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    Nigeria: Dialysis Subsidy in Nigeria – a Lifeline or a Short-Term Fix?

    OneAfricaYTBy No Comments5 Mins Read
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    President Bola Ahmed Tinubu’s decision to introduce a substantial subsidy for kidney dialysis is a laudable and compassionate move that offers immediate relief to thousands of Nigerians battling kidney disease.

    By reducing the cost of each dialysis session from ₦50,000 averagely to as low as ₦12,000, the government is taking a monumental financial burden that has pushed many families into poverty and forced countless patients to abandon life-saving therapy. Dialysis, which is normally a weekly or fortnightly session could potentially cost upto a hundred thousand naira a month. This is a huge expense in a country where the minimum wage is ₦70,000. For a majority, it is not a question of treatment or no treatment, but a question of living and going bankrupt or death.

    A 2022 study highlighted that only 2% of patients with end-stage kidney disease (ESKD) in Nigeria receive hemodialysis, with 80% unable to sustain treatment for more than three months due to the high cost.

    While the subsidy is already being rolled out in major federal hospitals across all six geopolitical zones to ensure wide coverage, it is necessary to examine if it is a sustainable, long-term solution or a short-term palliative. One big question is: are there enough dialysis clinics to absorb the potential increased traffic?


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    This is a valid worry, as there are very few open dialysis centres, particularly outside of urban areas. A 2021 study on the “Global Dialysis Perspective: Nigeria”, revealed that there are only 80 functioning haemodialysis centres across the country, of which 52 are public-owned centres, with most being hospital-based and concentrated in urban areas as opposed to freestanding haemodialysis centers that are not tied to a hospital’s location, allowing them to be established in a wider range of communities.

    Offering subsidised services at major federal hospitals is a positive step, but it may not fully resolve the issue of physical access for patients in rural or underserved areas. This disparity could create another bottleneck, where more people may still have to pay for transportation to receive treatment due to this limitation.

    Expanding access to health insurance is equally critical. At present, dialysis and other long-term illness coverage under private Health Maintenance Organisations (HMOs) and the National Health Insurance Authority (NHIA) remains limited, often requiring patients to opt into special plans.

    Beyond the subsidy

    The government’s subsidy is certainly a welcome intervention, but its long-term viability invites deeper scrutiny and its true impact hinges on the answers to a few key questions:

    • Is there a clear sustainability plan?
    • Will this programme be allowed to evolve into a more permanent and robust long-term strategy?

    A sustainable response to Nigeria’s epidemic of kidney disease requires a stronger, multi-faceted approach. The healthcare system must divert attention away from managing the effects of kidney disease to preventing its incidence. Preventative health measures are more cost-effective than curative care, and would ease the burden on households and the health system while saving lives.

    As a priority, public awareness campaigns are immediately required to make people aware of the risk factors for kidney disease. Hypertension and diabetes are the two leading causes of kidney diseases, and both are highly prevalent in Nigeria. Addressing this challenge requires a multi-pronged approach, which includes the following priorities:

    (1) Promoting awareness on lifestyle changes, early detection, and effective management of chronic conditions is essential. Encouraging regular health check-ups and fostering personal responsibility for well-being among Nigerians will be key. This goal can be supported by equipping community health workers with the skills to screen for and manage illnesses such as hypertension and diabetes.

    (2) There is a need for the government to strengthen primary healthcare centres (PHCs) to provide low-cost and accessible care for kidney diseases. PHCs can be early detection and management hubs. Training health workers at the community level to screen and treat illnesses like hypertension and diabetes can significantly reduce the number of people who develop End-Stage Renal Disease (ESRD).

    (3) Treatment needs to be diversified. Dialysis is a life-sustaining therapy but not a cure. The ultimate treatment for ESRD is kidney transplant. Although it has its limitations in Nigeria including a shortage of trained surgeons and well-equipped centers, a lack of legal and ethical frameworks for organ donation exists. Therefore, Nigeria needs to invest in building its kidney transplantation potential. This involves training more transplant surgeons, building well-equipped transplant centres, and putting in place a solid legal and ethical framework for organ donation. Making transplantation more accessible and affordable would be a lifetime solution for many patients, freeing them from the ongoing process of dialysis.