By Mercy Gadia Adi
The Minister of State for Health and Social Welfare, Dr. Iziaq Adekunle Salako, on Thursday declared that Nigeria is at a “decisive turning point” in its pursuit of a resilient and inclusive health system, as the Federal Government intensifies reforms across financing, governance, digitalisation, and primary healthcare.
Speaking during his inaugural address at the second day of the 2025 Joint Annual Review (JAR) held at the Transcorp Event Centre, Maitama, Abuja, Dr. Salako said the global health shocks of the last half decade had exposed major weaknesses but also demonstrated the power of coordinated action.
“The last half a decade has tested health systems globally in unprecedented ways, both the COVID-19 pandemic and recent reductions in development assistance for health have exposed vulnerabilities but also challenged us to innovate, coordinate, and deepen political commitment,” he said.
The minister delivered a candid assessment of Nigeria’s health indicators. Citing the 2023 Nigeria Demographic and Health Survey, he noted improvements but stressed that the pace remains inadequate.
“Maternal Mortality Ratio stands at 512 deaths per 100,000 live births, down from 576 in 2018,” he said. “Under-5 mortality has reduced from 132 to 110 per 1,000 live births, neonatal mortality remains at 41 per 1,000, and skilled birth attendance has improved from 43 per cent to 53 per cent. But these figures are still not complimentary for a nation of our stature, resources, and ambition.”
He added: “Nigeria still accounts for approximately 14 per cent of global maternal deaths and 9 per cent of global under-5 deaths.”
Despite recent gains, health financing remains a major challenge. According to him, “Government health expenditure is 5.2 per cent of GDP—far below the 15 per cent Abuja Declaration minimum. Out-of-pocket expenditure remains as high as 71 per cent.” He warned that such levels continue to push millions of Nigerians into poverty annually.
Dr. Salako also highlighted critical human resource gaps. “Our doctor-to-population ratio is 1:5,000 against the WHO recommendation of 1:600,” he said. “Seventy-five per cent of health workers are concentrated in urban areas serving less than half of the population.”
Still, he stressed the Federal Government’s commitment to reversing these trends. “We are fully conscious of the issues at stake, and in the last 30 months we have implemented coordinated interventions to deliver a resilient Nigerian health system in line with the Renewed Hope Agenda.”
He listed significant progress under the Nigerian Health Sector Renewal and Investment Initiative (NHSRII), including improved management of the Basic Health Care Provision Fund (BHCPF). “Absorption capacity has risen from 45 per cent in 2019 to 78 per cent in 2023,” he said, praising the BHCPF gateways for better coordination.
On health insurance, the minister said the National Health Insurance Authority Act 2024 marked a “paradigm shift.” He revealed that “over 20 million persons have been enrolled into care through insurance mechanisms,” and projected faster growth following President Bola Tinubu’s executive order mandating enrolment for government agencies.
“The convergence of BHCPF and NHIA represents a powerful mechanism for achieving Universal Health Coverage, wee foresee significant acceleration and exceeding our 2027 target of 20 per cent coverage,” he asserted.
He also outlined improvements in primary healthcare revitalisation: “PHC governance structures in more than 400 LGAs are fully functional, and PHC quality scores have improved from 42 per cent to 67 per cent.”
In disease-specific programmes, he said: “We have enrolled 1.78 million people living with HIV on treatment, achieved approximately 80 per cent TB notification, distributed 63 million insecticide-treated nets, and maintained zero wild poliovirus cases since 2020.”
On workforce development, Dr. Salako stated: “Over 37,000 health workers have been employed, 75 per cent of them clinical. We have developed a health workforce migration policy to convert ‘JAPA’ to ‘JAPADA’.”
He also highlighted over 500 ongoing infrastructure projects, including the “Power for Health Initiative, which aims to guarantee reliable electricity for health facilities. We have a clear implementation plan, and we are confident that the necessary investment will be mobilised,” he added.
Digital transformation, he added, is at the heart of the government’s strategy. “We have developed the National Digital Health Architecture, ending the era of fragmentation, We are building the foundational digital highwaysnational registries, shared health records, and data exchanges”.
He cited major advances in health security: “PCR testing capacity has expanded from five to 129 laboratories. Emergency Operations Centres are now fully established in 32 states, and the SORMAS surveillance platform is deployed in all 36 states, with 96 per cent of LGAs reporting in real time.”
Despite progress, the minister warned that challenges remain substantial. “Our progress is not happening at the pace needed for 230 million Nigerians, too many mothers still die in childbirth, too many children don’t reach their fifth birthday, and too many families are impoverished by healthcare costs,” he said.
He reaffirmed the government’s determination to push for additional investment. “We will continue to advocate for increased budgetary allocations, guaranteed BHCPF releases, improved capital expenditure, and fulfilment of our Health Infrastructure Bond obligations.”
Calling for national unity and shared responsibility, Dr. Salako said: “The theme of this Joint Annual Review—All Hands, One Mission—is far beyond rhetoric. It reflects our determination to take collective responsibility for a resilient health system.”
“Only healthy people can build a prosperous nation. Let us join hands to deliver health to our people and make Nigeria great again. And so, with peace and plenty, Nigeria shall be blessed,” He concluded: