From Donor Dependency to Local Ownership: Policy Options for Building a Sustainable Health Commodity Supply Chain in Nigeria

Sustainable access to essential medicines and health commodities remains a defining factor in the resilience, equity, and responsiveness of health systems worldwide. Low- and middle-income countries have historically depended on donor-funded procurement and parallel supply chains to address gaps in financing, forecasting, and last-mile distribution. While these arrangements have supported major public health gains, they also create structural vulnerabilities, including fragmented procurement processes, limited government stewardship, and inadequate long-term investment in national logistics capacities. Nigeria exemplifies this challenge, with donor agencies still accounting for a significant share of financing for commodities such as vaccines, antimalarials, HIV medications, and family-planning supplies. As donor contributions plateau and the national burden of disease evolves, Nigeria faces a critical need to transition from donor dependency to a system anchored in local ownership, domestic financing, and institutional accountability. This paper examines policy pathways for building a self-sustaining, country-led health commodity supply chain in Nigeria. It highlights strategic priorities including strengthening federal and state-level supply chain governance, implementing pooled procurement mechanisms, expanding use of digital logistics management systems, and fostering public–private partnerships for cold-chain and last-mile delivery. The analysis further emphasizes the need for predictable domestic funding streams through budget reforms, insurance expansion, and improved fiscal transparency. To support long-term sustainability, the paper proposes investments in local pharmaceutical manufacturing, workforce development, and integrated monitoring frameworks that link commodity availability to service-delivery outcomes. By outlining these actionable options, the study provides a roadmap for Nigeria to achieve greater autonomy, reduce supply disruptions, and build a resilient health commodity ecosystem capable of meeting population needs without overreliance on external donors.