Billionaire philanthropist Bill Gates has warned that Nigeria’s health spending is ‘far too small’ to address its extensive healthcare challenges

[dropcap]B[/dropcap]illionaire philanthropist and Microsoft co-founder, Bill Gates, has delivered a stark warning regarding Nigeria’s healthcare funding, stating that the country’s current public health investment is “far too small” to adequately address its numerous health challenges.

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These challenges include alarming rates of maternal and child mortality and persistent disease outbreaks.

During a roundtable discussion with journalists in Lagos on Wednesday, June 4, 2025, as part of his visit to Africa, Gates stressed that Nigeria’s public health investment simply doesn’t reflect the immense scale of its problems.

“When you look at the numbers, the amount Nigeria spends on healthcare is very, very small,” Gates asserted. “It is not just about percentages; in absolute terms, Nigeria’s budget for health is insufficient to tackle the crises it faces.”

Gates, who was recently conferred with the national award of Commander of the Federal Republic by President Bola Tinubu, highlighted that Nigeria is grappling with one of the highest maternal mortality rates globally, widespread child malnutrition, and inadequate access to primary healthcare.

He noted that reversing these worrying trends will demand a deliberate increase in public funding, better governance, and sustained political commitment.

The philanthropist, whose Bill & Melinda Gates Foundation has worked in Nigeria for over a decade, emphasized that without substantial domestic health investments, the country risks stalling development gains and undermining the immense potential of its young population.

He underscored that while donor support can serve as a catalyst, internal commitment is irreplaceable.

“We can assist as partners, but the foundation of a functioning health system has to be built and maintained by the government,” he stated, warning against the country’s recurrent dependence on donor support and international partnerships for critical health programs.

Gates cautioned that global health financing is becoming more constrained due to shifting geopolitical priorities and economic uncertainty.

When you look at the numbers, the amount Nigeria spends on healthcare is very, very small.

“In the long run, you can’t depend on aid to fund your essential health systems. Countries need to build resilience internally,” he advised.

While acknowledging commendable efforts in some Nigerian states, particularly in immunization and family planning (like Kano and Lagos), Gates stressed that these initiatives aren’t widespread enough to significantly alter national health indicators.

“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 affirmed his foundation’s continued commitment to supporting Nigeria in critical areas such as immunization, polio eradication, nutrition, maternal health, and agricultural development.

He specifically 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 foundation is actively supporting innovations to make maternal and child care more affordable and accessible.

Gates cited examples such as low-cost ultrasound devices for identifying high-risk pregnancies, affordable bleeding intervention kits, and multiple micronutrient supplements for pregnant women.

He also revealed that recent clinical trials had yielded cost-effective ways to reduce anemia and postpartum hemorrhage, with one study even halted early due to its “overwhelming success.”

On vaccine affordability, Gates reiterated the foundation’s dedication 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 added that the Gates Foundation is now backing the development of vaccine patches that can be applied without needles, which would reduce the need for trained personnel and cut 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 explained.

Regarding investments in Nigeria’s immunization sector, Gates confirmed that the foundation’s contributions are substantial, stating: “You can take our portion of GAVI, which is about 20 per cent, and we do a ton of stuff directly.”

He expressed concern that although polio cases are down by 40 per cent compared to the previous year, the north still lags in immunization 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 lamented, urging Nigerian governors to recommit to high-coverage vaccination drives.

Despite rising global instability and shrinking foreign aid, Gates said his foundation remains committed to supporting health innovations.

“Innovation means we can do better, even if the health budget doesn’t go up,” he concluded optimistically.

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“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.”