USAID

What could we do without foreign healthcare funding?

By Saifullahi Attahir

Although not an expert in global health, the future for Nigeria’s healthcare intervention looks bleak.

Over the decades, we have become overly dependent on foreign aid in managing HIV/AIDS, Tuberculosis, Malaria, Maternal mortality, and malnutrition. Looking at it critically, it seems only a few medical conditions are not supported by foreign aid. 

Of course, it’s true that these medications would cost a huge chunk of our budget if left to be funded domestically.

As someone who works and mingles in the lower ranks, I have witnessed many sorrowful occurrences;Nigerians and even healthcare professionals do not contribute to improving the situation every day. 

The gross mismanagement, working solely for the sake of remuneration, and how locals can manipulate thingsto ensure that funding for the Polio and measles vaccine campaign keeps coming is abominable. 

Local community health workers eagerly take what little support is available for the poor victims. I have witnessed dozens of people only interested in switching to public health positions to work with NGOs (Non-Governmental Organisations). Everyone rushes toward the available funding for nurses, doctors, anatomists,  scientists, etc.. 

This is apart from an article I read in 2016 by the legendary Sonala Olumhense about the 2010 report by the Global Fund about crude mismanagement of the fund by several Nigerian agencies regarding the money allocated to fight HIV/AIDS, TB, and Malaria.

Ideally, foreign funding should not be eternal; the country must find a way to sustain the programs.

 Public health is well-versed in public-private partnerships (PPPS) and the design of each primary healthcare program so that locals can sustain it. Since day one, this has raised the issue of affordability, which the US should have taught Nigerians how to develop drugs locally at a cheaper rate, so as not to depend on their markets and pharmaceutical companies.

President Trump has already come, and we should expect and prepare for more shocks rather than continual crying out. This should serve as a wake-up call for our policymakers and the President to find a way out.

It’s unlikely the USAID funding would be reversed. We should have prepared for the rainy days ahead.

Saifullahi Attahir, a 400l Medical student of  Federal University Dutse, wrote via saifullahiattahir93@gmail.com.

United States’ withdrawal from WHO and Africa’s looming health crisis

By Lawal Dahiru Mamman

Some Nigerians with the wrong intention to mock believe that sick individuals, particularly those living with Human Immunodeficiency Virus (HIV) in Africa, especially Nigeria, are now an “endangered species” due to the United States’ withdrawal from the World Health Organization (WHO).

On January 20, 2025, Donald Trump was sworn in as the 47th President of the United States, marking his return to the White House after defeating the Democratic candidate in a fierce election battle. As the world looked on to see how he would start fulfilling his promise to make “America great again,” he wasted no time signing executive orders that sent shockwaves around the globe.

One of his most controversial directives came just days into his presidency: the announcement of the U.S. withdrawal from the WHO, an organization of which it had been a founding member since 1948. This move was not entirely unexpected, as Trump had previously attempted to exit the WHO in 2020 before his decision was overturned by President Joe Biden in 2021.

To the delight of his supporters and the disappointment of his critics, Trump successfully achieved the withdrawal in early 2025. In February, he made further decisions, including cutting funding to certain organizations such as the United States Agency for International Development (USAID).

WHO leadership bemoaned the decision for obvious reasons. According to financing data, the U.S. contributed an estimated $988 million between January and November 2024, marking approximately 14% of WHO’s $6.9 billion budget. The organization further noted that U.S. funding provides the backbone for many large-scale emergency operations to combat diseases globally.

Citing an example, the WHO stated, “U.S. funding covers 95% of the WHO’s tuberculosis program in Europe, along with 60% of the agency’s TB efforts in Africa, the Western Pacific, and headquarters in Geneva.”

The African Union (AU) also expressed deep concern over the development as events continued to unfold. In a statement, AU Commission Chairperson Moussa Faki Mahamat emphasized the crucial role the U.S. has played in shaping global health standards over the past seven decades. He noted that the U.S. was a key supporter in establishing the Africa Centers for Disease Control and Prevention (Africa CDC), which works closely with WHO to tackle global health challenges, including those on the African continent.

This concern, coupled with comments such as those in the opening paragraph of this piece, should not be taken at face value or dismissed as mere press statements. It warrants careful consideration. Although the latter’s comment may be seen as a reaction to unfolding events or an attempt to mock Nigeria and Africa jokingly, more is at stake if the lives of millions of Africans solely depend on that funding.

Dead Aid: Why Aid Is Not Working and How There Is a Better Way for Africa, a 2009 book written by Zambian economist Dambisa Moyo, comes to mind. It earnestly challenged the traditional approach to foreign aid in Africa.

Moyo argues that foreign aid has failed to lift Africa out of poverty and has instead fostered a culture of dependency, corruption, and stagnation. She claims that aid has weakened Africa’s incentive to develop its own economic and political systems. Consequently, it has hindered the growth of Africa’s health sector.

It is a universal truth that no nation can survive in isolation; however, countries should be able to provide for their basic survival needs. The concern raised by the AU may validate Moyo’s hypothesis, as Africa remains dependent on aid from foreign entities like the WHO, despite having a continent-wide centre for disease control.

In 2001, African leaders signed the Abuja Declaration, promising to increase budgetary allocation for health, eradicate HIV/AIDS, and strengthen the health sector through improved infrastructure, human resources, and access to essential medicines.

Two decades later, we are lamenting a single nation’s withdrawal from the WHO because we have failed to uphold the promises we made to ourselves. What will happen if other “powerful” countries choose to leave? Will our already poor health metrics deteriorate? This should serve as a wake-up call.

All hope is not lost, as some progress has been made. In Nigeria, there was a breakthrough in November 2024. Doctors at Lagos University Teaching Hospital (LUTH), in collaboration with the Sickle Cell Foundation, successfully carried out a bone marrow transplant on two patients. This procedure once thought impossible in Nigeria, was described as “a significant step forward in the treatment of sickle cell disease—the first of its kind in West Africa.”

Also, in February 2025, Usmanu Danfodiyo University Teaching Hospital (UDUTH) joined the ranks of medical facilities that have successfully performed kidney transplants.

Nigeria can build upon and enhance these developments, attracting patients from other regions for treatment. This influx will generate revenue and may elevate us to a point where we no longer depend on funding from external organizations.

Nigeria and other African nations can leverage their existing resources to generate revenue while investing further in research to discover cures or treatments for diseases for which we have traditionally relied on palliatives.

Lawal Dahiru Mamman writes from Abuja and can be reached at dahirulawal90@gmail.com.