Nigeria, grappling with a multitude of health and economic woes, is poised to receive a $250 million loan from the World Bank in September 2025. This funding, allocated under the third phase of the Health Security Programme in Western and Central Africa, aims to bolster Nigeria’s capacity to prevent, detect, and respond to health emergencies. The loan, structured as an International Development Association credit, will be managed by the Nigeria Centre for Disease Control (NCDC) under the oversight of the Federal Ministry of Finance. The World Bank’s appraisal document highlights the urgency of this intervention, emphasizing Nigeria’s dire health indicators, including low life expectancy, high maternal and child mortality rates, and the pervasive threat of infectious diseases. This loan marks a continuation of the World Bank’s significant financial involvement in Nigeria’s development efforts.
Nigeria’s health landscape is characterized by a complex interplay of challenges. A population exceeding 223 million faces alarmingly low life expectancy, coupled with high maternal and child mortality rates, painting a grim picture of public health. Infectious diseases, including malaria, HIV/AIDS, tuberculosis, and diarrheal diseases, are among the leading causes of death, further exacerbated by widespread poverty, inadequate infrastructure, chronic underfunding of the health sector, and a shortage of skilled healthcare professionals. These interconnected factors contribute to a fragile health system ill-equipped to handle routine health needs, let alone effectively respond to emergencies. The World Bank’s assessment underscores the magnitude of these challenges and the urgent need for comprehensive interventions to strengthen Nigeria’s health security.
The proposed $250 million loan aims to address critical gaps in Nigeria’s health security architecture. A central focus will be strengthening disease surveillance systems, enhancing laboratory capacity, improving emergency preparedness, and ensuring the continuity of essential health services during outbreaks. This includes establishing emergency operations centers across all 36 states and the Federal Capital Territory, along with developing a national warehouse to stockpile emergency medical supplies. Furthermore, the project will support initiatives to improve pharmaceutical regulation and promote local production of essential medicines, in collaboration with relevant national agencies such as NAFDAC and NIPRD. These efforts are crucial for building a resilient health system capable of effectively managing both routine health concerns and unforeseen health emergencies.
Despite some progress in recent years, Nigeria’s public health response capabilities remain fragile. While the country’s performance in the 2023 Joint External Evaluation of International Health Regulations core capacities improved compared to 2017, significant weaknesses persist. Inadequate legal frameworks, limited detection capacity, and weak logistics for emergency response, particularly at the subnational level, hinder effective health emergency management. Fragmented surveillance systems and underfunded veterinary and environmental health services further compound the challenges. The proposed project will prioritize addressing these systemic weaknesses and bolstering the country’s overall health security posture.
The project encompasses a multi-pronged approach to strengthen Nigeria’s health security framework. Key initiatives include integrating disparate surveillance platforms, such as the Surveillance Outbreak Response Management and Analysis System (SORMAS) for human health and the National Animal Disease Information System (NADIS) for animal health, to enhance collaborative surveillance efforts. Investing in information and communication technology (ICT) equipment, providing comprehensive training, and strengthening community-based health services, particularly at the local government level, are also prioritized. Notably, the project aims to empower women by promoting their participation in epidemiological training and leadership roles in health emergency response, recognizing the gender disparities observed during previous outbreaks like Ebola and COVID-19.
The implementation of this project will involve a multi-tiered governance structure. A National Project Coordination Unit, housed within the NCDC, will oversee project activities under the guidance of a National Steering Committee comprising key government ministers. Similar structures will be replicated at the state level, led by State Commissioners for Health, ensuring coordinated execution and local ownership. Participating states will be required to meet specific eligibility criteria, including formal expressions of interest, commitment of counterpart funding, and adoption of national health security policies. While the loan promises significant improvements to Nigeria’s health security landscape, the World Bank acknowledges substantial environmental and social risks associated with the project, highlighting the need for careful monitoring and mitigation throughout implementation. This $250 million loan signifies a substantial investment in strengthening Nigeria’s health system and its overall resilience to future health threats. However, it also increases Nigeria’s indebtedness to the World Bank, adding to the country’s existing debt burden and raising concerns about long-term sustainability.
