Former Minister of Health and Nigeria’s Ambassador-designate to Canada, Prof. Isaac Adewole, has warned that recent reductions in foreign development assistance could jeopardise decades of progress in the fight against HIV/AIDS, tuberculosis, malaria and other public health challenges unless Nigeria strengthens domestic healthcare funding.
Adewole spoke in Abuja during the 25th anniversary celebration and public health symposium of APIN Public Health Initiatives, where health stakeholders assessed the organisation’s impact over the past quarter-century and explored strategies for sustaining health gains amid declining global donor support.
Delivering a presentation on sustaining health gains amid global uncertainty, Adewole noted that significant advances had been recorded globally in reducing child and maternal mortality as well as combating infectious diseases. However, he cautioned that these achievements could be reversed if countries fail to invest adequately in healthcare systems and financing.
According to him, improved immunisation coverage, enhanced maternal healthcare, better nutrition, and stronger disease management programmes have contributed to substantial reductions in under-five mortality over the past three decades.
He highlighted notable progress in the fight against HIV/AIDS through expanded access to antiretroviral therapy, prevention of mother-to-child transmission services, decentralised care and community-based interventions. Similar gains, he said, have been recorded in tuberculosis control through the deployment of rapid diagnostic technologies and improved integration of TB and HIV services.
Adewole also pointed to successes in malaria prevention and treatment, including the widespread distribution of insecticide-treated nets, increased access to effective therapies, rapid testing and the introduction of malaria vaccines.
On immunisation, he noted that global polio cases have declined by more than 99 per cent since 1988, while Nigeria has expanded access to vaccines against diseases such as hepatitis B, rotavirus, meningitis and human papillomavirus (HPV). He disclosed that nearly 17 million Nigerian girls have received HPV vaccines aimed at preventing cervical cancer.
Despite these achievements, Adewole warned that emerging challenges such as climate change, pandemics, antimicrobial resistance, economic instability and declining donor funding pose serious threats to public health programmes.
He observed that cuts in development assistance are not limited to the United States, noting that several European countries, including the United Kingdom, Germany, the Netherlands and Sweden, have also reduced overseas aid budgets.
“The issue of local funding has become critical, and countries must now use their own resources to address health challenges,” he said.
Adewole stressed that crises often weaken health systems by disrupting routine services, damaging supply chains and diverting resources, making sustained investment in healthcare more important than ever.
Representing the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Pate, the Director-General of the National Agency for the Control of AIDS (NACA), Dr. Temitope Ilori, described APIN as one of Nigeria’s most successful indigenous public health organisations.
She said APIN was established 25 years ago during a period when HIV treatment options were limited and stigma remained widespread, but has since evolved into a major partner of the Federal Government in healthcare delivery.
According to Ilori, APIN currently operates in 30 states and provides treatment services to nearly 20 per cent of Nigerians living with HIV. She added that the organisation has strengthened laboratory networks, improved health data systems, conducted major public health surveys and supported healthcare infrastructure development nationwide.
She noted that APIN’s work aligns with the Federal Government’s Health Sector Renewal Investment Initiative and has contributed to expanding HIV services at primary healthcare centres, strengthening prevention programmes and building workforce capacity.
However, Ilori acknowledged that significant challenges remain, including persistent HIV infections among vulnerable populations, the growing threat of drug-resistant tuberculosis, rising cases of non-communicable diseases and continued dependence on foreign donors for health financing.
“The need for more sustainable domestic health financing to reduce our over-dependence on international donors remains critical,” she said.
Also speaking, APIN Chief Executive Officer, Prof. Prosper Okonkwo, expressed confidence that the organisation would continue delivering impact despite shifts in global health financing.
He said APIN has spent years building the capacity required to navigate changing funding realities and will continue leveraging technology, skilled personnel, strong institutional systems and strategic partnerships to sustain public health interventions across the country.
Founded in 2000 as an HIV/AIDS prevention, treatment and research programme, APIN has expanded its scope to include tuberculosis, malaria, maternal and child health, disease surveillance, health systems strengthening and workforce development.
The anniversary celebration comes amid growing concerns over declining international health funding. Nigeria remains one of the countries with the highest burdens of HIV, tuberculosis and malaria and has historically relied on support from international partners and donor agencies.
Health experts maintain that sustaining progress against these diseases will require stronger domestic financing, resilient health systems and closer collaboration among government agencies, development partners and indigenous health organisations.
