The World Bank is set to approve a $250 million health loan for Nigeria by September 23, 2025, under the third phase of its Health Emergency Preparedness and Response Project (HEPR) for Western and Central Africa. The funding aims to enhance the country’s capacity to prevent, detect, and respond to health emergencies more effectively — a critical intervention as Nigeria continues to grapple with alarming public health and economic challenges.
According to the World Bank’s appraisal document, the proposed loan will be provided through the International Development Association (IDA), the bank’s concessional financing arm. The Nigeria Centre for Disease Control (NCDC) will be responsible for implementing the project, while the Federal Ministry of Finance will act as the formal borrower.
With over 223 million citizens, Nigeria is Africa’s most populous country but faces some of the worst health outcomes globally. Life expectancy hovers at just 54 years, maternal mortality stands at over 1,000 per 100,000 live births, and under-five mortality is estimated at 114 per 1,000 — leading to over 800,000 child deaths and 80,000 maternal deaths annually.
The World Bank flagged the country’s health sector as dangerously under-resourced, noting that Nigeria spends just 0.62% of its GDP on healthcare. Out-of-pocket health expenditure accounts for a staggering 76.24% of total health spending, one of the highest globally, leaving millions unable to access quality medical care.
Additionally, the growing threat of antimicrobial resistance in Nigeria is alarming. In 2019 alone, it directly caused over 64,500 deaths and was associated with more than 263,000 additional fatalities.
The $250 million facility is designed to build resilient health infrastructure by enhancing laboratory capacity, expanding disease surveillance, and reinforcing emergency preparedness across Nigeria’s 36 states and the Federal Capital Territory. It will also support the establishment of Emergency Operations Centres nationwide and the development of a centralized national warehouse for emergency medical supplies.
A portion of the funds will be allocated to bolstering pharmaceutical regulation, stimulating local production of essential medicines, and fostering collaboration with regulatory agencies like NAFDAC and the National Institute for Pharmaceutical Research and Development (NIPRD).
Importantly, the project seeks to integrate health data systems by linking human health platforms such as the Surveillance Outbreak Response Management and Analysis System (SORMAS) with animal health monitoring systems, including the National Animal Disease Information System (NADIS).
Despite some progress in preparedness, Nigeria still lags behind in core health security capabilities. While its 2023 score on the Joint External Evaluation of International Health Regulations rose to 54% from 39% in 2017, critical vulnerabilities remain. Legal frameworks are outdated, detection capabilities are limited to urban centers, and subnational logistics for emergency response remain inadequate.
The World Bank also stressed the need for greater gender inclusivity, with funds earmarked to support women’s participation in health leadership, particularly in epidemiological training, which was identified as lacking during previous pandemics like Ebola and COVID-19.
Implementation of the program will be coordinated by the NCDC through a newly created National Project Coordination Unit, under the oversight of a National Steering Committee chaired by the Coordinating Minister of Health. Ministers of Finance, Environment, and Livestock Development will also serve in co-chairing capacities.
At the state level, health commissioners will lead corresponding committees, with participation limited to states that meet eligibility criteria — including counterpart funding, policy alignment, and formal expression of interest.
While the loan could improve public health outcomes, it comes at a time when Nigeria’s debt to the World Bank is rising. Data from the Debt Management Office reveals that as of March 31, 2025, Nigeria owed the World Bank $18.23 billion — a $420 million increase from December 2024. This accounts for nearly 40% of the country’s total external debt stock of $45.98 billion.
Loans from the IDA increased from $16.56 billion in December 2024 to $16.99 billion by Q1 2025, while borrowing from the International Bank for Reconstruction and Development (IBRD) remained stable at $1.24 billion.
Despite concerns over sustainability, experts suggest that well-targeted loans such as the proposed health financing package could yield long-term socioeconomic benefits by reducing mortality, enhancing workforce productivity, and averting costly health crises.
As Nigeria prepares for potential board approval next month, the $250 million World Bank loan could serve as a pivotal step in reinforcing national health security, addressing long-standing service gaps, and building a more resilient healthcare system — provided it is efficiently implemented and transparently managed.