As I board a flight from Dulles Airport in Washington, D.C., to Abuja, Nigeria enters this quarter with the Central Bank’s monetary policy rate near its highest level in a generation and headline inflation firmly stuck in double digits, notwithstanding the recent downward adjustment. The current monetary policy rate set by the Central Bank of Nigeria stands at 23 percent, while the latest data from the National Bureau of Statistics puts headline inflation at 14.63 percent year-on-year for October 2026. Economists naturally read these metrics as an unfolding story about price stability, macroeconomic tightening and currency pressure. But there is also a health story: when money tightens and food and energy prices climb, the people who feel the effects first are those who must pay for life-saving medical care entirely out of pocket, precisely when they can least afford it.
What if Nigeria’s greatest barrier to sustainable healthcare delivery is not a dearth of clinical talent, knowledge or technology, but a peculiar reflexive habit of treating a system-wide failure as a collection of isolated, disconnected problems?
For the African diaspora, a timeless Yoruba proverb offers a warning: “Omi titun ki n san ki o gbagbe orisun re” — fresh water flowing down a river never forgets its original source. Having spent three decades working within elite North American health and research institutions, performing complex cardiac surgical operations and directing transformative biomedical portfolios at the National Institutes of Health (NIH) and the Advanced Research Projects Agency for Health (ARPA-H), I return to work directly alongside healthcare professionals, entrepreneurs and policymakers building localised African health-tech solutions for our patients and communities.
Before we prescribe software, inject venture capital or pass sweeping reforms, we must first diagnose the patient accurately. We must speak the rigorous language of evidence, numbers and concrete economic returns. One of my objectives during this immersion is to participate in the inaugural Artificial Intelligence in Health Summit 2026, designed to strengthen health systems and accelerate universal health coverage in Nigeria and Africa.
A high-interest-rate, high-inflation environment does not remain confined to the trading floors of Lagos; it reaches the clinic floors of our primary healthcare centres. It leads a market trader in Aba to delay critical blood-pressure screening until neglect results in an avoidable, catastrophic stroke. It forces a vulnerable family in Owerri to liquidate its limited income-generating assets to pay for a relative’s renal dialysis following the sudden discovery of kidney failure. It also means that an expectant mother in a peri-urban community may reach a functional health facility far too late because transport costs have risen beyond her immediate means.
In Nigeria, households, not the state, bear the financial burden of healthcare. In a comprehensive study titled “The Lancet Nigeria Commission: Investing in Health and the Future of the Nation”, published in The Lancet in 2022, lead author Ibrahim Abubakar reported that out-of-pocket payments constituted 75 percent of total health spending in 2019 and had stubbornly resisted falling below the 70 percent threshold since 2005.
Subsequent reports validate this continuing financial strain. In a 2025 study published in BMC Public Health on the determinants of health insurance enrolment, Faith Effiong found that out-of-pocket payments had reached 76 percent of total health expenditure. This stands in stark contrast to the sub-Saharan African regional average of approximately 32 percent, while the global benchmark is about 17 percent. Not surprisingly, the report noted that Nigeria’s Universal Health Coverage service-coverage index stood at just 38 out of 100.
According to World Bank estimates cited by Effiong and colleagues (2025), healthcare expenditure pushes more than one million Nigerians into poverty each year. This is happening in a country where, according to the 2022 Lancet Nigeria Commission, 40 percent of the population already lives below the poverty line. The Commission also noted that government health spending stood at just 0.5 percent of GDP, far below the African regional average of 2 percent and the global average of 3.5 percent. Health received only 5.2 percent of government spending, a fraction of the 15 percent budgetary target pledged in the 2001 Abuja Declaration.
Nigeria’s disease burden is shifting. The 2022 Lancet Nigeria Commission, led by Abubakar and colleagues, reported that non-communicable diseases overtook communicable, maternal, neonatal and nutritional causes combined in 2015 as the leading contributor to mortality. They accounted for an age-standardised 567 deaths per 100,000 people in 2019. Cardiovascular disease is the dominant contributor, accounting for more than one-third of non-communicable disease deaths, followed by cancers at approximately 17 percent, while chronic kidney disease remains a smaller but growing cause.
Compounding this worsening situation, our medical frontline is critically understaffed. International benchmarks tracked in the 2025 Lancet Countdown to 2030, by Amouzou and colleagues, measure countries against the World Health Organisation’s 2016 minimum threshold of 44.5 doctors, nurses and midwives per 10,000 people. Nigeria operates far below this threshold. A 2025 analysis in Human Resources for Health by Alawode and colleagues, drawing on WHO’s 2021 workforce accounts, reports approximately 3.95 doctors, 9.45 nurses and 6.18 midwives per 10,000 people, with public-sector attrition reaching as high as 41 percent in states such as Kaduna.
The continuing “Japa” phenomenon, the mass emigration of our healthcare workforce, is a perfectly rational response to poor working conditions and uncompetitive real wages. The same macroeconomic pressures that squeeze household food budgets also erode the real value of domestic wages that would otherwise help retain our brilliant clinicians and healthcare professionals. These are not separate, isolated crises; they are interconnected symptoms of a single system failing in a highly coordinated way.
Yet, despite these depressing figures, Nigeria possesses structural assets that many emerging economies would envy: an energetic and deeply tech-literate youth population, profound clinical expertise, a highly connected global diaspora and a technology sector that has already demonstrated, through fintech, that stakeholders can align to solve complex, systemic infrastructure problems at scale.
To build a true predictive shield, we must execute four immediate, macro-strategic moves to redirect some national capital away from brick-and-mortar buildings and towards verifiable health outcomes.
Replace catastrophic out-of-pocket payments with prepaid risk pooling
Establishing comprehensive prepaid financing frameworks is central to achieving universal health coverage. Humphrey Karamagi argues in a 2022 study published in PLOS ONE that structured risk pooling provides a direct hedge against an inflationary economy, which can transform a single unexpected medical bill into a multi-generational financial catastrophe.
Increase government spending on primary healthcare and design for reach
Strengthening local primary healthcare facilities represents one of the most cost-effective routes to improving population health. A global health systems blueprint published by Etienne Langlois in the Bulletin of the World Health Organization in 2020 recommends increasing government primary healthcare spending by at least 1 percent of national GDP. This investment should be paired with localised community health worker initiatives that link direct funding to audited clinical quality.
Deploy validated, non-invasive screening as a workforce multiplier
Smartphone-enabled machine-learning diagnostics can extend the reach of scarce clinicians and diagnostic laboratories rather than attempting to replace them. In a landmark clinical validation study published in Nature Medicine in 2020, Robert Avram demonstrated that an ensemble algorithm analysing non-invasive vascular signals or biomarkers through a standard smartphone camera could successfully flag type 2 diabetes, achieving an area under the curve (AUC) of 0.77 to 0.83 without requiring needle pricks or expensive laboratory tests. These tools must be explicitly calibrated for West African populations and certified by NAFDAC before being deployed at scale.
Hold every single health naira to three inflexible questions
Does it actively reduce the direct cost or physical time required for a citizen to obtain diagnostic care? Does it explicitly improve baseline clinical safety and quality? Can it function effectively at the subnational level, beyond the affluent areas of Lagos and Abuja? If a technology project or capital investment cannot decisively answer yes to all three questions, it is a commercial distraction, not a national solution.
Healthcare transformation across sub-Saharan Africa must not be treated as an act of international charity. Rather, it should be recognised as a core pillar of human development, a prerequisite for macroeconomic stability and one of the largest undercapitalised investment opportunities on the continent today.
Yet, as a cardiac surgeon, I know that a doctor cannot successfully treat a patient who refuses to accept the diagnostic evidence. Nigeria’s healthcare architecture is under historic strain, but it is not beyond repair. The ultimate question facing our political elite and technology innovators is simple: will we continue to stand idly by, passively admiring the signs and symptoms of disease, or will we finally organise our collective capital and intellect to treat the underlying condition?
Dr Jonah N.K. Odim has spent three decades in North American health and research institutions as a cardiac and transplant surgeon and leader of transformative biomedical research portfolios at the NIH and ARPA-H. He works with Nigerian patients, healthcare professionals, entrepreneurs and policymakers on health-system reform. He is the Founder and CEO of Oculome Nexis. This is the first of an eight-part series.
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