Thought Leadership

7 Billion and counting – implications for Nigeria

A few weeks ago, the worlds’ population was said to have crossed the 7 million mark. Apart from the normal ritual of sound bites in the Nigerian media, there has been very little thought on what this means for us. But the population growth has profound implications. Below is a diagram called a ‘population pyramid’ for Nigeria. You do not need to see the details, on the right side are females and the left males. The youngest are at the bottom of and it rises to the oldest at the top. Nearly 50% of Nigerians are under the age of 15. Our dear country Nigeria has been experiencing a population explosion for the last 50 years due to high fertility rates, quadrupling its population over this time.

Some Nigerians pride themselves as the ‘Giant of Africa’ based on a numerical advantage offered by the stroke of Lord Luggard’s felt pen in 1914. Only recently, with the exponential growth of MTN has the country come to realise the potential economic value of its rising population. It is definitely a great market, but there is more to building a country than  market size, especially one like ours that consumes a lot and produces very little. 

So, what does this mean for Health? Firstly, let us look at the shape of our population? The Nigerian Population Commission tells us that there are now 167 million of us. These 167 million Nigerians are not evenly distributed. They are mostly young consumers of services. Across the country, while we have seen growth in the private sector driving sections of the economy, our public services, especially health have lagged behind. With some notable exceptions in Lagos and Rivers states, the health sector has received little investment. Our politicians do not find political capital in investing in health. So, we are sitting on a time bomb….failing public services and a burgeoning young population. Is any one listening? We are unable to provide for the health of our population, the same population that is growing exponentially – something will have to give. 

We are not the only ones worrying about this. On the day the Nigerian Population Commission announced that our population was now a staggering 167,912,561 and is projected to hit 221,392,163 by July 1, 2020. – hardly anyone paid attention. As described by the Regional Head of Research, Africa, Global Research, Standard Chartered Bank, Razia Khan, Nigeria’s “big concern of course is whether sufficient employment opportunities can be generated to absorb the country’s growing pool of labour, and whether this can take place rapidly enough.”

We have to prepare or be prepared to fail. Business as usual will not be good enough. Our leaders will have to lead…in no sector is it more critical than the health sector.

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

By Chikwe Ihekweazu

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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