Billionaire philanthropist and Microsoft co-founder Bill Gates has raised concerns over Nigeria’s inadequate health spending, stating that current funding levels are far too low to tackle the country’s pressing healthcare challenges, including high maternal and child mortality rates, malnutrition, and disease outbreaks.
Speaking during a roundtable discussion with journalists in Lagos on Wednesday, Gates emphasised that Nigeria’s public health investment fails to match the scale of its healthcare needs.
He said: “When you look at the numbers, the amount Nigeria spends on healthcare is very, very small.
“It is not just about percentages; in absolute terms, Nigeria’s budget for health is insufficient to tackle the crises it faces,” Gates said.
The philanthropist, who was recently awarded the national honour of Commander of the Federal Republic by President Bola Tinubu, noted that Nigeria is struggling with one of the highest maternal mortality rates in the world, alongside widespread child malnutrition and insufficient access to primary healthcare.
According to Gates, reversing these trends will require a deliberate increase in public funding, improved governance, and sustained political commitment.
Gates, whose foundation has operated in Nigeria for over a decade, emphasised that without significant investment in healthcare, the country risks stalling developmental progress and jeopardising the potential of its young population.
He stressed that while donor support can act as a catalyst, domestic commitment remains irreplaceable.
“We can assist as partners, but the foundation of a functioning health system has to be built and maintained by the government,” he said.
He described the country’s recurrent dependence on donor support and international partnerships for critical health programmes as unsustainable, warning that global health financing is becoming more constrained due to shifting geopolitical priorities and economic uncertainty.
“In the long run, you can’t depend on aid to fund your essential health systems. Countries need to build resilience internally,” he said.
While acknowledging that some Nigerian states are making commendable efforts, particularly in immunisation and family planning, the philanthropist said these efforts are not widespread enough to change national health indicators.
“In states like Kano and Lagos, you are seeing some positive movement. But if you take the country as a whole, the funding just isn’t there yet to achieve universal health coverage or even deliver basic services equitably,” he noted.
Gates said his foundation remains committed to supporting Nigeria in areas such as immunisation, polio eradication, nutrition, maternal health, and agricultural development.
He called for a shift towards facility-based deliveries and improved emergency obstetric care, stressing that home deliveries remain a leading cause of preventable maternal deaths.
“If a mother delivers at home, there are certain complications that you can’t solve,” he said.
The philanthropist disclosed that his foundation is supporting innovations aimed at making maternal and child care more affordable and accessible.
He cited low-cost ultrasound devices that identify high-risk pregnancies, affordable bleeding intervention kits, and multiple micronutrient supplements for pregnant women as some of the tools being promoted.
Gates added that recent clinical trials had yielded cost-effective ways to reduce anaemia and postpartum haemorrhage, noting that one such study had to be halted early due to its overwhelming success.
On vaccine affordability, Gates reiterated the foundation’s commitment to dramatically lowering prices through innovation and market guarantees.
“We took the rotavirus vaccine from $60 to $2. We took the pneumococcus vaccine from $60 down to $2,” he revealed.
He said the Gates Foundation was now backing the development of vaccine patches that can be applied without needles, reducing the need for trained personnel and cutting waste.
“We’re trying to take vaccines from being a shot that you have to be somewhat trained to give and just make a patch you can put on your arm,” he said.
Responding to a question on how much the foundation had invested in Nigeria’s immunisation sector, Gates said the numbers were substantial.
“You can take our portion of GAVI, which is about 20 per cent, and we do a ton of stuff directly,” he said.
He lamented that although polio cases are down by 40 per cent compared to the previous year, the north still lags in immunisation rates.
“We’ve got lots of cases in six states, including Kano and Sokoto. We’re not getting to the 90 per cent yet,” Gates said.
He expressed concern that campaign fatigue may be setting in among stakeholders and urged Nigerian governors to recommit to high-coverage vaccination drives.
“You have to refocus like you did and get these coverage levels up, because we’re not getting to the 90 per cent yet,” he stressed.
Gates said his foundation remains committed to supporting health innovations, even in the face of rising global instability and shrinking foreign aid.
“Innovation means we can do better, even if the health budget doesn’t go up.
“Over time, with economic growth, innovation, and some restoration, if you take the five-to-20-year period, I would be very optimistic about these things,” he stated.
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