The governments of the United States and Nigeria have on Saturday signed a five-year bilateral health agreement worth approximately US$2.1 billion, aimed at strengthening Nigeria’s health system with a special focus on expanding faith-based healthcare delivery and tackling major infectious diseases.
Announced by the US Department of State, the Memorandum of Understanding (MoU) commits nearly US$2.1 billion in American funding toward prevention and treatment programmes for HIV/AIDS, tuberculosis, malaria, maternal and child health, and polio. In tandem, Nigeria has pledged to substantially increase its domestic health expenditures by nearly US$3 billion over the life of the agreement, marking what US officials described as “the largest co-investment any country has made to date under the America First Global Health Strategy.”
According to the State Department statement released after the signing in Abuja, the partnership “focuses strongly on promoting Christian faith-based health care providers” alongside broader health system strengthening objectives. “Today, the United States Department of State signed a five-year bilateral health Memorandum of Understanding with the Federal Republic of Nigeria to strengthen Nigeria’s health system, with a strong emphasis on promoting Christian faith-based health care providers,” the statement said.
The agreement includes dedicated funding targeted at Christian-run health facilities, which the State Department estimates currently number around 900 clinics and hospitals nationwide and serve more than 30 per cent of the Nigerian population. Investment in these facilities is intended to complement public healthcare infrastructure and expand access to integrated services for infectious diseases as well as maternal and child health care.
“The MOU was negotiated in connection with reforms the Nigerian government has made to prioritise protecting Christian populations from violence and includes significant dedicated funding to support Christian health care facilities,” the department added.
Although the partnership highlights support for faith-based services, its scope aligns with Nigeria’s broader health sector priorities, including boosting disease prevention, detection and response systems, expanding access to quality primary healthcare, and strengthening health infrastructure. The technical MoU builds on ongoing health reforms such as the Nigeria Health Sector Renewal Investment Initiative (NHSRII), a reform programme launched in 2023 aimed at improving healthcare accessibility, affordability, quality, accountability, and efficiency across the country.
Under the terms of the agreement, both countries will work collaboratively on critical health system components including:
strengthening disease surveillance and outbreak response systems;improving laboratory infrastructure and biosafety procedures for pathogen testing and storage, supporting frontline health workers, enhancing data management systems and securing access to essential medical commodities.
The MoU also reflects Nigeria’s stated commitment to long-term health sector self-reliance, marked by a deliberate shift toward increased domestic financing and partnerships rooted in trade and investment rather than external aid alone. As part of this commitment, Nigeria has agreed to allocate at least 6 per cent of annual Federal and State budgets to health — a figure projected to mobilise close to US$3 billion in domestic health financing through to December 2030. This pledge has already been factored into the government’s proposed 2026 Appropriation.
“This partnership underscores our determination to build a health system that can prevent, detect, and respond to health threats, while expanding access to affordable, quality care for all Nigerians,” said Prof. Muhammad Ali Pate, Nigeria’s Coordinating Minister of Health and Social Welfare. “It also reflects our firm commitment to domestic investment, accountability, and long-term sustainability.”
US officials emphasised that this agreement is part of a broader shift in American global health policy under the America First Global Health Strategy, which prioritises bilateral agreements and country co-investment as mechanisms to strengthen health systems worldwide while combatting priority diseases. However, the State Department also noted that US assistance remains subject to review, and that funding may be paused or terminated should programmes diverge from stated national interests.
The MoU was signed amid heightened scrutiny of Nigeria by the United States, including recent travel restrictions imposed by the Trump administration citing national security and visa overstay concerns.
