Weak systems trap Nigeria’s life expectancy behind peers despite health reforms
… Experts share reasons, solutions
Despite years of health sector reforms, Nigeria’s life expectancy remains alarmingly low, trailing behind its peers like Tunisia and Algeria and raising concerns among experts who point to deep-rooted poverty, a broken emergency care system, and weak universal health coverage as key drivers of the crisis.
Reports, this year, by the United Nations show that Nigeria’s average life expectancy as of 2024 is 54.6 years—far below the global average of 73.7 years, Africa’s average of 64.2 years, and the lowest worldwide. By comparison, Monaco tops the chart at 86.5 years, while other African countries like Tunisia (76.5) and Algeria (76.2) outperform Nigeria by more than 21 years.
The wide gap between Monaco’s world-leading life expectancy and Nigeria’s position at the bottom highlights a deepening crisis. In Nigeria, rising poverty has fueled widespread malnutrition, driving up death rates among children and young adults according to reports.
More concerning issues are the fragile emergency healthcare systems, limited universal health coverage, and high out-of-pocket payments for medical bills leaving millions without access to care. Also, Insurance coverage remains painfully low, while insecurity continues to disrupt health services across the country experts warn.
“Poverty, insecurity, environmental pollution, poor emergency healthcare infrastructure and low universal health coverage deeply affects Nigeria’s life expectancy,” Adeniji Adeoluwa, chief medical director at Mecure Cancer Center told BusinessDay in a phone conversation.
“ Low insurance coverage makes most poor citizens resort to local remedies for treatments as high out-of-pocket payments for medical bills continue to limit their chances of survival, making it difficult to access quality medical care.
“Whenever there is an accident or a traffic incident for instance, emergency response becomes exceedingly difficult due to the absence of a dedicated route for ambulances and a lack of proper infrastructure and facilities to manage urgent cases effectively.”
Paul Abba, director of medical laboratory services at Benue State University Teaching Hospital, also highlighted critical factors contributing to Nigeria’s low life expectancy, pointing to gaps in healthcare access, food insecurity, and widespread misuse of antimicrobials.
“Many Nigerians lack access to quality healthcare and so resort to self-medication, overuse and misuse of drugs, leading to preventable deaths,” Abba said.
He emphasised that the low coverage of universal health services continues to drive this troubling trend. He also drew attention to the broader systemic issues undermining public health.
“Food insecurity as well as national security are other factors that must be addressed,” Abba added.
Abba also pointed to the dangers of weak pharmaceutical regulation, particularly the easy availability of antibiotics without prescriptions.
“We need to ban the sales of over-the-counter antimicrobials, as sometimes their misuse could lead to preventable deaths,” he said.
For him, compulsory health insurance is not optional but essential. “Nigeria must also ensure compulsory insurance coverage for its citizens in order to improve life expectancy in the country,” he explained
Universal health coverage means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship according to the World Health Organisation (WHO).
“Nigeria lags far behind its peers in terms of universal health coverage (UHC) which could further reduce the quality of life,” said Nkata Chuku, founding partner at Health Systems Consult Limited.
WHO defines life expectancy as the average number of years a newborn is expected to live if current mortality rates remain constant. In Nigeria’s case, those rates continue to reflect systemic weaknesses.
Studies show that education, GDP, access to healthcare, diet, infrastructure, and income levels significantly influence life expectancy. A recent study by Nurudeen Lawal and his research team found no direct link between inflation and life expectancy but a strong correlation between exchange rate fluctuations and citizens’ lifespan, as published in Acta Universitatis Danubius.
While other nations extend lives through inclusive health policies and robust systems, Nigeria’s progress remains hindered by gaps in access, equity, and investment.
Read also: ‘Primary Healthcare Centres should not be run by youth corps medical doctors’
Lessons for Nigeria from other countries
Once grappling with low life expectancy, African sister nations like Algeria and Tunisia have made remarkable strides, offering valuable lessons for Nigeria.
For instance, Algeria’s life expectancy stood at a mere 40.8 years in 1960. By 2023, it had risen dramatically to 76.3 years. Tunisia followed a similar trajectory, moving from 44 years in 1960 to 76.5 years in 2023. These are not accidental gains, they reflect decades of deliberate investment and reform.
At the heart of this transformation were three core pillars. Robust investments in health infrastructure and social services, Large-scale disease control and immunisation campaigns and significant improvements in literacy and education
The results have been profound. According to UNICEF, Algeria’s infant mortality rate has plummeted—from 147 deaths per 1,000 live births in 1965 to just 24 per 1,000 in 2024. On the other hand, Nigeria still records 60 infant deaths per 1,000 live births—a figure that signals persistent systemic failures.
Tunisia has also prioritised healthcare financing, doubling its health spending to approximately 7 percent of the national budget. Nigeria, while making modest progress, allocates just 5.1 percent—a figure way below global standards of 15 percent and equally inadequate for its massive and growing population
The contrast deepens when considering disease elimination. Algeria has successfully eradicated polio, neonatal tetanus, and malaria through sustained vaccination drives and aggressive public health interventions. Meanwhile, Nigeria continues to carry the heaviest malaria burden globally, accounting for 27 percent of all global cases and over 200,000 malaria-related deaths in 2021. This burden, coupled with high rates of malnutrition, drives persistently high infant and maternal mortality.
Where do we go from here?
The experiences of the two North African countries show that transforming national health outcomes is not only possible, but achievable through consistent investments, strong political will, and a deliberate focus on equity in healthcare delivery. These lessons hold crucial relevance for Nigeria as it grapples with poor life expectancy and fragile health infrastructure.
“If we must improve on our life expectancy as a country, we must start with policies,” said Adeoluwa, emphasising that reforms must go beyond surface-level interventions. “Nigeria’s reforms must be centered on policies that ameliorate poverty, ensure inclusive healthcare access, reduce environmental pollution, and promote public-private partnerships, as the government cannot do it alone,” he added.
Central to this transformation is the need for a robust health insurance scheme that eliminates economic barriers to care. “An inclusive healthcare access through a robust insurance scheme will enable both the poor and the rich access to medical care without social or economic disparity,” Adeoluwa explained. “Systems that enable everyone to access quality healthcare not because they have money but because they have access to a robust insurance scheme,” he added.
