Nigeria's health system is run concurrently at the national, state and local level, and is a highly heterogeneous system, with private and government providers, unregistered healers and other forms of traditional medicine all playing an important part.
However, access to quality healthcare is extremely limited, with childhood vaccination rates amongst the worst in the world. Despite obtaining significant revenues from the export of oil, the Nigerian government only provides per capita health spending of a maximum of $4 per year. Corruption is endemic within the health sector, and the government's regulatory agenda is rarely implemented or enforced. Counterfeit and substandard drugs are a major problem.
Although Nigeria has attempted to improve access to medicines via its National Health Insurance Scheme (NHIS), this is struggling to keep up with demand. There is big potential, however, to harness the capacity of Nigeria's large private sector.
Although tariffs on medicines have been reduced from the 2002 level of 20%, they are still amongst the highest in the world at an average of around 15%. Tariffs on antibiotics are between 16.6% and 20%, which is unconscionable for a country with such a high burden of infectious disease.