Nigeria and US Renew Health Partnership Emphasizing National Ownership and Domestic Funding

For over twenty years, Nigeria and the United States have collaborated to address major public health challenges, significantly improving health outcomes through efforts aimed at combating HIV/AIDS, malaria, polio, and other diseases. Programmes such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative, and contributions through global health funds have played crucial roles in saving lives and strengthening Nigeria’s health systems.

Recognizing the achievements of this partnership, both countries have now agreed to enter a new phase that prioritizes Nigeria’s national ownership of health programs and a gradual shift towards domestic financing to sustain essential health services. This approach responds to the reality that countries of Nigeria’s size cannot rely indefinitely on external assistance to fund critical healthcare.

New Memorandum of Understanding Focuses on Managed Transition

In December 2025, Nigeria and the United States signed a Memorandum of Understanding (MoU) covering cooperation from April 2026 through December 2030. This agreement is legally non-binding, respects Nigerian law, and allows either party to discontinue cooperation under its terms. The MoU outlines a managed transition from externally financed health interventions to an increased role for Nigerian government institutions and domestic resources.

The financial framework under the MoU specifies nearly $2 billion in U.S. support over five years, with a planned gradual decrease, while Nigeria commits to increasing domestic health financing by about $3 billion. Notably, Nigeria’s contribution remains within the country to be allocated according to national priorities, including programs targeting diseases such as HIV, tuberculosis, and malaria, maternal and child health, laboratory capacity, and healthcare worker support.

Alignment with Nigeria’s Broader Health Sector Renewal

This MoU aligns with Nigeria’s own reform initiatives, notably the Nigeria Health Sector Renewal Investment Initiative and Health Sector Renewal Compact launched by President Bola Ahmed Tinubu in December 2023. These reforms aim to reduce fragmentation and duplication in health programming, unify funding streams and reporting, and promote accountability through the Sector-Wide Approach. Such structural changes are designed to strengthen domestic health institutions and ensure more effective use of resources.

The Nigerian government has already demonstrated its commitment through substantial increases in the health budget. In 2025, the federal health budget rose by nearly 60 percent, raising health’s share of the national budget to 5.2 percent. The 2026 Appropriation Act further increased health spending, with allocations totaling ₦2.48 trillion, equivalent to approximately 6 percent of the federal budget excluding liabilities. Under the MoU, Nigeria’s financial commitment is measured by actual health expenditure across federal and state budgets to ensure real investment.

Implications for Nigeria’s Health Sector

This renewed partnership exemplifies an important shift towards sustainable health financing in Nigeria. It acknowledges the necessity for the country to gradually assume greater responsibility for funding and managing its health services while maintaining vital support from international partners during the transition. The arrangement also covers a wide range of health system components beyond medicines and vaccines, including disease surveillance, laboratory infrastructure, health data systems, and local manufacturing of health commodities.

For Nigerian citizens and stakeholders, this development signals a move towards greater self-reliance and institutional strengthening. It promises continuity of essential health services while encouraging more transparent, accountable, and efficient use of resources domestically. As Nigeria confronts evolving health challenges, such cooperation frameworks that emphasize national sovereignty and domestic investment will be critical to sustaining and expanding health gains achieved over the past decades.