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In 1960, three physicians at Johns Hopkins University developed one of the most important emergency interventions in modern medicine: Cardiopulmonary Resuscitation. Their discovery was simple but revolutionary. When the heart stops, you do not stand around making promises. You act immediately. You apply firm, rhythmic chest compressions to restore circulation and keep oxygen flowing to the brain.
CPR is not cosmetic. It is not symbolic. It is not a gradual reform. It is urgent action taken when a system is on the brink of death.
Nigeria’s health sector is on that brink.
Twenty five years ago, African leaders gathered in Abuja and adopted the Abuja Declaration, pledging to allocate at least 15 percent of national budgets to health. Nigeria signed the declaration. It made the commitment publicly and proudly.
Since then, Nigeria has not once allocated even 6 percent to the health sector.
Today, the 2026 budget proposal sits before the National Assembly. The total budget stands at ₦58.18 trillion. If Nigeria were honouring its Abuja commitment, the health sector would receive approximately ₦8.7 trillion. Instead, it has been allocated ₦2.48 trillion, about 4.3 percent. Debt servicing receives almost seven times more than healthcare.
If Nigeria were a patient, the diagnosis would be cardiac arrest, and the prescription would be paracetamol.
The numbers reveal a crisis that rhetoric cannot hide. One in every nine Nigerian children dies before reaching the age of five. Most of these deaths are from preventable causes such as malaria, pneumonia, and diarrhoea. Nigeria has the highest number of zero dose children in the world, with more than two million children who have never received a single vaccine. The country accounts for about 24 percent of global malaria cases and 30 percent of global malaria deaths.
Nigeria represents only 2.5 percent of the world’s population, yet contributes nearly 20 percent of global maternal deaths. Approximately 75,000 Nigerian women die each year from pregnancy-related causes. That translates to about 205 deaths every day. The scale is staggering.
The workforce crisis compounds the problem. Nigeria has roughly one doctor for every 10,000 patients, far below the World Health Organization recommendation of one to 600. Meanwhile, over 12,000 Nigerian trained doctors are licensed to practise in the United Kingdom alone. The country spends significant public resources training doctors in its universities, only to lose them to better funded systems abroad because local hospitals lack basic infrastructure such as stable electricity, running water, and essential equipment.
What is often jokingly referred to as “japa” is in reality a symptom of systemic underfunding. Nigeria is effectively subsidising the healthcare systems of wealthier countries.
Infrastructure conditions are equally troubling. Fewer than ten functional radiotherapy machines serve a population of more than 200 million people. Only about 20 percent of Primary Healthcare Centres are fully functional. Many lack electricity. Many lack reliable water supply. Most experience frequent stock outs of essential medicines. There have been reports of surgeons using phone torches during procedures because hospitals could not afford diesel for generators. Patients are sometimes turned away due to lack of bed space.
Yet the allocation remains at 4.3 percent.
When broken down per citizen, ₦2.48 trillion for approximately 237 million people amounts to about ₦10,400 per person per year, roughly ₦870 per month. That amount is expected to cover malaria treatment, immunisation, maternal care, emergency surgery, and cancer treatment. It is clearly insufficient.
As a result, more than 70 percent of health spending in Nigeria is out of pocket. An estimated 1.5 million Nigerians fall below the poverty line each year because of medical expenses. Illness in Nigeria is not only a health risk but also an economic shock that can push families into long-term hardship.
This is why the metaphor of CPR is not dramatic. It is accurate.
CPR is applied when circulation has stopped. It forces blood to flow when the body can no longer sustain itself. It buys time and prevents irreversible damage. But it must be applied immediately and with sufficient pressure.
A 15 percent allocation to health is not generosity. It is not extravagance. It is emergency stabilisation. A nation that seeks economic growth cannot afford a workforce weakened by preventable diseases. A country that cannot protect mothers in labour or shield children from measles and malaria cannot claim to be secure.
The 10th National Assembly recognised the crisis in its legislative agenda. It acknowledged the Abuja target. The 2026 budget is now in its hands. Lawmakers possess what is constitutionally known as the power of the purse. They can choose to maintain the status quo at 4.3 percent, or they can finally honour a 25 year old commitment and move toward 15 percent.
₦870 per month per citizen is not a serious health strategy. It is managed decline.
When a patient flatlines, history does not remember the speeches made in the room. It remembers who acted quickly enough, and firmly enough, to restart the heart.