Shalom David and Prudence Enema (Lead writers)
Barely a month into 2026, Nigerians are riding the global “2026 is the new 2016” wave, posting throwbacks and “then vs now” comparisons that ask what has really changed in ten years. A decade later, the transformation cuts across sectors. Nigerian music and film now reach global audiences through platforms such as Netflix and Spotify. The tech ecosystem has expanded rapidly, with fintech, health tech, and growing engagement with artificial intelligence reshaping how Nigerians work, learn, and build solutions. If Nigeria’s creative, digital, and technology ecosystems have evolved so significantly over the past decade, can the same be said of the country’s health system?
Health funding in a loop
The relationship between 2016 and 2026 is less “neglect, then action” and more “ambition, then repetition”. In 2016, Nigeria’s health system was under visible strain, shaped by fiscal tightening and deep structural weaknesses that limited what budgets could translate into at facility level. In 2016, out-of-pocket spending accounted for about 75.2% of current health expenditure; by 2026, it is about 76.1%, a signal that financial protection has not changed much.
In 2026, the talk of transformation is louder, but the lived reality for many Nigerians is familiar. Care is still often accessed when people can pay, not when they need it. Funding frameworks may be more elaborate on paper, but health still sits low among public priorities, and households remain the primary funders of care. That reality reinforces a damaging message that access depends more on personal means than public protection. And when coverage is measured, progress still looks modest. Nigeria’s universal health coverage (UHC) service index was about 44 in 2016 and is about 47 in 2026, a small shift over the last decade, and far from what Nigerians need from a primary care-led system.
Different budget, same level of effort
In 2016, the Federal Government budgeted about ₦6.08 trillion, with about ₦257.38 billion for health, around 4.2% of the overall budget. The allocation was heavily inclined towards recurrent spending, limiting room for infrastructure, system strengthening, and long-term investment. Health funding also far below the 15% target set by the Abuja Declaration. A decade later, the naira figures are larger, but the proportions look stubbornly similar.
In 2026, the Federal Government proposed about ₦2.48 trillion for health, around 4.2% of the proposed ₦58 trillion Appropriation Bill. The budget framing promises consolidation and resilience, alongside stronger primary healthcare, expanded access, and faster progress towards UHC. The pattern of ambitious language, modest allocation, and a widening credibility gap between policy intent and financial commitment persists.
Progress that is too slow for mothers and children
Nigeria’s maternal health indicators painted a grim picture in 2016. National estimates put the maternal mortality ratio (MMR) at 576 maternal deaths per 100,000 live births. Skilled attendance at birth was 38% in 2016, meaning 3 in 5 births happened without a skilled birth attendant present. By 2026, progress still reads as incremental rather than transformative. By the latest available national estimates, Nigeria’s MMR is about 512 per 100,000 live births, still far from the SDG target of 70. Skilled attendance improved to 46%, but that still leaves millions of women exposed to preventable risk.
The point is not that nothing has changed; it is that change has not been fast enough to match the scale of avoidable death. In 2016, routine immunisation coverage was already a warning light. DTP3 coverage (third dose of the DPT-HepB-Hib (pentavalent) vaccine among children aged 12–23 months) was 38% in 2016; by 2026, it is 53%. That is upward movement, but not the kind that builds herd protection, prevents outbreaks, and reassures parents that primary care can reliably deliver essential care.
Policies that outlast their impact
In 2016, Nigeria approved a revised National Health Policy, framing health as a driver of socio-economic development and aligning national goals with the Sustainable Development Goals (SDGs). That same year, the Nigeria Supply Chain Policy for Pharmaceuticals and Other Healthcare Products was adopted to address fragmentation in the procurement and distribution of essential medicines and health commodities. A decade on, many of those ambitions remain only partly realised. Policies and plans signal intent, but persistent weaknesses in the form of stock availability, last-mile delivery, and data visibility continue to undermine resilience, especially at primary care level.
In 2026, Nigeria’s health system operates under the National Health Sector Renewal Investment Initiative (NHSRII), unveiled in December 2023 following adoption by the National Council on Health. It is positioned as a flagship agenda to accelerate UHC, strengthen primary health care, and improve service delivery across states. The NHSRII builds on earlier reforms rather than replacing them, which reveals both progress and stagnation. We keep diagnosing the same gaps, but implementation remains uneven.
Global visibility and domestic struggles in AMR
Nigeria’s response to antimicrobial resistance (AMR) captures the tension between leadership and delivery. In June 2016, Nigeria developed a multi-sector National Action Plan on AMR (2017–2022), designed to strengthen surveillance, stewardship, infection prevention and control, and governance across human, animal, and environmental health. The plan achieved only 44% implementation.
A second National Action Plan on AMR (2024–2028) again signals urgency, but the real test is sustained implementation, funding, and enforcement beyond documents and events. In 2026, Nigeria will host the 5th Global High-Level Ministerial Conference on AMR. The symbolism is powerful, but the question is not whether Nigeria can speak convincingly about AMR, but whether health facilities, pharmacies, and communities will experience tighter stewardship, stronger regulation, and better diagnostics where it matters most.
Health workers’ strikes that mirror the brain drain
In 2016, the Federal Government spoke repeatedly about “industrial harmony”, yet resident doctors still downed tools. In May 2016, the National Association of Resident Doctors (NARD) declared a five-day nationwide warning strike, citing unpaid salaries and arrears and other unresolved welfare issues, with patients in public hospitals forced to rely on the far fewer consultants available. By June 2016, NARD escalated further, announcing an indefinite, phased shutdown after months of engagements, a warning strike, and ultimatums that it said did not deliver on remuneration and welfare commitments. Fast-forward to January 2026, and the same storyline is playing out, only louder, longer, and more system wide. JOHESU commenced an indefinite nationwide strike on 14 November 2025, and by mid-January 2026 it remained ongoing, with the union alleging major service and revenue disruption across 73 federal health institutions.
Nigeria’s National Policy on Health Workforce Migration flags outward movement using “letters of good standing” and reports that requests peaked at over 3,000 doctors in 2022. Peer-reviewed evidence links the “strike–migration” loop to the same underlying drivers such as pay, working conditions, career progression, and system governance. The hard comparison, 10 years later, is that when strikes repeatedly interrupt care and migration steadily drains experienced staff, the system pays twice, first in service disruption today, and then in reduced capacity tomorrow. The question for 2026 is whether Nigeria will keep treating health workers’ welfare, pay equity, and workplace conditions as episodic labour disputes, or finally as core health-system reforms that directly determine access, quality, and survival.
As nostalgia floods our timelines and 2016 replays itself, Nigeria faces a far less entertaining question of not whether 2026 feels like 2016, but whether we are comfortable letting history repeat itself. Trends come and go, but systems endure. The real choice is whether we accept another decade of déjà vu or decide now that the failures of 2016 and 2026 will not be the ones we are still explaining in 2036. If 2026 mirrors 2016, it is because we keep funding promises, not concrete healthcare. Nigeria must finance PHC, protect households, implement reforms, and fix the welfare of health care workers today, not in 2036.