Bill Gates Criticizes Nigeria’s Low Health Budget: Calls for Increased Investment in Maternal and Child Healthcare
Bill Gates, the billionaire philanthropist and chairman of the Bill and Melinda Gates Foundation, has raised serious concerns over Nigeria’s inadequate investment in public health. Speaking during a media roundtable on Wednesday, June 4, Gates did not hold back as he criticized the Nigerian government's low budgetary allocation to healthcare—a factor he says is directly contributing to the country's high maternal and child mortality rates.
Gates, whose foundation has invested billions of dollars in global health, revealed that he had personally raised the issue with President Bola Tinubu, urging the Nigerian government to increase its spending on health if it hopes to see any real and lasting improvements.
“Well, the amount of money Nigeria spends on health care is very, very small,” Gates said. “I don’t know why you would have expected that number (referring to maternal mortality) to go down. If a mother delivers at home, there are certain complications that you can’t solve. So what countries like India do is they drive delivery into centres where they can give C-sections. But that takes money.”
Why Bill Gates Is Speaking Out
Bill Gates is not new to Nigeria. Through the Gates Foundation, he has supported numerous public health initiatives in the country—from fighting polio to improving vaccine delivery systems. However, his recent comments reveal a deeper concern: despite years of donor-funded efforts, the Nigerian government still fails to prioritize healthcare in its national budget.
According to Gates, meaningful progress in health outcomes—such as reducing the number of women who die during childbirth or cutting down child mortality—requires consistent government investment. He emphasized that healthcare improvements are impossible to achieve if mothers continue to give birth at home without access to emergency services or professional care.
“Delivery at home is risky,” he said, highlighting that complications like obstructed labor or hemorrhage require hospital interventions such as cesarean sections, which are only possible in properly equipped facilities. Without such investment, Gates suggested, expecting improvements in Nigeria’s maternal health outcomes is unrealistic.
Current Healthcare Budget Still Falls Short
In February 2025, the Nigerian National Assembly announced an increase of ₦300 billion to the federal health budget, bringing the total to ₦2.48 trillion. While this figure may sound impressive, it only represents 5.18 percent of Nigeria’s national budget. According to global health experts, including those at the World Health Organization (WHO), this is far below the 15 percent target set by the Abuja Declaration—an agreement signed by African leaders in 2001, pledging to allocate a larger portion of national budgets to the health sector.
Gates acknowledged this increase but said it is still not enough to bring about real change.
“The amount of money Nigeria spends on health care is very, very small,” he repeated, stressing that much more must be done.
The Link Between Low Health Spending and High Mortality Rates
Nigeria has one of the highest maternal mortality rates in the world. According to the World Bank, approximately 512 women die per 100,000 live births. This means thousands of Nigerian women die each year simply because they don’t have access to quality medical care during childbirth.
The situation for children is equally dire. Nigeria also ranks among the top countries for under-five mortality, with 117 deaths per 1,000 live births, according to UNICEF.
Experts like Gates argue that without well-funded hospitals, trained medical staff, and access to essential medicines, these grim statistics will remain unchanged.
“If a mother delivers at home, there are certain complications that you can’t solve,” Gates warned. “That takes money.”
Global Health Funding Is Declining—and It’s Hurting Africa
In addition to highlighting Nigeria’s internal challenges, Gates expressed alarm over shrinking international funding for global health programs. For decades, the United States government has been a leading contributor to disease control programs, including efforts to fight HIV/AIDS, malaria, and maternal mortality. But according to Gates, that support is now waning.
When asked whether the Gates Foundation would step in to fill the gap, his response was sobering:
“The problem with the Gates Foundation is we don’t have some special bucket of money,” he said. “We spend more every year, and all my money will be spent. And so no matter what the other people do, it’s the same amount of money.”
Gates explained that while the Foundation may occasionally step in—for example, when critical drug supplies go unused or when clinical trials are abandoned—it cannot match the scale of funding once provided by governments like that of the United States.
“There’s nobody who can match that US government money,” he added. “And the European money is all coming down. We have like a 40% decrease from Germany and the UK.”
Economic Pressures Threaten Future Aid
Gates attributed the decline in global health aid to several economic challenges facing Western countries. Many governments are now spending more on war-related costs and also dealing with the financial pressures of aging populations. As a result, public health spending—especially aid to developing countries—is being cut back.
“I’m very upset about it,” Gates said. “We’ll have more HIV deaths, malaria deaths, and maternal deaths. There’s just no denying that that money was being well spent. And there’s no alternate source that matches up to what was available.”
His message is clear: without international support and domestic investment, Africa’s public health crisis could worsen.
Gates Pledges Nearly All His Wealth to Help Africa
Despite the gloomy outlook, Gates reaffirmed his commitment to supporting Africa. Last month, he announced that he plans to give away nearly all his wealth—an estimated $200 billion—over the next two decades. A significant portion of this massive donation will go to programs that improve healthcare, agriculture, education, and innovation across the African continent.
While Gates has been one of the world’s most generous philanthropists, he insists that even his vast fortune cannot replace the need for government funding—both in donor nations and in countries like Nigeria.
“No private organisation could replace the scale of funding previously provided by the U.S. government,” he said.
What This Means for Nigeria’s Future
Gates' message is a wake-up call for Nigerian policymakers. The truth is harsh but clear: without increasing investment in healthcare, Nigeria will not be able to reduce its appalling maternal and child mortality rates. The current health budget, though improved, still falls short of what's required to build a functional and responsive health system.
Moreover, with global health donors like the U.S. and European countries cutting back, Nigeria can no longer rely heavily on foreign aid. It must look inward, prioritize healthcare in its national agenda, and build systems that can stand on their own.
Conclusion: Time for Action, Not Talk
Bill Gates has once again shone a spotlight on Nigeria’s health crisis. His comments serve not as condemnation, but as a call to action. Nigeria must rise to the occasion, increase its health funding, and take concrete steps to protect the lives of its women and children. The health of a nation is its wealth, and without it, sustainable development remains a distant dream.
If Nigeria truly wants to progress, it must invest in its people—starting with their health.
