By Dr Pavel Ursu |
When Africa’s health ministers convened in Addis Ababa for the Seventy-sixth session of the World Health Organization Regional Committee for Africa (RC76), they faced a question of growing urgency: How can Africa build health systems strong enough to meet its people’s needs at a time when external health assistance is falling and, in many low-income countries, debt service now exceeds government spending on health?
From 25 to 28 August 2026, the Regional Committee convened health ministers and senior officials from all 47 Member States in the WHO African Region to address the continent’s most pressing health challenges. Ministers adopted four regional strategies: on the health workforce, early childhood development, health financing, and the regulation of medical products. Additionally, the Committee advanced frameworks for emergency medical teams, polio transition, implementation of amendments to the International Health Regulations, and endorsed a broader agenda, “A new era of health for Africa: united action for Vision 2035”.
Addressing delegates, WHO Regional Director for Africa Professor Mohamed Yakub Janabi called for renewed commitment to transforming health outcomes across the continent. He urged countries to strengthen primary health care, invest in the health workforce, widen access to quality services and prepare better for public health emergencies. Achieving Universal Health Coverage and health security, he stressed, will depend on sustainable financing and stronger partnerships.
For Nigeria, Africa’s most populous country and home to nearly one in five people in the WHO African Region, the decisions made in Addis Ababa should be viewed as both a reflection of national priorities and a call to action. Nigeria has assets few countries can match. How far it uses them will weigh heavily on whether the Region meets its targets.
Perhaps the most striking commitment was adopting the Africa Health Workforce Agenda 2026–2035, under which African countries committed to planning, educating, employing, and retaining an additional three million health workers by 2035. In the Regional Director’s words, it is “a collective commitment to transform one of the foundations of its health systems, its people.”
Africa had an estimated 5.72 million health workers in 2024, yet this represented only about 46 percent of the workforce the continent needs. At the same time, an estimated one million trained health professionals are unemployed. This is a paradox: too few health workers in facilities, while many trained professionals cannot find jobs. WHO estimates that closing the gap would cost US$4–6 per person per year, and that every dollar invested can return up to ten.
Nigeria is acutely familiar with this paradox. It is one of 55 countries on the WHO Health Workforce Support and Safeguards List 2023, which identifies countries with the most pressing workforce shortages and discourages active international recruitment. The National Health Workforce Profile released this month shows 6.95 licensed doctors, nurses and midwives per 10,000 people, against the SDG index threshold of 44.5.
Discussions about Nigeria’s health workforce often center on migration, known locally as ‘the Japa syndrome,’ in which doctors, nurses, and other professionals seek better opportunities abroad. In 2024, 3,919 doctors and 274 dentists requested letters of good standing, a usual first step towards practicing abroad. That is equivalent to about 85 percent of the 4,634 doctors who graduated that year. Across all cadres, the Profile records some 50,000 external migrations of health workers in 2023–2024, half of them nurses and midwives. However, migration is only one aspect of a broader challenge: how the health workforce is trained, employed, compensated, distributed, and retained.
Expanding health worker training without creating sufficient jobs is not effective workforce planning. Nigeria already has building blocks: a National Policy on Health Workforce Migration adopted in 2024, strong training capacity, more than 37,000 health workers recruited into federal institutions since 2023 (according to government figures), and some 220,000 registered community health practitioners who form the backbone of primary health care. The task now is to align them. That means funding posts where gaps are deepest, notably in northern states such as Yobe, Zamfara, Katsina, Jigawa and Kebbi, which have the lowest doctor densities. It means improving pay, security and career paths for rural and primary care posts. And it means building a single, up-to-date national workforce registry from data still spread across 13 regulatory bodies.
Nigeria is also a major source country for international recruitment. The WHO Global Code of Practice on the International Recruitment of Health Personnel gives Nigeria a basis for negotiating government-to-government bilateral agreements that invest back into training and retention at home, rather than simply watching skills leave.
The second strategy touches every household: how health care is paid for.
The new Strategy for Financing the Future of Health in the WHO African Region, 2026–2035, aims to strengthen domestic resource mobilization, enhance efficiency, and increase the resilience of health financing. The urgency is evident: approximately 385 million people in the African Region are pushed into or further into poverty each year due to out-of-pocket health expenditures. Household payments constitute an average of 35 percent of current health expenditure across the Region, significantly exceeding the WHO benchmark of 20 percent. In Nigeria, the burden is far heavier: households pay roughly seven of every ten naira spent on health.
For Nigerian families compelled to sell property, borrow funds, or deplete savings to cover medical expenses, these statistics represent lived realities rather than abstract figures.
Universal health coverage must extend beyond mere proximity to a hospital. It should ensure that, for example, a mother in rural Zamfara or Bayelsa can access timely and quality care for her child without facing the dilemma of choosing between medical expenses and basic needs.
Governments at all levels should treat health financing as an investment in economic security, not merely a routine budgetary item. For Nigeria, that means releasing health budgets fully and on time at federal and state levels, extending the Basic Health Care Provision Fund and health insurance to the poorest households, and getting more health for every naira through strategic purchasing.
The third strategy adopted in Addis Ababa focused on early childhood development.
This may seem less urgent than epidemics or hospitals, but it could ultimately prove one of the meeting’s most consequential decisions. By 2050, two out of every five children born globally are expected to be African. Yet up to two-thirds of children in sub-Saharan Africa may not reach their full developmental potential. WHO estimates that every dollar invested in early childhood development returns between six and seventeen dollars.
For Nigeria, where millions of children are born every year, this is not a program for the future. It is an investment in the Nigeria we will become.
Nigeria is already showing what this can look like. In Osun State, frontline primary health care workers are being trained to spot developmental delays early and to support caregivers through nurturing care. The next step is to scale these approaches through primary health care, alongside nutrition and immunization services.
The fourth strategy, for 2026–2035, addresses medical product regulation. It aims to bring more national regulators to WHO Maturity Level 3 and deepen cross-border cooperation as Africa expands local pharmaceutical and vaccine manufacturing.
Local production is critical to reducing import dependence and strengthening health security. But local production is only half the equation. Those medicines must also be safe, effective, and of assured quality.
For Nigeria, with its large pharmaceutical market and growing ambitions for local manufacturing, this is a real strength. NAFDAC first attained WHO Maturity Level 3 in 2022 and was re-confirmed at that level in 2025. The Presidential Initiative for Unlocking the Healthcare Value Chain is expanding local production. Nigeria can use this standing to support neighboring regulators and to make “made in Nigeria” a mark of assured quality across the continent.
Strengthening preparedness for future outbreaks
The meeting further reinforced a lesson Africa has repeatedly demonstrated: health emergencies transcend national borders.
RC76 advanced frameworks for emergency medical teams, polio transition and sustainability, and implementation of the amended International Health Regulations, which entered into force in September 2025.
These developments matter especially for Nigeria. According to the Polio IHR Emergency Committee, Nigeria accounted for half of all circulating vaccine-derived poliovirus type 2 cases reported worldwide in the first four months of 2026. The country must finish the job of eradication even as it turns the surveillance networks, laboratories and skilled staff built by the polio program into the backbone of broader disease detection and response.
From diphtheria and Lassa fever to cholera, mpox, and other emerging threats, Nigeria’s health security is inseparable from its neighbors’. Disease surveillance cannot stop at a border post. Neither can emergency preparedness. With the Nigeria Center for Disease Control and Prevention, its emergency operations centers, and years of outbreak experience, Nigeria can offer much to the Region, including national emergency medical teams that can deploy at home and across borders.
Nigeria now has a choice: to use its size, institutions and experience to lead in turning these commitments into results. Leadership will be measured by sustained investment and by visible improvements in the lives of all Nigerians, particularly the most underserved. Three early steps would show that intent: a costed plan that matches health worker training to funded posts; a credible path to reducing out-of-pocket spending; and full integration of polio assets into national disease surveillance.
Although the meeting in Addis Ababa has concluded, the substantive work is only beginning. Governments at every level, development partners, the private sector, professional bodies and communities all have a part to play. WHO stands ready to support Nigeria in turning the commitments of Addis Ababa into results that people can feel.
Dr. Ursu is the World Health Organization Nigeria Country Representative.
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