Amid ongoing strikes by healthcare professionals and the worsening "japa" phenomenon, along with reduced U.S. financial support for HIV initiatives and frequent disease epidemics, Nigeria's healthcare system faced significant challenges throughout 2025, culminating in an all-out emergency. State-run medical facilities frequently shut down due to labor disputes, disrupting vital care and causing many individuals to be left without assistance, ignored, or even forsaken. JANET OGUNDEPO reports
Fifty days. This is the duration for which public hospitals throughout Nigeria have been paralyzed due to the continuing strike by the Joint Health Sector Union, which started near the end of 2025.
The beginning of the year was marked by optimism, as interested parties showed confidence in the execution of laws passed in 2024 and higher financial support for healthcare. Nevertheless, ongoing waves of protests affected the progress made within the sector.
Cycle of strikes
The initial walkout by healthcare professionals in 2025 started on September 12, as the Nigerian Association of Resident Doctors initiated a five-day cautionary strike. The action was suspended following two days on September 14.
The medical professionals' strike aimed at securing overdue salary payments and pending benefits, such as unissued consolidated medical salary structure, CONMESS, revisions, reimbursement of attire allowances, and back pay for promotions and specialized roles, complete execution of the 2025 Medical Residency Training Fund, readmission of five suspended trainee physicians in Lokoja, better staff allocation and fair work schedules, settlement of credentialing conflicts, and immediate improvements to healthcare facility structures and tools.
Following 47 days without resolution, NARD announced an all-out and permanent national strike starting on November 1.
After 15 days of the resident doctors' strike, the Joint Health Sector Unions and the Assembly of Healthcare Professional Associations initiated a complete and ongoing work stoppage.
Throughout this time, hospital operations were disrupted because both physicians and other medical personnel failed to report for work. The consultant doctors who were present could provide limited assistance.
Results indicate that patients admitted to tertiary hospitals were released and transferred to government-run secondary institutions, private clinics, and various other alternatives selected by the patients and their families.
Inspections conducted at certain secondary-level hospitals during that period showed vacant consultation areas, lounges, and patient rooms.
PUNCH Healthwise reported that patients scheduled for surgery were instructed to come back once the strike had ended.
Following 29 days of protest, NARD withdrew from the strike. However, the JOHESU strike persisted and ushered in the healthcare sector into 2026.
The union's strike stems from the government's inability to introduce the revised Consolidated Health Salary Structure, CONHESS, in accordance with the Consolidated Medical Salary Structure, CONMESS, applicable to physicians, which has undergone multiple reviews since 2014.
50 days of strike
Today marks the 50th day of the strike, but there remains no indication of when it might conclude.
Several days prior to the conclusion of 2025, NARD warned of resuming a countrywide walkout as "there has been no noticeable or meaningful advancement in its execution."
Initial setback in 2025: Budget reductions
Around the world, the healthcare industry faced significant challenges in 2025 when the U.S. government reduced its international assistance funding shortly after Donald Trump was inaugurated as the 47th president on January 20.
Initially, the Executive Order was introduced as a 90-day suspension and evaluation of U.S. international assistance grants.
Nevertheless, on January 29, an urgent humanitarian exception was approved to enable the President's Emergency Plan for AIDS Relief, PEPFAR, to keep delivering essential HIV treatments in 55 nations.
Having an annual budget of $6.5 billion, PEPFAR provides HIV/AIDS care to over 20.6 million individuals worldwide, with approximately two million receiving assistance in Nigeria.
As highlighted by the United Nations in February, this decision resulted in a reduction of $377 million in financial support for the UNFPA, the organization responsible for reproductive and sexual health initiatives.
The World Health Organization, with the United States being its main contributor, additionally revealed that budget reductions led to a decrease of as much as 70 percent in essential healthcare services within lower- and middle-income nations.
HIV funding amid cuts
Following the declaration of budget reductions, specialists cautioned that Nigeria, heavily reliant on external financial support, could experience an increase in cases of HIV, tuberculosis, and malaria, and called for prompt activation of local resources.
As a reply, the Federal Executive Council authorized a budget of N4.8 billion to purchase 150,000 HIV medication packages in preparation for possible reductions in financial support.
The central government additionally provided $200 million to the healthcare fund to mitigate the effects of the financial shortage.
Even with the government's involvement, numerous services primarily supported by external contributors and the United States continued to face challenges.
In August, the UNICEF reported a $160 million shortfall in financing essential humanitarian assistance within Nigeria.
The financial shortage has similarly affected HIV care, with medical facilities across the nation lacking essential testing supplies, and individuals living with HIV expressing concerns over the limited availability of their critical medicines.
Due to the limited availability of test kits, experts informed PUNCH Healthwise, community testing has been delayed, hindering progress toward achieving the 95-95-95 global objective of ending AIDS by 2030.
At present, the National Agency for the Control of AIDS reports that approximately 1.9 million individuals are infected with HIV in Nigeria.
Professionals have also voiced concern that the reduction in financial support might result in more fatalities from malaria affecting expectant mothers and kids below five years old.
Malaria accounts for 11 percent of Nigeria's maternal death rate, which stands at 1,047 fatalities per 100,000 live births.
Nigeria bears the greatest load of malaria globally, contributing approximately 27 percent to the world's total malaria cases.
Disease outbreaks
The healthcare industry also experienced more frequent disease epidemics and fatalities.
During the first week of January 2025, an outbreak of the Human Metapneumovirus occurred in China. This respiratory virus can lead to conditions varying from minor cold-like symptoms to serious breathing difficulties.
The anxiety about the virus reaching the nation affected numerous Nigerians, yet the Nigeria Centre for Disease Control and Prevention, through a risk evaluation, categorized the threat posed by HMPV as medium.
By 2025,Mpox,a contagious virus capable of affecting both people and animals,had been identified as spreading within the nation, presenting a continuous threat to public health.
According to PUNCH Healthwise, specialists have expressed worries that although some advancements have been achieved, Nigeria continues to encounter obstacles such as restricted availability of vaccines for vulnerable groups, insufficient knowledge and false beliefs, social prejudice, and inadequate access to medical centers.
Even though six fatalities occurred from January to October, there were 1,623 reported cases, of which 414 were officially diagnosed as Mpox.
Additionally, in 2025, the official situational updates published by the Nigeria Centre for Disease Control and Prevention along with the World Health Organization in December indicated that 1,738 fatalities were reported due to cholera, Lassa fever, measles, and meningitis during that year.
The report mentioned that by November, a total of 26,866 potential measles cases had been documented across the country.
Measles is a sudden, very contagious virus-related illness characterized by high temperature, skin rashes, hacking cough, and inflamed eyes.
An outbreak of cholera, which is an intense intestinal illness resulting from ingesting food or water tainted with the bacteria Vibrio cholerae, reported 22,102 instances of the disease and 500 fatalities, leading to a case fatality rate of 2.3 percent.
The nation reported 9,164 possible instances of Lassa fever, 1,097 verified infections, and 201 fatalities across 21 states and 103 local government regions, resulting in a Case Fatality Rate of 18.3 percent.
The findings further indicated that the nation still records the most diphtheria cases within the African Region, reporting 12,150 suspected instances, 8,587 verified cases, and 884 fatalities, resulting in a Case Fatality Rate of 7.2 percent.
Diphtheria is an infectious disease caused by bacteria which impacts the mucus lining of the nasal passages and throat, resulting in difficulties with breathing or swallowing, along with symptoms such as fever and enlarged lymph nodes, possibly leading to serious consequences including harm to the heart or nerves.
Regrettably, the number of newborn fatalities rose within the nation.
The 2025 Nigeria Health Statistics Report published by the Federal Ministry of Health and Social Welfare indicated that approximately 20,811 maternal, newborn, and child deaths occurred in Nigeria from January through September 2025. Newborn mortality rose from 1,706 cases in the first quarter of 2025 to 1,900 in the third quarter.
Pediatricians, after reviewing the report alongside PUNCH Healthwise, criticized the nation's elevated infant death rates, calling the more than 281,000 child births fatalities annually in Nigeria intolerable.
They identified infections, issues occurring at birth, and respiratory distress syndrome as the top three immediate health-related reasons for newborn fatalities.
Child health specialists also highlighted maternal conditions like malaria, HIV, and certain sexually transmitted infections as factors leading to newborn fatalities.
Shortage of trained midwives and poorly equipped birthing centers were additional causes behind the increase.
Japa syndrome
Mass migration of medical professionals, known as Japan Syndrome, also impacted the healthcare industry in 2025.
In April, Professor Muhammad Pate, the Coordinating Minister for Health and Social Welfare, stated that more than 16,000 Nigerian physicians have departed the nation within the past five to seven years in search of better opportunities elsewhere.
He mentioned that the present physician-to-population ratio stands at 3.9 for every 10,000 people in the nation, with the projected expense of educating a single doctor surpassing $21,000.
Additionally, recent information from the Nursing and Midwifery Council registry of the United Kingdom indicates that 16,156 nurses and midwives trained in Nigeria have received licenses to work in the UK as of September 30, 2025, covering the period starting from 2017.
Additional healthcare professionals, such as physical therapists, clinical laboratory scientists, and pharmacy specialists, are also departing the nation, resulting in the current workforce being insufficient to meet the needs of the growing population.
Professionals have repeatedly cautioned about the deterioration of the healthcare system as the JAPA syndrome keeps depleting the staff.
Inadequate pay, poor workplace environments, declining hospital infrastructure, insufficient tools, excessive job demands, and an unstable atmosphere are contributing to the rise of the japa phenomenon.
The current scenario has deteriorated further with numerous doctors currently in their residency programs and recently appointed individuals opting to leave the country.
According to PUNCH Healthwise, this situation has caused numerous public hospitals to face difficulties in finding applicants for residency and job positions.
A confidential informant shared with our reporter that in a recent staffing assessment, the tertiary hospital managed to secure only 28 physicians from the 60 required.
The source stated, "We're aiming to bring in 60 substitute physicians, but have faced difficulties securing 28 of them. We ended up hiring trainee doctors, but the total remained incomplete. It's becoming increasingly challenging to locate medical professionals willing to work."
Additionally, Professor Aminu Muhammad, the former president of the Medical and Dental Consultants' Association of Nigeria, stated that it could take Nigeria ten years to replenish the 500 physicians who have recently departed the country in pursuit of better opportunities.
He stated that 50 of the 80 chapters within the organization verified that 500 medical specialists have departed the nation.
Individuals involved in the healthcare field have remained worried about the shortage of mentors for upcoming and recently certified physicians due to the large-scale departure of experienced medical professionals.
Primary healthcare reforms
Looking back, the healthcare industry achieved certain advancements in 2025. Specifically, there was greater attention given to Primary Healthcare along with additional financial support for the field.
For instance, on October 22, 2025, FG authorized and distributed N32.9 billion via the Basic Healthcare Provision Fund, signifying the third installment of payments this year.
The Coordinator of Health and Social Welfare, Professor Muhammad Pate, stated in a document entitled "The Red Letter" that the money will be distributed to enhance local clinics nationwide by offering fundamental medical services, reinforcing primary healthcare, and setting aside supplies for urgent treatments.
This funds isn't remaining in Abuja. It has already started moving into the commercial bank accounts of primary healthcare centers in each neighborhood throughout Nigeria.
"It belongs to your clinic. It's your community's opportunity. It represents your nation's commitment," Pate stated.
Approximately ₦32 billion was authorized in July 2025 to support health funding operations during the first and second quarters, while ₦32.88 billion was allocated for the third quarter of 2025, with payments anticipated by late August 2025.
In December, the National Primary Health Care Development Agency reported that 2,125 local health centers have been completely renovated across the country, as part of initiatives aimed at enhancing community-based healthcare services.
Reduced maternal mortality
In an effort to lower the maternal death rate within the nation, the national administration launched the Maternal and Child Mortality Program, known as MAMII, in 2025.
FG stated that the program resulted in a 17 percent reduction in maternal fatalities and a 12 percent decline in newborn deaths across 172 regions with significant disease prevalence.
In December, Dr Muyi Aina, the Executive Director of the NPHCDA, stated via MAMII that the nation experienced a 22.5 percent increase in antenatal care visits from the second to the third quarter of 2025.
He mentioned that 500,000 expectant mothers have joined the initiative, of whom 41,193 were followed up until childbirth.
The FG also highlighted that 4,000 expectant mothers throughout the nation have been provided with free cesarean deliveries through the National Health Insurance scheme, an accomplishment of MAMII.
20 million insured Nigerians
Another emphasis was placed on enrolling more Nigerians into the health insurance program.
In July, the Director-General of the National Health Insurance Authority, Dr. Kelechi Ohiri, stated that more than 20 million Nigerians are currently registered under the National Health Insurance Scheme, an increase from 16.8 million in 2023.
Stakeholders also called for increased funding in innovation, financial support, and governmental commitment to tackle Nigeria's underperforming healthcare system.
They made this statement during the 2025 National Health Dialogue held in Abuja, which had the theme "Evidence, Innovation, and Financing for a Healthier Nigeria."
More funding
In contrast with the budget reductions early this year, in December, the United States announced via the America First Global Health Strategy that it has allocated more than $515 million in health aid to Nigeria. This funding supports initiatives related to HIV/AIDS (PEPFAR), malaria, maternal and child healthcare, tuberculosis, nutrition, global health security, polio elimination, other preventable diseases through vaccination, and enhancing immunization programs.
Knocks, kudos, expectations
In assessing the healthcare system in 2025, Professor Mike Ogirima, a past president of the Nigerian Medical Association, pointed out that although steps have been taken to enhance service provision, fundamental issues continue to persist without resolution.
"The healthcare industry hasn't changed significantly compared to how it was before. We're educating our medical professionals at a lower cost, whereas advanced nations are attracting them with highly attractive wages. The phenomenon commonly referred to as 'Japa syndrome' poses a major issue for the healthcare field," he stated.
Nevertheless, the previous president of the NMA admitted that some issues influencing employee retention fall outside the government's immediate influence, stating, "I concur, no one can manage the movement of workers. It's a global issue. Therefore, I won't hold them responsible for preventing the Japan phenomenon, as the labor force exists in a kind of unregulated area. Thus, everyone has the freedom to go wherever they want in search of better opportunities."
Ogirima also highlighted that insufficient financial support is among the key challenges facing the healthcare system, pointing out that present funding amounts are still significantly lower than global standards.
"With regard to financing, there isn’t much available. Only around five to six percent of the budget is allocated, which falls well short of the 15 percent of the yearly budget that African nations approved under the Abuja Declaration. We're still quite distant from this target, although some states have made progress beyond or near that 15 percent mark. Locations such as Lagos, Port Harcourt, and Rivers have achieved significant contributions. Aside from these three regions, however, little else has been observed," he stated.
The Professor and Head of Orthopaedics and Trauma Surgery at Ahmadu Bello University also pointed out that numerous states have focused on setting up higher education institutions while overlooking primary and secondary health care centers which cater to most people.
"The states typically attempt to shift focus away from their main duties of managing and enhancing the secondary level of healthcare. Instead, they aim for having a medical college or specialized hospital, neglecting the fact that primary health centers and general hospitals are the nearest healthcare options for individuals. Therefore, the states aren't performing effectively in this aspect," he stated.
Commenting on the health indicators for this year, the ex-president of the NMA stated, "The data doesn’t differ much from previous years. High maternal death rates continue to persist. Child illnesses are still common — although there has been some progress in expanding vaccination programs, many children’s ailments remain widespread. Non-infectious conditions such as hypertension, diabetes, and cancer are becoming more frequent. This rise might be due to changes in our diet, with people shifting away from traditional foods toward processed options," Ogrima mentioned.
He also linked the increase in non-communicable illnesses partially to economic and social conditions impacting the community.
"The economic strain and the expensive cost of living are increasing pressure, leading to higher burdens on the people," the leader said.
Ogrima identified key actions necessary to stabilize and enhance the healthcare system.
"In 2026, we hope that funding will become available for infrastructure developments. The Minister of Health has several initiatives aimed at modernizing and enhancing technological facilities within our hospitals. Therefore, additional financial support is required," he stated.
He also emphasized the critical importance of the government integrating jobless medical personnel into the workforce, stating, "We must incorporate government-educated physicians who have completed their studies and are seeking employment. They can be found everywhere, which is why advanced nations readily recruit them. Therefore, we should involve them, hire them, alongside other health practitioners such as physiotherapists, nurses, and others where needed. The government isn’t taking sufficient action to integrate them."
The primary cause behind people departing the country is financial incentives. A physician can exit the nation and receive approximately N3 million monthly. The top earners among specialists in the country only make about N1.2 to N1.3 million. Hence, this is why individuals are quick to relocate for higher compensation.
Health care inequality driving protests
Additionally, well-known pharmaceutical specialist Olumide Akintayo characterized the present government's management of healthcare issues as unmatched in terms of shortcomings.
"Since the start, this administration aimed for failure within the healthcare field, and regarding abnormal outcomes, it has never been worse than now," he stated.
Akintayo also criticized the dominance of the medical field by doctors, excluding other healthcare workers.
He claimed the government provided money solely to doctors, neglecting other healthcare workers with similar needs.
The ministers responsible for health have taken over the exclusive authority previously held collectively by all other healthcare professionals," Akintayo said, pointing out that this trend has led to extraordinary discrimination inside the health field.
He characterized the japa syndrome as a "poor investment" that weakens sustained development within the healthcare system.
The ex-president of the Pharmaceutical Society of Nigeria also mentioned that the current JOHESU strike has resulted in a loss exceeding N350 million in internal revenue generation.
He mentioned that since the strike started, infant and maternal death rates have risen by 22.73 percent, while general illness levels have deteriorated by more than 18 percent and deaths have gone up by about 13 percent.
Akintayo criticized the pay gap and rank differences between doctors, medical practitioners, and other healthcare staff, noting that even though a collective negotiation deal was reached in 2009, the government has only partially modified wage systems, often leaving out other healthcare workers—especially nurses and related health professionals—who make up more than 95 percent of the workforce.
Akintayo stated that the present system leads to a scenario where a new medical graduate joins the public sector at a pay scale corresponding to level 10, whereas other health workers with similar or more extended training begin at levels 8 or 9.
He mentioned that this gap becomes more pronounced with career advancement, resulting in what specialists refer to as "unprecedented" ratio of relative earnings not observed in labor practices across the globe.
He also highlighted the creation of universities called "Medicine and Health Sciences," contending that this terminology reinforces bias by suggesting that medicine is the sole component of health science, thus pushing aside other healthcare disciplines and "undermining the self-esteem of students enrolled in different courses."
In 2026, Akintayo advocated for legal measures to contest the legality of permitting doctors to head federal and state health institutions, along with the selection of medical professionals lacking doctorate degrees for academic administrative roles.
"We should start expressing these matters as they truly are. When freedoms lack limits, they turn into oppression. That's precisely what has occurred within our healthcare system," he stated.
In his critique, the Secretary General of the Nigeria Network of Non-Governmental Organisations, Ayo Adebusoye, recognized certain achievements within the field, such as an observed two-digit decline in maternal death rates and enhancements in critical service metrics.
"The Basic Healthcare Provision Fund has been increased to 2.0, with additional facilities being recognized, allowing more Nigerians to access subsidized or free essential services through the health insurance portal," the health advocate noted.
Adebusoye, who previously served as a board member of the Lagos State Health Management Agency, highlighted that the ongoing disparity between Nigeria's health expenditure and the 15 percent objective outlined in the Abuja Declaration from 25 years back continues to be a major obstacle.
He stated, "It's crucial for us to examine ways to boost our funding sources from both the federal government and the private industry."
The head of the Public Health Sustainable Advocacy Initiative also voiced worries regarding the safety conditions that discourage new physicians from taking positions in remote regions where their presence is crucial.
"The security system needs enhancement to guarantee the safety of physicians and healthcare personnel in the most remote regions," Adebusoye stated.
He cautioned that even the newly founded Lagos State University of Medicine and Health Sciences, intended to train thousands of healthcare professionals each year, might fail to halt the exodus of skilled personnel unless circumstances change.
Adebusoye expressed worries regarding the standard of healthcare availability, pointing out that around 70 percent of Nigeria's healthcare spending comes from personal expenses, which he referred to as "the least effective method of funding medical care."
A public health champion outlined three key focus areas for 2026: enhanced financial support for healthcare at both national and regional levels, improved results in maternity and pediatric care, and integration of changes aimed at reinforcing medical systems and bridging disparities between city and rural regions as well as affluent and underprivileged communities.
He further urged Nigeria to adopt a more calculated approach in its bi-lateral health partnerships, especially with the United States, highlighting the importance of safeguarding national interests and data independence.
Supplied by SyndiGate Media Inc. ( Syndigate.info ).
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