Analysis of Nigeria's budget for health in 2014

N262B (1.7Billion USD) has been allocated to #health in Nigeria’s 2014 budget; of which 82% is going to recurrent expenditure. All the detailed allocations to the Ministry of Health can be found here. We urge you to go to the website, download a copy (who knows how long it will be up) and use it to hold our health sector organisations accountable. Remember that we do have a Freedom of Information Act in Nigeria and we cannot blame government if we don’t use it. 

Health Allocation in 2014 Nigerian Budget
The N262B allocated to #health is about 6% of the total budget and second only to defense, education and finance (finance includes debt servicing). It is slightly less than the N279 allocated to Health in 2013. 

Some interesting aspects of the budget includes the N4B budgeted for the National Health Insurance Scheme, this is before  premiums are collected! Yet, it still covers less than 4% of the population, mostly employees of the Federal Government and its parastatals. 
The National Arbovirus and Vector research Institute (heard of it?…..not surprised you haven’t….we have not either). Its gets a budget of N175M. We marveled at the existence of such an important research institute in Nigeria and desperately searched online for its outputs. We found a grand total of two articles published in 2008 and 2009. We will be looking for this institute in Nigeria next year – if you have any clues where they are, kindly share! 
Our regulator; the National Agency for Food and Drug Administration and Control (NAFDAC), gets a cool N4Billion – maybe 2014 will be the year fake medicines and fake “pure” water disappears from our shelves and the ‘medicine line’ in Ogbete main market is finally closed down! 
For our tertiary hospitals, which in combination consume a huge part of our health expenditure; the University of Nigeria Teaching Hospital gets more than any other teaching hospital in Nigeria in 2014 – a cool N10Billion! The Chief Medical Director; Dr Christopher Ama must be smiling in his office this morning (as on their website). In 2014, we will be visiting Dr Mba to experience what his “transformation agenda” is bringing to UNTH!  UCH Ibadan gets N9B, ABU Zaria  N6B, and LUTH gets N6B. 
The Nigeria Centre for Disease Control, said to be located in Abuja is finally on the map with N701M. We could neither find a physical address nor a website. If you can find any of these, please do let us know. How can we hold them accountable if it exists virtually? 
Then, there are all the health related items that for some reason or the other are not under the health budget, but under “The Presidency”. The Nigerian State House has budgeted N34M for an XRay machine, N41M for a mammography machine, and N1.6M for an embalming machine. We will not comment further on this…find out why here
Also not on the the health budget is the N2.1B allocated to the National Agency for the Control of AIDS  (NACA). The most worrying aspect of this is that  none of this is will go to providing the 2.5 million Nigerians living with HIV/AIDS with life-saving antiretrovirals. N50M will be spent on one line item; supervision, monitoring and evaluation. This will be enough to provide an extra 3500 Nigerians with ARVs at a conservative estimate of $100 per patient, per year in 2014. 
To do all your personal research, download the health sector’s budget here. To find a lot more analysis on the budget (not health sector specific) go to the the excellent  website of “Budgit” and follow them on twitter @BudgITng. They have an excellent spread sheet comparing the 2014 to 2013 budgets here.  
We have a lot more information to hold the institutions in the health sector accountable for how they spend our money! We will be doing a lot more of that in 2014!

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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