Get Guardian on GoogleThe House of Representatives has uncovered accountability and governance gaps in Nigeria’s management of $4.6 billion in international health grants.
Nigeria received the funds from the Global Fund and the United States Agency for International Development (USAID) between 2021 and 2025.
The lawmakers identified failures in financial reporting, weak legislative oversight, procurement concerns and delays in counterpart funding among the shortcomings affecting the implementation of donor-supported health programmes.
The grants comprise $2.8 billion from the Global Fund and $1.8 billion from USAID. They support Nigeria’s response to HIV/AIDS, tuberculosis (TB) and malaria, as well as efforts to strengthen the country’s health systems.
The House made the findings public on Wednesday following the adoption of a nine-page investigative report by its Committee on Infectious Diseases.
Speaker Abbas Tajudeen presided over the Committee of the Whole, which considered the recommendations clause by clause before adopting the report.
One of the major concerns was the failure of Principal Recipients and Sub-Recipients to submit annual implementation plans to the National Assembly for review and approval before commencing grant-funded activities.
The committee also discovered that implementing partners did not submit quarterly programme and financial reports to the legislature. This, it said, restricted lawmakers’ ability to monitor expenditure, evaluate performance and track the results of the interventions.
The report further faulted the exclusion of the National Assembly from the Country Coordinating Mechanism (CCM) Nigeria, leaving elected representatives outside key decisions on the deployment of substantial international health resources.
Beyond legislative oversight, the lawmakers identified delays in counterpart funding and concerns over the diversion of insecticide-treated mosquito nets after distribution.
They also questioned disparities in the selection of states for interventions and the large number of Sub-Recipients involved in implementing the programmes.
The committee raised concerns about the location of some tuberculosis clinics, warning that their placement could expose patients to stigma.
It also identified weak collaboration between grant implementers and anti-corruption agencies, particularly the Economic and Financial Crimes Commission (EFCC) and the Independent Corrupt Practices and Other Related Offences Commission (ICPC).
On procurement, the lawmakers observed that Principal Recipients did not use Nigeria’s national procurement systems for all commodities required under the programmes.
However, the CCM and implementing partners explained that Global Fund grant conditions demand transparent procurement procedures, effective financial controls and measurable health outcomes.
They noted that the Global Fund’s Wambo.org platform handled much of the procurement of health and non-health products for Nigeria’s portfolio, with the Fund making payments directly.
To address the identified deficiencies, the House recommended that all Principal Recipients and Sub-Recipients submit annual implementation plans to the National Assembly for legislative scrutiny and approval before receiving grant funds.
It also called for mandatory quarterly submission of programme and financial reports to strengthen monitoring and accountability.
The lawmakers urged the government to establish formal collaboration between grant implementers and anti-corruption agencies to promote transparency, investigate possible financial irregularities and ensure compliance with established standards.
They further recommended that future grants empower Nigerian institutions to manage resources while ensuring that implementation reflects the country’s national health priorities.
On domestic financing, the committee called for stronger government commitments to counterpart funding and urged the National Assembly to make appropriate budgetary provisions for Nigeria’s pledged contributions.
It also recommended increased budgetary allocations to the health sector, including dedicated funding lines for HIV, tuberculosis and malaria programmes.
According to the report, stronger domestic financing would reduce Nigeria’s dependence on external donors and ensure the sustainability of essential health interventions.
The House also urged the Federal Ministry of Health and Social Welfare to provide adequate operational funding for CCM Nigeria.
Such support, it said, should include permanent office accommodation and improved working conditions for the coordinating mechanism and national health programmes.
The lawmakers further called on the ministry to ensure that Nigeria fulfils its financial commitments towards the replenishment of future Global Fund grant cycles.
Nigeria established CCM Nigeria in March 2002 through the Federal Ministry of Health as a national platform for coordinating access to Global Fund resources.
The mechanism brings together representatives of government, civil society, religious organisations and the private sector.
Although it does not directly manage or execute grants, it provides governance, strategic direction and oversight. Its responsibilities include identifying priority interventions, preparing funding requests and offering technical and managerial guidance to implementing partners.
The report disclosed that CCM Nigeria mobilised more than $4.8 billion from the Global Fund between 2002 and 2020 for HIV, tuberculosis, malaria and health system strengthening, particularly in underserved communities.
For the 2021–2023 funding period, the Global Fund approved $1.214 billion for interventions covering HIV, tuberculosis, malaria, COVID-19 response and resilient and sustainable health systems.
The allocation received an extension until December 31, 2025.
Similarly, the 2023–2025 allocation for HIV, TB and malaria initially stood at approximately $962.7 million but dropped to $867.2 million in 2025 because of constraints in the global funding environment.
Despite the identified shortcomings, the committee acknowledged the contributions of Global Fund investments to Nigeria’s health sector.
It cited improvements in diagnostic capacity, the continuity of essential health services during the COVID-19 pandemic and reductions in disease-related morbidity and mortality.
The lawmakers maintained, however, that stronger accountability, effective legislative supervision and increased domestic investment remain necessary to protect these gains and ensure that international health assistance delivers lasting benefits to Nigerians.
