The Health Sector Reform Coalition (HSRC) has raised the alarm over the dwindling financial fortunes of Nigeria’s health sector, warning that the strain is disrupting critical services, including immunisation, maternal care, disease surveillance, and emergency preparedness.

At the coalition’s joint yearly review in Abuja, Chairperson of HSRC Nigeria, Dr Mustafa Lecky, said the prolonged underfunding, coupled with the persistent “Japa” syndrome, has left the health system overstretched.

According to him, the exodus of medical professionals continues unabated. “Almost every one of us knows a health worker, an erstwhile colleague, or that town doctor who has gone overseas,” he said, stressing the urgent need to stop the drain.

Lecky acknowledged efforts by the Federal Ministry of Health to confront the sector’s challenges, including growing the health budget by an additional $200 million to cushion declining external assistance. However, he argued that this is still far from sufficient to meet the country’s expanding health needs.

He called for more creative collaboration between civil society organisations (CSOs) and the government to ensure the Ministry of Finance releases funds as appropriated.

“We commend the steady progress being made with the transparent fund flow within the Basic Health Care Provision Fund (BHCPF),” he said. “The BHCPF has become the anchor for ongoing reforms across all levels of government. But this is not enough. The health sector needs more funding.”

Lecky noted that Nigeria’s health system remains highly vulnerable. “Our resilience in responding to outbreaks, ­climate-related health risks, and emergencies remains patchy and unimpressive,” he warned.

He said human resources for health remain a major concern, with severe shortages, uneven distribution of personnel, and inadequate training. He emphasised the need for strategies to address the Japa syndrome and strengthen the domestic workforce pipeline.

On financing, Lecky highlighted the burden of out-of-pocket expenditure on households, stressing the need to diversify and protect funding for essential services.

He also identified deep equity gaps, including disparities in access to care for rural communities, persons with disabilities, and marginalised groups.

He called for equitable access to basic health services regardless of geography or income, and for stronger, more resilient systems capable of withstanding shocks such as epidemics and climate-related events.

Lecky further noted that despite ongoing efforts, persistent challenges remain, particularly in the socialisation and adoption of the Sector-Wide Approach (SWAp), which he said still has a long way to go. He also urged the government to tackle the fragmentation of service delivery across federal, state, and local levels, as well as between public and private providers.

While acknowledging progress in expanding primary health care (PHC) facilities and services, Lecky said “much is still needed,” especially in ensuring adequate financing for PHC revitalisation.

He reaffirmed the coalition’s commitment to promoting accountability, transparency in resource use, and meaningful community participation in health decision-making. HSRC, he said, remains focused on driving measurable improvements in health outcomes for all Nigerians, particularly women, children, and other vulnerable populations.