ISIOMA MADIKE 
- We had free lunch, but now, we realised no lunch is free -Onajole.
- It’s an opportunity to fund scientific research, says Ezeibe
- There’s need to also explore innovative financing –Babalola
- Nigeria to encourage local production of drugs to reduce foreign currency outflows
The recent U.S. pull out of the World Health Organisation, which started in January 2025, represents a significant shift in international health financing. As the largest donor of the global body, its withdrawal could create a substantial funding shortfall, especially for Nigeria, which relies heavily on the WHO-coordinated programmes, reports ISIOMA MADIKE
There have been fears for weeks now by medical experts that Nigeria’s fight against HIV/ AIDS and Tuberculosis (TB) may face fresh setbacks following signals of funding shifts by the United States government.
Health experts are worried about potential drug shortages, weakened service delivery, and a possible rise in drug resistance with the U.S. new position. Recall that President Donald Trump had initiated the United States’ withdrawal from the World Health Organisation (WHO) in January 2025.
By early 2026, President Trump officially announced a final cut off from the world health body. This action, according to health experts, represents a significant shift in global health financing. As the largest donor, the U.S. is said to have contributed between 12 and 15 per cent of the WHO’s total funding. This translated to, roughly, between $600 and $700 million annually.
With this outlook, America’s departure from WHO, experts say, will create a substantial funding shortfall. For Nigeria, which relies heavily on the WHO-coordinated programmes for disease control, vaccine procurement, and health system strengthening, America’s current posture, no doubt, may spell serious danger for her health sector.
The implications are dire. The withdrawal would not only disrupt the country’s critical health programmes, it would, according to medics, threaten essential drivers employed for combating HIV/ AIDS, TB, malaria, and maternal/ child health. Nigeria’s polio-free certification could also be at risk, as the Global Polio Eradication Initiative (GPEI), heavily funded by the U.S., faces funding uncertainty.
Aside from these, it is expected to reduce vaccine access as Nigeria depended on the WHO-supported vaccine procurement. A reduction in capacity could also lead to shortages, and possibly increase the risk of outbreaks for vaccine-preventable diseases. Experts foresee a situation where disease surveillance would be weakened given that the WHO provided critical technical support for tracking infectious diseases in the country.
They are citing diseases such as COVID-19 and Mpox to illustrate their fear, saying reduced WHO presence may weaken Nigeria’s capacity to detect and respond to future outbreaks. There is also the humanitarian crisis in the NorthEast of the country where over seven million Nigerians, particularly in conflict-affected areas, are said to rely on UN-coordinated aid, which included the WHO-supported health services.
The fear, therefore, is that funding cuts could worsen health outcomes in that region. A consultant Ophthalmologist & Public Health Advocate, Prof. Femi Dokun-Babalola, harped on these fears, insisting that the U.S, withdrawal from the WHO, will create unpleasant gaps in technical and surveillance areas.
Dokun-Babalola told one of our reporters that the WHO’s role in dis- ease surveillance (for outbreaks like meningitis, Lassa fever, Ebola) and vaccine-preventable diseases would become weaker without the U.S. funding, placing greater strain on Nigeria’s emergency response capacity.
The professor noted that Nigeria’s HIV/AIDS response had depended heavily on the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and contributions to the Glob- al Fund to Fight AIDS, TB and Malaria. Without the U.S. funding, he said, antiretroviral therapy (ART) procurement and distribution could be slow or become inconsistent. He added that the HIV testing, prevention and key population outreach could equally shrink dramatically.
He also said that funding reductions pose risks for surveillance, drug supply, and treatment continuity for diseases like TB and malaria — areas where the U.S. bilateral and the WHO-coordinated funding have been significant. For broader programme disruptions, Dokun-Babalola, said the UNAIDS has warned that tens of millions more infections and deaths could occur globally if U.S.-funded HIV/ AIDS services collapse, a scenario that could extend to Nigeria without rapid mitigation. This, he said, represents a reversal of decades of progress in HIV and TB control.
He said: “Around 20% of Nigeria’s health budget is linked to the WHO technical support and programmes, which include critical areas like immunisation, outbreak response, and health policy implementation. The WHO also serves as global coordinator of health norms and evidence-based guidance, which Nigeria uses to shape national interventions.
“The U.S. was historically the largest single contributor to the WHO and global health financing (providing around 18–22% of WHO’s budget and massive bi- lateral funding such as PEPFAR). With the U.S. withdrawal taking effect in January 2026, the WHO is expected to trim at least 25% of its activities, which could directly impact Nigeria’s access to resources, expertise, early warning systems, and training.”
Professor Adebayo Onajole, a Professor of Community Medicine and Public Health, also echoed the sentiment of Dokun-Babalola as he said the implication of the U.S. pull back from the WHO was not too good for Nigeria and several countries that depend heavily on donors to implement several health programmes.
Onajole, however, believes that the action on the other hand will help in looking inwards. “There are several hidden resources in health, which we refuse to tap into because we had free lunch, but now, we need to realise that no lunch is free. These are critical issues which in the short term will impact negatively on our health indices. In the long run it will assist us to limit the wastages within the system.
“The government can and should look at the budgetary provisions on health and ensure that the funds are utilised efficiently.
We should change the way we do things,” the professor said. Dokun-Babalola, aligning with Onajole, believes it is time for the Nigerian government to strengthen its domestic financing by prioritising health funding in national budgets.
This, he noted, would gradually raise the government allocations toward HIV, TB, and primary health care rather than relying mainly on external donors.
“Nigeria should also explore innovative financing (sin taxes, levies earmarked for health, tobacco taxes, and dedicated health bonds).
Expand local partnerships by engaging the private sector (e.g., pharmaceutical companies, insurers) to co-finance HIV/AIDS and TB programmes.
The country should encourage local production and procurement of drugs and diagnostics to reduce foreign currency outflows.
“The country should equally diversify international partnerships, strengthen collaborations with other partners such as the European Union, UK development partners, Japan, and China, as well as foundations (e.g., Global Fund, Unitaid) to fill the emerging funding vacuum.
“It should also leverage regional platforms like the African CDC and ECOWAS health bodies for coordinated disease surveillance and response.
Carry out institutional reforms by investing in Nigeria’s disease surveillance, lab networks, health workforce training, and data systems to reduce dependency on external technical support,” he said. The professor is of the opinion that strengthening public-private-partnerships and integrating donor-funded programmes into mainstream public health delivery could do the magic.
He also said that there won’t be instant cessation of ART or TB drugs, as, according to him, stocks already procured and ongoing national programmes will continue for a time. “However, future procurement funding may become uncertain without alternative financing,” he said.
He believes that the WHO pro- grammes won’t disappear overnight as they still exist and can operate with support from other donors and Nigeria’s contributions.
The shortfall, he said, would create gaps but “is not an outright termination of programmes. “Panic is premature but vigilance is necessary.
Panic among patients stems from concern about costs and drug availability. But with strategic government intervention and alternative funding mobilisation, catastrophic outcomes can be prevented. Nigeria will face pressure to fill funding gaps and may have to reallocate budget resources toward health.
“Some international programmes might face delays or reduced scope unless new donors are mobilised. If Nigeria invests in health financing reform and domestic capacity, it can lessen dependency on external donors.
“Without strategic response, there’s risk of slower progress in reducing HIV/TB incidence and mortality, increased out-of-pocket costs, and weakened outbreak detection systems.”
A Professor of Veterinary Medicine and Clinical Virology, Maduike Ezeibe, told one of our reporters that the USA-withdrawal from the WHO and the “hardship” it portends for Nigeria is an opportunity for the country to become the great nation God wants it to be.
Ezeibe believes that the country can convert the USA’s withdrawal from the WHO, to its advantage by starting to promote the scientific discoveries of her citizens.
He said by the time Nigerian scientists start achieving a cure for HIV/ AIDS and other viral diseases, cancers and other tumors, the country would be noticed and recognised within the scientific world.
By doing so, the withdrawal by the USA from the WHO would become a blessing. “Recall that Nigerian Institute of Medical Research (NIMR) confirmed Medicinal Synthetic Aluminum Magnesium silicate (MSAMS) as safe, though they are yet to announce the outcome of trials of the medicine on HIV/AIDS they have conducted since 2020.
We have seen that abundance of natural resources without adequate scientific input has not helped us. Science and technology are what make nations great.
“Nigeria spends a lot, maintaining universities and other tertiary institutions yet when scientists from the institutions announce that they have achieved what other nations have not achieved; instead of encouraging them, many Nigerians get annoyed as if we (Nigerians) are supposed to be inferi- or,” Ezeibe stated.
On his part, Medical Director of Ajaokuta Steel Company Limited (ASCL) Medical Centre, Ajaokuta, Kogi State, Dr Usman Abdulrahman, raised concerns that Nigeria’s HIV and TB treatment programmes, largely sustained by donor funding, could suffer severe disruptions if international support dwindles.
He said that the U.S withdrawal from the WHO could have a negative impact on the treatment of TB and HIV because the programmes largely depend on donor funding.
The United States government, through agencies such as USAID and PEPFAR, Abdulrahman noted, has for years been a major contributor to Nigeria’s HIV response, supporting the provision of antiretroviral drugs, laboratory services, and community-based interventions.
He warned that emerging policy directions and funding uncertainties could destabilise ongoing interventions. Nigeria has one of the largest HIV burdens globally, with about two million people living with the virus, while the country also ranks among the high TB burden nations identified by the WHO.
According to Abdulrahman, any reduction in funding may not only affect existing patients but also expose newly infected persons to higher risks. He explained that inconsistent access to antiretroviral therapy often leads to treatment interruption, a major driver of drug-resistant HIV strains.
“Most of the international agencies relating to TB and HIV management are already collapsing or downsizing. That will inevitably affect the quality of healthcare delivery to patients living with HIV and TB.
“From President Trump’s recent speech, he indicated that priority would be given to those already on treatment. While that may sound reassuring, it makes newly affected persons vulnerable. If new patients cannot access timely treatment, the trajectory could lead to increased HIV drug resistance rates in Nigeria.
“When drugs are not consistently available, patients default not because they want to, but because the system fails them. That is how resistance sets in, and once resistance increases, treatment becomes more expensive and more complicated,” he added.
Despite the looming concerns, Abdulrahman noted that the Nigerian government has initiated high-level engagements to ensure continuity of care.
He described the proposed integration as a strategic move to reduce over-reliance on donor-driven, vertical programmes. Abdulrahman also pointed to potential alternative funding streams, though he cautioned that replacing U.S. support would not be easy.
He added: “Nigeria has been interacting with all relevant agencies to discuss a smooth transition towards full local funding of the programme. A lot of policies are being developed, including the integration of HIV management into routine hospital activities.
“When HIV services are fully integrated into general hospital systems, it strengthens ownership and sustainability. But this transition requires substantial domestic funding and political will.
“There are a few alternative funding options, possibly from countries like China and some European nations. But the scale of the U.S. support over the years has been massive. Any replacement must match both the funding volume and technical assistance.
“This is not the time for panic, but it is the time for deliberate action. The government must prioritise sustainable health financing to protect the gains we have recorded in HIV and TB care. The lives of millions of Nigerians depend on it,” he said.
A Public health analyst, George Hwande, also noted that Nigeria must urgently scale up domestic health financing to cushion potential funding shocks.
Hwande warned that progress made over the past decade in reducing HIV-related deaths and improving TB detection rates could be reversed if the government does not act swiftly.
According to him, with the looming funding uncertainties, Nigeria’s ability to mobilise domestic resources and secure diversified global partnerships will determine whether the country sustains or loses hard-earned progress in the fight against HIV and TB. “It will be disastrous if Nigeria fails to scale up domestic financing.
This is time for action, not just talk. Last year, so much money was wasted for some so-called dialogues on health financing, millions of naira were spent.
The dialogues as far as I’m concerned were un- necessary; there was nothing new but the same songs we have been singing.
“I know the minister is trying but we should limit the money we waste on massive beautiful halls, logistics and what have you.
Such funds should not be regarded as a drop in the ocean; they will go a long way in HIV and TB care,” he added.
•Additional report by Regina Otokpa (Abuja)
