeria’s health financing. The challenge has persisted for years with a pattern of approved capital allocations not released fully and in time
For decades, Nigeria’s health allocation has failed to meet the recommendation of the 2001 Abuja Declaration of allocating at least 15 percent of the National budget to the health sector.
In 2024, 5,1 percent of the federal budget was allocated to health, 5m75 percent in 2023, and 4.7 percent in 2022. For the capital budget allocation, in 2024, 15.06 per cent of the ministry’s capital allocation was released, 30 percent in 2023, and 45 percent in 2022. The allocation release in 2021 was 70 percent, the highest on record for the country over the last decade.
Nigerians slam FG over shortfall
The disclosure has been generally met with a mixture of shock, skepticism, and anger from different quarters. To concerned health watchers and advocates the financial shortfall is like a death blow to the nation’s health system and infrastructure.
Expressing “profound shock and astonishment”, the North East Health Awareness Forum (NEHCAF), said that “it is alarming to learn that only ¦ 36 million has been received by the Ministry of Health and Social Welfare out of the staggering N218 billion earmarked for this critical sector.”
The Chairman of the Forum, Abdullahi Ahmad, and the Secretary, Ummu Kulsum Rabiu, in a joint statement, said the development called for “a thorough investigation into the funding processes to ensure that allocated resources are utilised efficiently and transparently.
“This disclosure raises serious concerns about transparency and the effective management of healthcare resources in Nigeria. The health sector is pivotal to the well-being of our citizens, and such discrepancies in funding allocation cast a shadow over our commitment to providing quality healthcare services.
“We are particularly troubled by the implications this may have for ongoing and future health projects that are vital to improving health outcomes nationwide. Under a democratic dispensation, our citizens deserve a health system that is adequately funded and well-equipped to meet their needs. We remain committed to advocating for the necessary reforms to ensure that financial resources are not only allocated but also effectively utilised for the benefit of all Nigerians,” the Forum declared.
General responses on social media highlight the immediate and long-term consequences even as health advocacy groups unanimously described the development as a systemic failure.
Civil rights activist and former Kaduna Central Senatorial District lawmaker at the defunct 8th National Assembly, Senator Shehu Sani, called for a full explanation from the finance minister. Expressing concern on his verified X handle. “If it’s confirmed that only N36 million was released for the health sector in 2025, then it’s unfortunate and a demonstration of lack of seriousness in the health sector. The finance minister needs to fully respond to this,” he avowed.
A health commentator stated, ”You cannot run a healthcare system by paying salaries and giving doctors empty rooms to work in. A 0.02 percent release is a national embarrassment, it is japa by force, “ he noted.
Another stakeholder in the private sector remarked, “When the government refuses to fund the equipment doctors need (hospitals, equipment, labs) they are essentially telling them to pack their bags and go to countries that actually release their budgets.”:
Reacting on his X handle, Ugo Eve Na’aja stated, “That’s alarming and heartbreaking. A N218 billion health budget means nothing if only ¦ 36m is released, lives are put at risk, hospitals suffer, and citizens pay the price. Health isn’t a luxury; it’s a basic responsibility of the government, accountability here is non-negotiable.
Mr. Imbuya also on his verified X handle said, “In Nigeria, where it’s not uncommon for budgets to achieve just 30 percent performance, this is alarmingly low. Not 20 percent, not 10 percent…zero. So, what exactly is happening to appropriated funds? Where is all the money that Nigerians are suffering for due to subsidy removal?
“Why the silence from President Tinubu? Why is there no urgent clarification from the Ministers of Finance and Budget? Where is the oversight intensity from anti-corruption agencies? Yes, electoral reform matters and has rightly taken all our attention recently, but right now, Nigeria is hemorrhaging fiscally, and the focus has to shift to this monumental plundering urgently.”
According to John Udoh, another social commentator “The health sector in Nigeria is bleeding, N36 million is how many percent of the entire health budget in 2026? This government needs to take the health of its citizens very seriously and provide basic equipment for the hospitals and adequate remuneration for health officers.
On his X handle, Rufai Oseni quoted one Adesuwa_G who posted, “I haven’t slept through the night since the Minister of Health Ali Pate revealed that only N36 million was released for capital projects for the health ministry last year; N500 million was released to SA to the President on Media & Policy comms for ‘strategic global media engagement”.
Over the years, public health watchers have been vocal about the “paper budget” phenomenon with the medical community expressing frustration over the lack of capital funds saying that they are working in facilities without basic equipment or medicines, further fueling japa.
Where it hits hardest
Many capital projects which are the “building and buying” part of the budget failed, hence there were no new hospitals, equipment, or major repairs. Weak infrastructure, persistent brain drains and widening socioeconomic inequalities, have continuously deepened health disparities in the country.
According to the World Health Organisation (WHO), a country’s health system should have a 1:1 ratio between appropriation (what is promised) and release (what is spent).
At 0.0165 percent release for 2025, Nigeria did not just miss the benchmark; it completely decoupled health policy from financial reality.
What the 2001 Abuja Declaration – a proximity benchmark set by the African Union – entails is that a minimum of 15 percent of actual government spending must go to health. If for instance a country appropriates 15 percent of its national budget to health, but releases only releases just 1 percent of the capital, it has failed the Abuja Declaration. The “actual spend” is considered to be the only true measure of commitment.
Saturday Vanguard findings reveal that among the directly impacted areas is primary healthcare. For instance, plans by the National Primary Healthcare Development Agency (NPHCDA) to carry out renovations and to refurbish 8,000 primary healthcare centres nationwide were largely stalled. Many health projects co-funded by international donors including Gavi, the Global Fund, and The World Bank were affected because grants could not be unlocked and crucial programmes such as vaccination initiatives, malaria control, and HIV/AIDS treatments that rely on these partnerships were stalled.
Tertiary care was not spared as hospitals and equipment felt the brunt. For instance, the planned expansion of cancer centers across the six geopolitical zones was delayed. The procurement of high-end diagnostic equipment like Magnetic Resonance Imaging (MRI) machines and Computerised Tomography (CT) scanners for Federal Medical Centres (FMCs) and Teaching Hospitals was halted, forcing patients who largely paid out of pocket to continue patronising expensive private labs.
Under the WHO principle of “efficiency and transparency”, a budget is only as good as its execution, hence such paltry capital budget financing is considered a “systemic failure”. It prevents long-term planning, destroys donor trust, and halts the infrastructure growth needed to stop the “brain drain” of medical professionals.
The WHO also says a health system is considered “failed” if people pay out-of-pocket and at the point of care. The benchmark for out-of-pocket expenses is that it should not exceed 15-20 percent of total health spending. Currently, the total out-of-pocket health spending by Nigerians is over 70 percent.
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