Nigeria

Nigeria's One Health platform, coordinated through the Nigeria Centre for Disease Control and Prevention alongside agriculture and environment ministries, prioritizes Lassa fever, avian influenza, and antimicrobial resistance surveillance across its large and diverse agricultural sector.

Nigeria carries one of the world's largest absolute burdens of malaria, tuberculosis, and cholera, alongside recurring Lassa fever outbreaks concentrated in the southern and central states. Rapid urbanization in Lagos and other major cities is straining water, sanitation, and primary care infrastructure faster than it can be rebuilt.

Nigeria's federal structure gives states substantial authority over health service delivery, producing wide variation in quality and financing between wealthier states like Lagos and lower-resource northern states. Primary health care remains underfunded relative to need across most of the country.

Water and sanitation access remains a central environmental health constraint, particularly in the rapidly growing informal settlements surrounding Lagos and other major cities, where cholera risk stays persistently elevated. Air pollution from transportation and informal industry is a growing but under-addressed urban health burden.

Nigeria's large and largely informal livestock and poultry sector creates significant surveillance blind spots for avian influenza and other zoonotic threats, even as formal veterinary services have improved in commercial operations concentrated around major cities.

Flooding along the Niger and Benue river basins has produced some of the continent's most severe recent displacement events, each one followed by predictable spikes in cholera and other water-borne disease. Northern Nigeria's growing desertification pressure is compounding food insecurity and displacement in a region already facing significant conflict-driven health system strain.

The Nigeria Centre for Disease Control has built genuinely strong outbreak response and genomic sequencing capacity, tested repeatedly through Lassa fever seasons and other outbreak events. That national-level capacity doesn't yet extend evenly into the state-level response systems that determine how quickly an outbreak signal becomes an effective local response.

Expanding domestic health financing through the Basic Health Care Provision Fund and strengthening primary health care are the dominant stated federal priorities, alongside continued investment in the country's disease surveillance infrastructure.

Nigeria has historically been one of the largest recipients of global health financing on the continent, particularly for malaria, HIV, and immunization programs. Contracting development assistance is forcing a faster transition toward domestic financing than the health system's budget structures were built to absorb smoothly.

The Global Fund, Gavi, the World Bank, the Bill & Melinda Gates Foundation, the Africa CDC, and major bilateral partners maintain substantial programs across malaria, immunization, and health system strengthening in Nigeria.

The gap between Nigeria's federal-level disease surveillance sophistication and state-level primary care and response capacity is the country's most consistent implementation constraint, particularly in northern states facing simultaneous conflict, displacement, and health financing pressure.

Nigeria's implementation opportunity is less about building new national capacity and more about translating existing federal capability into consistent state-level execution, especially in the states carrying the heaviest and most complex disease burden with the least financing capacity.