Nigeria poised to lead new era of health system transformation — WHO

By Sola Ogundipe Reform of the global health architecture is now being driven by a Member State-led process established by the 79th World Health Assembly in May 2026. Hosted by the World Health Organisation (WHO), it brings together UN agencies, Gavi, the Global Fund, the Pandemic Fund, the World Bank and regional health organisations to develop a more coherent, country-led system with clearer mandates and financing aligned with national priorities.

The reform options will go before participating institutions’ governing boards between late 2026 and February 2027, ahead of recommendations to the World Health Assembly in May 2027. The process is linked to the UN80 reform initiative and Africa’s Accra Reset, which promotes health sovereignty. In this interview, the World Health Organisation (WHO) Representative and Head of Mission, Nigeria, Dr.

Pavel Ursu, reflects on the Global Health Architecture Reform from the country level perspective. Excerpts: What the reset means for health outcomes in Nigeria The first point is that the reset is a Member State-driven process. As institutions and partners in global health, we respect that process and look forward to its outcomes and the decisions of Member States on how we should focus and adapt our work.

The structural questions being considered are important, and the reshaping of the global health architecture should follow this process. However, if you ask what this should ultimately mean for Nigerians, my perspective is pragmatic. The reset itself will not change health outcomes in Nigeria, certainly not in the short term. What matters is whether the changes it produces help countries translate resources, partnerships and technical capacity into stronger services and better health outcomes.

For a mother in Sokoto or a child in Borno, the global health architecture is quite distant. What matters is whether it strengthens the services people depend on: primary healthcare, functioning supply chains, surveillance and laboratory systems, and adequately equipped and supported health workers. Countries do not have to wait for the global process to accelerate progress.

When governments invest domestic resources through national plans, strengthen accountability and align partners behind national priorities, they build the foundations that any future global health architecture should support. Nigeria already has important foundations through the Health Sector Renewal Investment Initiative and the Sector-Wide Approach (SWAp).

These offer opportunities to strengthen country ownership, partner alignment and accountability. The Joint Annual Review, alongside quarterly performance reviews, should go beyond assessing progress to identifying bottlenecks, correcting course and accelerating measurable results. The Lusaka Agenda and Africa’s Accra Reset reinforce this direction towards greater country leadership and stronger alignment of global health initiatives with national priorities.

Nigeria has an opportunity not only to accelerate its own progress but also to demonstrate what country-led transformation can achieve. Ultimately, the test of the reset will be whether it enables countries such as Nigeria to lead more effectively, mobilise sustainable domestic financing, coordinate partners behind national priorities and translate these efforts into better health outcomes.

Role of country capacity in achieving impact National capacity is the pillar on which the others rest. Sustainable progress depends on countries being able to plan, finance, deliver, measure and continuously improve health services. International support is most effective when aligned with national priorities, systems and accountability mechanisms.

I would assess any proposal, whether it involves merging agencies, pooling funds or setting timelines for reducing external aid, against one question: will it leave Nigeria’s health system more capable five years from now than it is today? Where results should show: Polio and immunisation Nigeria was certified free of wild poliovirus in 2020, a remarkable national achievement that many once considered impossible.

However, variant poliovirus continues to circulate. According to the Global Polio Eradication Initiative’s October 28, 2026 update, Nigeria had reported 36 type 2 variant cases this year, down from 66 in 2025, alongside 15 type 3 cases, up from eight. The August IHR Emergency Committee noted that Nigeria remains the largest contributor to the global variant poliovirus caseload.

The priority now is improving delivery and making better use of limited resources. Transmission is concentrated in a number of local government areas in the North-West, where campaign quality, access and routine immunisation remain weak. We are working with NPHCDA and state governments to address each of these LGAs as a specific delivery challenge, with clearly assigned responsibilities, weekly performance reviews and a focused set of indicators.

Rather than applying uniform national mea