By Okey Akpa

Few aspects of President Bola Ahmed Tinubu’s reform programme have attracted more public attention than the economy. Debate has centred on fiscal policy, exchange-rate reforms, inflation, taxation, investment and the cost of living. These are the measures by which governments are usually judged because they shape economic confidence and influence the daily lives of citizens.

Healthcare has occupied a different place in that conversation. Discussion has focused on access to care, the condition of public hospitals, maternal and child health, health insurance, the availability of medicines and the performance of primary healthcare. Those remain the principal measures by which the success of health sector reforms should be judged.

They are not, however, the only ones. Some of the most significant effects of the reforms are unfolding beyond hospitals and clinics. As access to healthcare improves, the sector is also attracting investment, expanding domestic manufacturing, strengthening scientific capability, developing skilled human capital and creating new opportunities for enterprise.

A sector long regarded primarily as a consumer of public expenditure is becoming a productive sector capable of generating investment, innovation, industrial growth and skilled employment.

That wider economic significance has received far less attention than it deserves. Yet it may ultimately prove to be one of the administration’s most consequential achievements.

The reform that changed the market
The changes across Nigeria’s health sector are the product of a reform programme designed not simply to improve individual initiatives, but to reorganise the sector itself.

That process began on 12 December 2023, when President Bola Ahmed Tinubu launched the Nigeria Health Sector Renewal Investment Initiative (NHSRII) under the Renewed Hope Agenda and secured the endorsement of the Health Renewal Compact by the Federal Government, the thirty-six states and the Federal Capital Territory, together with development partners.

Implemented through the Sector-Wide Approach (SWAp), the initiative replaced fragmented interventions with a common plan, shared priorities, coordinated execution and a stronger framework for accountability. Under the leadership of the Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, that framework has been pursued with sustained discipline and consistency, translating presidential direction into coordinated action across the health sector.

The significance of that reform extended well beyond governance. Markets become investable when demand is organised, financing is predictable and institutions inspire confidence. Fragmented systems rarely create those conditions. Coherent systems do.

The effects are already evident. Since 2023, more than six million Nigerians have entered organised health insurance, expanding the market for healthcare services and essential commodities. More than 4,100 primary healthcare centres are under revitalisation, with over 3,100 already completed, while reforms to the Basic Healthcare Provision Fund are making frontline financing more reliable. Investments in the health workforce and specialist care are expanding the system’s capacity as utilisation of essential health services continues to rise.

Taken together, these reforms are creating something larger than a better organised health system. They are creating a health economy that is larger, more predictable and increasingly attractive to long-term investment. That transformation provides the foundation upon which the wider economic consequences of the reforms are beginning to unfold.

Capital follows confidence
Markets expand as demand grows. They attract investment when confidence grows with it.

That is precisely what is now happening in Nigeria’s health sector. For decades, unmet healthcare needs alone were insufficient to attract sustained investment because demand was fragmented, financing uncertain and long-term production commercially risky. The reforms are changing those fundamentals by creating a larger, more organised and more predictable market.

The Presidential Initiative to Unlock the Healthcare Value Chain (PVAC) has become the principal instrument for translating that confidence into investment. Together with the Presidential Executive Order on local manufacturing and related reforms to procurement, regulation and market shaping, it has lowered many of the structural barriers that once discouraged long-term investment while signalling a growing recognition that healthcare is not only a social sector but also a productive sector of the economy.

The response has been substantial. More than ninety investment projects, representing a pipeline valued at over US$5 billion, are under development across pharmaceuticals, vaccines, diagnostics, medical oxygen, medical devices and related industries. Afreximbank’s $1 billion financing platform, alongside additional financing involving the European Investment Bank, the Bank of Industry and other partners, is widening access to long-term capital, while collaboration between Nigerian and international manufacturers are expanding domestic production, accelerating technology transfer and strengthening industrial capability.

The significance of these developments extends beyond the value of the investments announced. They demonstrate that investors respond where policy is credible, institutions are strengthening and markets offer the prospect of sustained growth. The growing flow of capital into Nigeria’s health sector therefore reflects confidence not only in individual projects, but in the direction and durability of the reform programme itself.

That confidence is already beginning to influence the wider economy. New investment is strengthening manufacturing, expanding domestic supply chains, supporting research, encouraging innovation and creating opportunities for Nigerian enterprise. A sector once regarded largely as a destination for public expenditure is steadily becoming a platform for productive investment, industrial expansion and long-term economic growth.

Making more at home
Every economy reaches a point at which it must decide whether to remain principally a consumer of other countries’ production or become a producer in its own right. For many years, Nigeria’s health sector belonged firmly in the former category. Medicines, vaccines, diagnostics, medical devices and other essential health commodities were largely imported, leaving the country exposed to external supply disruptions while much of the economic value created by domestic demand accrued elsewhere.

The current reforms are beginning to change that equation.

The ambition extends beyond producing more medicines locally. It is to build an integrated healthcare manufacturing ecosystem capable of serving a growing domestic market while positioning Nigerian firms to compete across regional and global value chains. The Presidential Executive Order on local manufacturing, market-shaping interventions, pooled procurement through Medipool and strategic partnerships with Nigerian and international manufacturers are all directed towards that objective

The results are already evident. Investment is expanding pharmaceutical manufacturing, oxygen production, diagnostics, rapid diagnostic tests, treated bed nets and medical technologies. Companies that once viewed Nigeria primarily as a destination for imported products are increasingly investing in local production, assembly and technology partnerships, while established manufacturers are expanding operations in response to a market whose long-term direction has become clearer.

To be continued tomorrow.

Akpa, PhD, is the Managing Director of SKG Pharma, a leading pharmaceutical research and manufacturing company in sub-Saharan Africa. He is also the former Chairman of the Pharmaceutical Group of Manufacturers’ Association of Nigeria and the current President of West African Pharmaceutical Manufacturers Association (WAPMA). He is based in Lagos.