In 2025, only about 10% of Nigerians have reliable access to health insurance coverage, while access to quality healthcare services remains below 45% nationwide—and considerably lower in rural and underserved communities. More than 76% of Nigerians continue to pay for healthcare out-of-pocket, highlighting deep inequities and the persistent failure of public insurance schemes to reach most of the population. With over 54% of Nigerians projected to be living in extreme poverty (earning less than $2.15 per day)—75.5% in rural areas and 41.3% in urban areas—access to healthcare often becomes a mirage after the harsh reality of meeting basic needs like food and shelter.
Official counts now estimate 127,000 new cancer cases each year, but leading oncologists in Nigeria warn that the real figure is likely double or more, since most cases are not diagnosed until late stages. Rural and poor communities are disproportionately affected due to stigma, cost, and distance from the few available cancer centers—leading to high mortality rates and thousands dying undiagnosed. Similarly, more than 2 million Nigerians are estimated to have Chronic Kidney Disease (CKD), but experts agree this is a major undercount. Hospital studies show up to 85% of CKD patients present late, with many never reaching tertiary care because of the high costs—virtually all of which must be paid out of pocket.
Access to cancer and CKD treatment in Nigeria is determined largely by socioeconomic status, geography, and financial capacity. Well-off urban residents access care more reliably, while rural and low-income Nigerians face severe barriers due to cost, distance, service availability, and limited awareness. Cancer and CKD data must therefore be seen as just the “visible tip” of a much larger health crisis.
Prevention, they say, is better than cure. If the majority of citizens cannot access functional healthcare systems and diagnostics for chronic diseases, they should at least have access to safe, nutritious food. Yet exposure to contaminated food, unsafe water, air pollution, and dermal contact with toxic substances contributes to cancer, kidney disease, organ failure, nerve damage (e.g., Parkinson’s disease), reproductive disorders, and impaired brain development.
Pesticide residues in Nigerian food are a documented public health concern. Over 65% of active pesticide ingredients used in Nigeria are classified as Highly Hazardous Pesticides (HHPs). Chronic exposure to these chemicals through food has been linked to cancer, kidney failure, hormone disruption, and other severe health impacts.
As Nigeria’s health and agriculture sectors face mounting crises, government and legislative subsidies for cancer and CKD treatments have soared—while constituency projects, public budget allocations for agriculture, and donor funding continue to push toxic pesticides onto farms and plates. This contradiction reveals a vicious cycle that undermines both public health and the nation’s economic wellbeing.
Kidney Disease: Counting the True Cost of Subsidized Care
Nigeria has more than 2 million CKD sufferers, yet only about 2% (≈40,000 people) receive lifesaving hemodialysis due to cost and access limitations. The federal government now subsidizes each dialysis session by ₦38,000 (patients pay ₦12,000, down from ₦50,000). At the medically recommended two sessions per week (≈104 annually), the cost is:
- Annual subsidy per patient: ₦38,000 × 104 = ₦3,952,000
- Total annual subsidy for 40,000 patients: ₦3,952,000 × 40,000 = ₦158.08 billion
Despite this, funding reaches only a fraction of those in need, leaving most CKD patients to struggle without adequate support.
Cancer Treatment: The Numbers Behind Nigeria’s Subsidy Shortfall
Cancer cases are rising sharply, with 127,000 new diagnoses each year. The National Health Insurance Authority (NHIA) offers a ₦400,000 subsidy for radiotherapy. If every new patient received it, the cost would be:
- Annual subsidy required: 127,000 × ₦400,000 = ₦50.8 billion
Yet, the federal allocation for cancer care in 2025 is just ₦200 million (₦150 million for the National Cancer Health Fund and ₦50 million for the Childhood Cancer Health Fund)—a minuscule fraction of actual need. Philanthropy and private sector support attempt to fill the gap, but the financial burden remains catastrophic for most households.
The Export Rejection Trap: Hidden Losses from Hazardous Pesticides
Nigeria loses $362.5 million annually due to the EU’s ban on Nigerian beans, citing high pesticide residues. Up to 76% of Nigerian agricultural exports are routinely rejected on safety grounds, including for pesticides banned internationally but still legal domestically. Beans, melon, sesame, and fish increasingly fail international quality checks.
What is rejected abroad for health reasons is consumed back home—amplifying exposure and fueling cancer and kidney disease. An Alliance for Action on Pesticides in Nigeria (AAPN) survey found that 7 of the 13 most common pesticide brands in use are cancer-causing and linked to organ failure. With over 85% of farmers lacking knowledge of safe pesticide use, and with little government support for scaling safer alternatives, Nigerians are losing their health to the very food they eat.
The health risks are stark: 75% of surveyed women farmers reported health problems linked to pesticide use, including respiratory illness, skin rashes, nausea, vomiting, eye irritation, and even suicide. Yet legislators, state governments, and NGOs still distribute these toxic chemicals to poor communities and farmer associations—without considering the health, environmental, or social costs.
Why Support for HHPs Makes No Economic Sense
Federal, legislative, and donor support for HHPs not only perpetuates disease but also drives up national health spending. These policies directly fuel the same illnesses that consume billions in treatment subsidies. Export rejections over pesticide contamination drain hundreds of millions of dollars annually, while scarce public funds are wasted subsidizing both disease and hazardous inputs.
Nigeria must gradually phase out HHPs from government, legislative, and philanthropic supply chains, rapidly adopting biopesticides and safe alternatives. This would protect public health, restore market access, and redirect scarce national resources toward safer, more productive investments.
Even major agrochemical and seed companies recognize that the future is not in HHPs. They are already diversifying into biopesticides, bioherbicides, and organic inputs—responding to global trends and consumer demand for safer, sustainable food systems. What remains is for governments, institutional buyers, and consumers to clearly signal and prioritize safer markets. With bold leadership and procurement shifts, the private sector is ready to accelerate Nigeria’s transition to health-protective, environmentally responsible agriculture.
Global experience shows that phasing out HHPs does not necessarily reduce food production—if bans are planned and paired with alternatives. In Kerala, India, a ban on 14 HHPs had no negative effect on crop yields; fluctuations were driven by rainfall and land use, not pesticide bans. Similarly, reviews from other regions confirm that targeted bans on HHPs—when paired with safer substitutes and Integrated Pest Management (IPM)—do not undermine food security.
However, abrupt blanket bans (such as Sri Lanka’s 2021 ban on all pesticides and fertilizers) cause disruptions when implemented without preparation, alternatives, or farmer training. The key lesson is that transitions must be planned, gradual, and supported by extension services, farmer training, and availability of safe substitutes.
The best global practice for Nigeria is to phase out HHPs while promoting biopesticides, scaling IPM, and investing in agroecology—methods proven to sustain yields while protecting both health and the environment. This approach is practical, evidence-based, and aligns Nigeria with international trends toward safer, more sustainable food systems.
Nigeria will be great—we need to want to make it great.
Donald Ikenna Ofoegbu, Snr. Program Manager, hbs Nigeria
Member, Alliance for Action on Pesticides in Nigeria (AAPN). ikennadonald@gmail.com
