As I begin the final days of my assignment with Malaria Consortium, I wanted to take some time to provide a high-level overview of healthcare in Nigeria. One of my goals whilst on PULSE was to enhance my understanding of the healthcare landscape in my host country. Whilst my assignment did not have me visiting hospitals and patients per se, I was in the field where healthcare in the villages is minimal at best as access is made difficult as there are no nearby health centres. As highlighted in previous blogs, sick children will be carried often on foot, to the closest health centre which can be miles away. During the rainy months, the paths can become impassable and sometimes upon reaching a health centre medicines may not be readily available.
I was fortunate to attend an evening dialogue on Health Financing in Nigeria which provided for an open platform where people’s voices could be heard and positive change could be made in the community. This was attended by the public/private sector with the Nigerian Ministry of Health to listen and learn. Senator Dr. Lanre Tejuoso who is Chair of the Senate Committee on Healthcare was the guest speaker. What impressed me most was the number of young adults in the audience, the questions they raised and the commitment as young people that they have for the future of their country.
The way a country finances its health care system is key to the health of its citizens. Selection of an adequate and efficient method of financing in addition to organized delivery for health services are essential for a country to provide health for all. Per the World Health Organisation, Nigeria has one of the largest human resources for health in Africa but has densities of nurses, midwives and doctors that are still too low to effectively deliver essential health services when they exist.
Healthcare in Nigeria is financed by tax revenue, out-of-pocket payments, donor funding, and health insurance. However, achieving successful health care financing system continues to be a challenge. Government expenditure on healthcare is limited. Despite the Abuja declaration in which the government committed to spend 15% of the Nigerian budget on health care, health care remains at 5.1% of the total budget at ~ 308 Billion Naira in 2017 down again from 2016. On the demand side, the increasing population, the yearly outbreaks that have plagued the country and the displacements resulting from insecurity in the Northeast of the country, has led to rising health care costs.[3,4] Further shrinkage in available funding for health care in predicted. With Nigeria’s rise to being classified as a middle-income economy, the country has become eligible for graduation from major external sources of funding for immunization which in turn increases the need for more government funding for an already overburdened system. 
Upon reflection after the panel discussion, I thought about my own healthcare and how lucky we are in the West even with its’ issues. So where does GSK fit into all of this? The Pulse team was fortunate to meet with the GSK General Manager of Nigeria and the head of Vaccines Global Industrial Operations whilst on the ground in Abuja. They had just come from a meeting with the Ministry of Health and we heard first-hand the challenges but also the opportunities for GSK in the marketplace here. I think of what I have seen on the ground, not just with Malaria but disease in general. GSK is working towards a world in which everyone has access to vaccines and can be protected against life-threatening diseases which can cause 2-3 million deaths a year. Vaccination can have a significant impact on global health and especially here in Nigeria.
Just as I am on a journey here in Nigeria, so is Vaccines and our commitment to the people. I think this only further highlights the good GSK is doing to bring medicines to those that need it most and help improve the quality of life for patients. It also highlights GSK’s part in tackling global health challenges and extend the benefits of our products to more people and collaborating to strengthen healthcare infrastructure. All this reinforces how proud I am, and we should be, to work for GSK and the commitment to help people do more, feel better, live longer.
 Atun RA, Advancing Economic Growth: Investing in Health 2005
 World Health Organisation Country Cooperation Strategy: Nigeria 2008-2013.
 World Bank Data 2016 (highlighted during the panel discussion)
 One Campaign research, Nigerian 2017 budget
 Clinton Health Access Initiative research (highlighted during the panel discussion)