Vital Signs - October 2025

Introduction

Welcome to this edition of Vital Signs, your trusted source for timely updates on Nigeria's healthcare and life sciences sector. This issue spotlights a dynamic mix of policy reforms and innovations shaping the nation's health landscape, from the NHIA's push to end out-of-pocket healthcare spending and the Federal Government's ₦300 billion renewable energy allocation for hospitals and universities, to Sokoto's groundbreaking ₦100 million family planning budget.

Across the country, the momentum for reform is accelerating. Initiatives such as the digitalisation of essential medicines inventories, the strengthening of sickle cell clinical trial capacity, and the crackdown on illicit online drug sales signal Nigeria's growing commitment to transparency, accountability, and scientific advancement. At the same time, the emergence of new partnerships, including the Healthcare Federation of Nigeria's Emergency Medical Trust Fund and the International Pharmaceutical Federation's Hypertension Toolkit, underscores the expanding role of collaboration in driving public health outcomes.

Yet, these gains unfold alongside persistent challenges, from weak regulatory enforcement to the disturbing rise of organ trafficking. Together, the developments captured in this edition illustrate a sector in transition, one defined by ambition, innovation, and the pressing need for effective implementation to deliver equitable, sustainable healthcare for all Nigerians.

Regulatory Updates

1. NHIA Pushes to End Out-of-Pocket Healthcare Costs

The Director-General of the National Health Insurance Authority (NHIA), Dr Kelechi Ohiri, has unveiled ambitious reforms to reduce Nigeria's heavy reliance on out-of-pocket payments, which currently account for 70% of health expenses. Speaking at a four-day national dialogue on health financing, Dr Ohiri emphasised the need for stronger federal–state alignment, transparent donor coordination, and mandatory health insurance.

A significant step forward is the new Executive Order mandating NHIA coverage for all federal workers and requiring all entities doing business with the Federal Government to present Certificates of Insurance as proof of compliance, akin to tax clearance certificates. This marks the first time healthcare insurance has been linked directly to federal contracting, creating a powerful compliance mechanism.

Dr. Ohiri noted that enrolment under NHIA has grown from 16 million to 20 million in just two years, with a stretch target to double this number by 2030. While the reforms promise to revolutionise health financing, experts caution that challenges remain around enforcement, integrating the informal sector, and ensuring affordability for vulnerable groups. Effective implementation will require extensive collaboration with civil society, professional associations, and private sector partners to avoid leaving millions uninsured.

2. FG Allocates ₦300 Billion to Power Hospitals and Universities

The Federal Government has earmarked ₦300 billion in the 2025 budget to address recurring power outages in teaching hospitals and universities, a move expected to significantly improve service delivery in critical institutions. The initiative was announced by House Committee on Appropriations Chairman, Hon. Abubakar Bichi, at the commissioning of a solar hybrid power project at Aminu Kano Teaching Hospital.

The allocation will fund renewable energy projects in federal universities and tertiary hospitals, prioritising institutions that provide life-saving services. This follows persistent appeals by Chief Medical Directors, some of whom reported spending up to ₦200 million monthly on electricity and diesel. By shifting to renewable energy, the initiative aims to reduce overhead costs, enhance efficiency, and provide sustainable clean energy solutions.

Stakeholders have welcomed the move as a landmark intervention but warn that its impact will depend on transparent procurement, careful project execution, and robust oversight to prevent cost overruns. Analysts also note that partnerships with private renewable energy providers and energy-efficient technologies will be critical for long-term sustainability.

3. Organ Trafficking Crisis: Over 650 Kidneys Illegally Harvested

Nigeria's struggle with illicit organ trade was brought to the fore when Professor Aliyu Abdu of Bayero University Kano disclosed that at least 651 kidneys were illegally harvested between 2015 and 2020, with links to a global black market valued at over $41 billion. The disclosure was made at a national seminar on organ and tissue transplantation standards.

Despite existing legislation under the National Health Act 2014 prohibiting the commercialisation of human organs, weak enforcement, regulatory lapses, and the absence of organ donation frameworks have left vulnerable populations exposed to exploitation. Many victims, often from low-income backgrounds, undergo unsafe surgeries with little or no post-operative care, leaving them at risk of lifelong complications.

Experts warn that the lack of cadaveric donation systems and the absence of functioning organ banks have created demand that criminal syndicates readily exploit. Calls are mounting for urgent policy reforms, tighter regulatory oversight, and collaboration between medical regulators, security agencies, and international partners to dismantle trafficking networks. Without decisive action, the illicit trade risks undermining the credibility of Nigeria's healthcare system and exposing the country to global scrutiny.

4. Nigeria Strengthens Sickle Cell Clinical Trial Capacity

The National Centre of Excellence for Sickle Cell Disease Research and Training (NCESRTA) at Yakubu Gowon University has launched a 12-week intensive training to build Nigeria's capacity for world-class clinical trials in sickle cell disease (SCD). Supported by IQVIA and Bio Ventures for Global Health, the programme is designed to equip researchers, clinicians, and regulators with skills in trial design, patient recruitment, ethics, and regulatory compliance.

Sickle cell disease remains one of sub-Saharan Africa's most prevalent genetic disorders, accounting for high mortality rates among children under five. By training a new generation of experts, Nigeria seeks to position itself as a hub for SCD clinical research, with spillover benefits for trials in oncology, cardiovascular disease, diabetes, and pulmonary disorders.

Participants from Nigeria, Sudan, Zambia, and other African countries are taking part, underlining the programme's regional impact. NAFDAC has also pledged to ensure that clinical trials conducted locally meet global standards, bolstering Nigeria's credibility in the global research community. If sustained, this initiative could reduce dependence on external trial sites and attract international investment into Nigeria's research ecosystem.

5. Sokoto Approves ₦100 Million for Family Planning

Sokoto State has set a historic precedent in Northern Nigeria by allocating ₦100 million in its 2025 budget specifically for family planning programmes. The move was announced at a stakeholders' meeting marking the conclusion of The Challenge Initiative's (TCI) intervention in the state, which has helped strengthen reproductive health services since 2022.

Officials emphasised that the allocation reflects the government's commitment to sustainability beyond donor support, ensuring continued access to contraceptives and reproductive health services. Family planning is recognised as a critical lever for improving maternal and child health, reducing poverty, and fostering economic growth.

Stakeholders applauded the allocation as a demonstration of political will, urging that community ownership and local advocacy remain central to sustaining progress. Analysts argue that Sokoto's model should be replicated in other states, particularly in Northern Nigeria, where access to family planning services remains limited.

6. FG Begins Digitalisation of Essential Medicines Inventories

In a bid to enhance accountability and eliminate persistent stockouts in federal hospitals, the Federal Government has launched the digitalisation of essential medicines and consumables inventories. The initiative, anchored by the Federal Ministry of Health and Social Welfare, introduces a digital consignment model that will ensure real-time tracking of drug supplies across tertiary hospitals.

According to Permanent Secretary Daju Kachollom, the digitalisation drive is expected to improve availability, affordability, and transparency, while reducing pilferage and waste. The Pharmacy Council of Nigeria and hospital administrators are partnering on implementation, with the goal of aligning the reform with the national supply chain management strategy.

Stakeholders note that while the initiative is timely, its success will depend on adequate training of hospital staff, robust cybersecurity safeguards, and continuous engagement with suppliers and regulators. If effectively executed, the reform could lay the foundation for a national digital health supply chain system, advancing Nigeria's universal health coverage goals.

7. NHIA Sanctions 96 Providers for Poor Health Services

The NHIA has sanctioned 49 healthcare facilities (HCFs) and 47 Health Maintenance Organisations (HMOs) for infractions ranging from denial of services to delays in referral authorisations. The sanctions followed the review of 3,507 complaints in 2024, of which 84% were resolved within the standard response time.

Penalties included 84 formal warnings, refunds totalling ₦4.38 million to 54 enrollees, four facility suspensions, and six delistings. HMOs were ordered to refund ₦748,200 to 15 enrollees and institute corrective measures.

Director-General Dr. Kelechi Ohiri stated that sanctions are central to NHIA's mandate under the Act to enhance accountability and rebuild trust. A new circular now mandates HMOs to issue referral codes within one hour; otherwise, facilities must provide care under established protocols. The crackdown sends a strong signal that poor service standards will no longer be tolerated.

8. PCN and NAFDAC Intensify Crackdown on Online Drug Sales

The Pharmacists Council of Nigeria (PCN), in collaboration with Interpol, has intensified efforts to curb illegal online drug sales, which often operate without physical premises and across borders. This partnership allows the Council to shut down non-compliant websites in 194 countries, with one such platform already taken offline.

The PCN Registrar highlighted the requirement that the backend of all licensed online drug platforms must be supervised by a registered pharmacist to ensure compliance and prevent abuse.

NAFDAC Director-General, Prof. Mojisola Adeyeye, noted that her agency began licensing online drug vendors two years ago. She cited a case in which a falsified anti-cancer drug sold online was traced to southern Nigeria, leading to an arrest. NAFDAC is also set to roll out advanced digital training for staff in September to improve monitoring and traceability of online sales.

Together, the PCN–NAFDAC measures represent a decisive step toward protecting patients, safeguarding supply chains, and strengthening public trust in e-pharmacy platforms.

9. HFN and HEI Launch Medical Trust Fund for Emergency Care

The Healthcare Federation of Nigeria (HFN) and the Health Emergency Initiative (HEI) have signed a Memorandum of Understanding to establish a Medical Intervention Trust Fund (MITF) aimed at strengthening Nigeria's emergency medical response system. The initiative seeks to address long-standing challenges including poor post-crash response, low insurance coverage, and the inability of many patients to pay for urgent treatment.

According to HFN President Njide Ndili, the Fund will provide a credible and transparent mechanism to finance emergency interventions and reduce preventable deaths resulting from delays in care. The partnership will bring together private sector players, government institutions, civil society, and development partners to ensure timely and equitable access to life-saving services across the country.

HEI Executive Director Paschal Achunine noted that the Fund will build on existing community-based emergency support models that have already saved thousands of lives. Beyond financial aid, the MITF will also strengthen national emergency preparedness through the training of first responders, bystanders, and community members in Basic Life Support, First Aid, and Trauma Care.

The MITF is expected to complement the Basic Healthcare Provision Fund, which allocates 5% to emergencies but faces implementation delays. It will also promote emergency infrastructure upgrades, integrate technology into rapid response systems, and advocate for a Good Samaritan law to protect volunteers and first responders. The Fund is projected to become operational within six months.

10. Mandatory Health Insurance: A New Era for Nigeria

In a landmark move to accelerate Universal Health Coverage (UHC), the Federal Government has mandated health insurance for all Nigerians and legal residents. This directive, issued via a circular from the Secretary to the Government of the Federation in September 2025, activates key provisions of the National Health Insurance Authority (NHIA) Act, 2022.

All Ministries, Departments, and Agencies (MDAs) are now required to enroll their employees in the NHIA plan, and businesses must present valid NHIA Health Insurance Certificates to participate in public procurement or renew licenses and permits. A digital verification platform will be launched to support compliance.

This policy marks a decisive shift toward institutionalizing health insurance as a national norm, embedding it into public sector operations and regulatory frameworks. It signals strong political will and offers a critical lever for expanding coverage, improving financial protection, and strengthening accountability across Nigeria's health system.

11. America's New Global Health Strategy: What It Means for Nigeria

In September 2025, the United States launched a new global health strategy that puts its national interests at the center of foreign aid. Called the "America First Global Health Strategy," it aims to make U.S. health assistance more efficient, more targeted, and more beneficial to both Americans and partner countries. For Nigeria, this shift could be a turning point. The strategy focuses on direct funding for frontline health workers and essential supplies, while encouraging countries to take greater ownership of their health systems. This aligns with Nigeria's own goals, like expanding NHIA coverage, investing in digital health, and strengthening state-led health insurance schemes. If Nigeria engages proactively, it could secure a bilateral agreement that supports outbreak surveillance, workforce development, and better data systems, while also reducing dependence on donor-funded overhead. In short, America's new approach could help Nigeria build a more resilient, self-sustaining health system, if we're ready to lead the conversation.

12. FIP Lauches Hypertension Pharmacy Toolkit on World Heart Day

In commemoration of World Heart Day 2025, the International Pharmaceutical Federation (FIP) has launched a Hypertension Pharmacy Toolkit to support pharmacy teams in the prevention, early detection, and management of hypertension. The resource aims to strengthen pharmacy-led interventions against one of the world's most prevalent cardiovascular diseases, which affects one in three adults and contributes to over 10 million deaths annually.

According to FIP, the number of people living with hypertension has doubled over the past decades, underscoring the need for early detection and collaborative management. The toolkit provides community pharmacists with practical materials to identify at-risk patients, offer lifestyle counselling, and coordinate effectively with prescribers to improve patient outcomes. It includes an educational guide, a hypertension assessment tool, patient information leaflets, and a referral template for use between pharmacists and physicians.

The Nigerian Medical Association (NMA) has described hypertension as a major public health concern, with an estimated prevalence of 27.3% nationally and roughly one in four adult hospital admissions linked to hypertension complications. The NMA warned that Nigeria's contribution to the global hypertension burden continues to grow, calling for improved awareness, preventive screening, and patient education at all levels of care.

The FIP has invited member organisations to adapt the toolkit to their local contexts and regulatory frameworks. The initiative aligns with ongoing global efforts led by the World Heart Federation (WHF) and World Health Organization (WHO) to reduce premature deaths from cardiovascular diseases, 80% of which are preventable through lifestyle changes and equitable access to care.

Commentary

Nigeria's healthcare sector is experiencing a dual trajectory: bold policy ambition paired with structural challenges.

The NHIA's drive to eliminate out-of-pocket expenditure signals a long-overdue commitment to financial protection in healthcare. The Executive Order mandating NHIA coverage for government staff and private sector partners is unprecedented, yet its success will depend on enforcement capacity, sustained funding, and private sector buy-in.

The ₦300 billion earmarked for powering teaching hospitals and universities through renewable energy solutions addresses one of the most persistent barriers to effective service delivery, unreliable electricity. However, without a coordinated execution and transparent monitoring framework, these funds risk being absorbed without tangible improvements.

At the subnational level, Sokoto's ₦100 million allocation for family planning marks a watershed in domestic resource mobilisation for reproductive health. This transition from donor-led interventions to state-led funding demonstrates growing political will that other states should emulate.

Conversely, the revelation of widespread kidney trafficking underscores the fragility of Nigeria's regulatory environment. Tackling such illicit practices requires stronger enforcement of existing laws, a functioning organ donation framework, and deeper cross-border cooperation to dismantle criminal networks.

Meanwhile, Nigeria's investment in strengthening sickle cell disease clinical trial capacity is a positive signal for scientific self-reliance. By equipping local researchers with globally recognised skills, Nigeria is positioning itself as a credible partner in international health research. The FG's digitalisation of essential medicines inventories is another forward-looking move that, if properly scaled, could dramatically improve access, accountability, and affordability across tertiary hospitals.

The PCN–NAFDAC crackdown on illicit online drug sales reflects a proactive response to new risks in a digital age. By leveraging international partnerships and technology, regulators are beginning to close gaps in oversight of internet-based healthcare.

New developments in this quarter further expand the scope of systemic reform. The Healthcare Federation of Nigeria (HFN) and Health Emergency Initiative (HEI) have introduced the Medical Intervention Trust Fund (MITF) to address emergency care gaps, a critical move toward reducing preventable deaths and improving post-crash and trauma response capacity. This Fund, built on transparency and collaboration, could redefine Nigeria's emergency healthcare financing model.

The mandatory national health insurance policy, recently operationalised, cements health coverage as a legal and economic requirement for individuals and institutions alike. This directive not only accelerates Nigeria's Universal Health Coverage (UHC) goals but also embeds health insurance into the country's regulatory and procurement ecosystem, signalling a long-term structural shift in health governance.

Internationally, the U.S. "America First Global Health Strategy" introduces both opportunity and responsibility for Nigeria. With its emphasis on efficiency and country ownership, Nigeria can leverage this policy realignment to attract targeted funding for digital health, outbreak response, and workforce capacity, provided local institutions demonstrate transparency and strategic alignment.

Lastly, the FIP Hypertension Pharmacy Toolkit exemplifies the growing global-local collaboration in preventive care. By equipping pharmacists with tools for early detection and patient education, Nigeria's pharmacy sector can play a pivotal role in addressing one of the nation's leading non-communicable diseases.

Altogether, these developments reflect a healthcare system undergoing transformation, one that is becoming more digitally integrated, policy-driven, and financially accountable. Yet, the persistent gap between policy ambition and operational execution remains Nigeria's greatest challenge.

Conclusion

The reforms outlined in this edition of Vital Signs paint an encouraging picture of Nigeria's evolving healthcare landscape, marked by structural reforms, inter-agency coordination, and growing international engagement.

From mandatory health insurance and emergency care financing to power investments, clinical research, and pharmaceutical digitisation, the sector is moving steadily toward resilience and self-sufficiency. The involvement of state governments, private actors, and global partners shows an increasing convergence around shared health goals.

However, the true measure of progress will lie in implementation, ensuring that ambitious policies yield real improvements in access, quality, and outcomes. Governance, transparency, and sustained stakeholder collaboration will be crucial in translating these policy wins into lives saved and systems strengthened.

As Nigeria stands at the crossroads of reform, this moment demands continued vigilance, accountability, and innovation to achieve a health system that delivers for every citizen.

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