Historic Funding for Hypertension and Noncommunicable Diseases in Nigeria’s Kano State
Responsive Image
In an important victory for public health in Nigeria, Kano State more than doubled its budget for Noncommunicable Diseases (NCD) between fiscal years 2024/2025 and 2025/2026. This substantial budgetary expansion demonstrates the power of sustained, data-driven advocacy and strategic partnerships in securing domestic health funding for chronic disease prevention and management.
The Challenge
Hypertension represents a critical public health crisis across Nigeria, with devastating implications for Kano State’s 16 million residents. According to a systematic review conducted by Nigeria’s Federal Ministry of Health in collaboration with the World Health Organization in 2018, hypertension prevalence reaches 31.2% nationally, with hypertensive heart disease affecting 27% of the population. In Kano State specifically, estimates indicate that more than 30% of adults suffer from high blood pressure, often undiagnosed or poorly managed.
CAPTION: Kano State Assembly plenary budget session.
This silent epidemic contributes to a growing burden of strokes, heart disease, kidney failure and premature deaths across the state. The challenge is compounded by Kano’s rapidly growing population, limited access to routine screening, low awareness of risk factors and inadequate investment in chronic care services at the primary health care level.
Historically, budgetary allocations for NCDs in Kano—particularly hypertension—remained minimal, often buried under general health budget lines or poorly implemented due to competing priorities. Primary Health Care (PHC) centers, which serve as the frontline for prevention and early detection, were ill-equipped to provide consistent care for chronic conditions, leaving millions of residents vulnerable to preventable complications and deaths.
Kano State has 1,324 PHC centers, yet only 260 currently provide comprehensive hypertension care using the Nigeria Hypertension Control Initiative (NHCI) model—leaving over 75% of PHCs offering only limited diagnosis and treatment. Additionally, just 50 PHC facilities offer diabetes screening. On a more positive note, all PHCs located in the eight metropolitan Local Government Areas now provide basic mental health assessments and referrals. However, budget tracking by BudgIT reveals that most PHC funding in Kano continues to prioritize infrastructure and personnel costs over NCD services.
Redirecting greater investment toward NCD prevention and care would not only reduce long-term healthcare costs but also improve productivity and overall quality of life for millions of residents.
GHAI’s Role
The Global Health Advocacy Incubator’s (GHAI) approach in Kano State exemplified strategic, locally-led advocacy that prioritized government ownership and data-driven engagement. GHAI’s In-Country Coordinator for Hypertension Control in Nigeria—Abdullahi Hamza Hassan—worked systematically with multiple stakeholders, including government officials and local partner Gammun Centre for Care and Development Nigeria (GCCDN), to build a compelling case for increased NCD funding during different phases of the fiscal year 2025 Annual Appropriation Act that started in June 2024 and ended in December 2024, when the Kano State Legislators approved the 2025 appropriation Act.
CAPTION: Shuaibu Indabawa, Senior Special Assistant to the Governor; Governor Abba Kabir Yusuf; and the Hon. Isiyaku Ali Danja, Kano State Legislator during the 2025Appropriation Bill session.
The advocacy strategy centered on several key components:
GHAI and GCCDN supported the generation and sharing of local data on NCD prevalence and the economic costs of inaction, presenting evidence in terms of population impact and long-term cost savings that resonated with decision-makers.
Rather than limiting engagement to formal budget periods, GHAI maintained continuous dialogue with government health budget officers and policymakers, providing ongoing cost-benefit analyses of preventive NCD programming.
Working closely with development partners including Resolve to Save Lives (RTSL), Project HOPE and Clinton Health Access Initiative (CHAI), GHAI helped create a coordinated advocacy ecosystem that amplified the message across multiple channels.
GHAI prioritized identifying and empowering champions within the Ministry of Health, Budget and Planning Commission, and Kano State House of Assembly, ensuring government officials took ownership of both the problem and the solutions.
GHAI provided technical assistance upon invitation and under specific guidelines, focusing on building sustainable capacity through knowledge transfer on budget tracking and cost modeling rather than creating dependency.
Results
The campaign achieved a historic breakthrough with Kano State’s approval of N566,748,000 (about US$380,000) for NCDs in the 2025–26 budget, representing more than a 200% increase from previous allocations. This substantial funding commitment reflects a fundamental shift in how state leadership views the importance of chronic disease prevention and management.
The victory extends beyond mere financial allocation to represent a paradigm change in government approach to NCDs. Key government stakeholders within the Ministry of Health, Budget and Planning Commission, and Kano State House of Assembly took ownership of the process and led from the front, ensuring the commitment became genuinely government-driven rather than externally imposed.
The funding is expected to strengthen primary health care platforms for integrated NCD services, including training, tools and medications, while establishing sustainable systems for ongoing chronic disease management across the state’s health infrastructure.
Lessons Learned
CAPTION: Tulari Tine, Executive Director of GAMMUN, facilitating an advocacy capacity strengthening workshop with staff of the Kano State Ministry of Health, members of the Association of People Living with Hypertension (APLH), and the media.
The Kano State experience offers valuable insights for advocates working to secure domestic health funding in similar contexts:
Data Drives Decision-Making: Government officials respond most effectively to evidence presented in terms of population impact and long-term cost savings. Local data proving the burden of disease and economic consequences of inaction proved more compelling than general statistics or external studies.
Sustained Engagement Yields Results: Successful budget advocacy requires year-round engagement rather than episodic intervention during formal budget cycles. Continuous relationship-building and ongoing technical support create the foundation for policy change.
Partnership Over Confrontation: Civil society organizations achieve greater impact by acting as partners and solution co-creators rather than solely highlighting problems. This collaborative approach builds trust and shared ownership of outcomes.
Government Ownership Is Essential: Ensuring government officials drive the process from the beginning creates sustainable commitment. By finding and empowering internal champions, advocates can achieve lasting policy change that survives political transitions.
Technical Capacity Strengthening Ensures Sustainability: Sharing new frameworks and experiences on budget tracking, cost modeling and evidence generation strengthens long-term advocacy capacity within local government systems, reducing dependence on external support.
According to Kano State’s Non-Communicable Disease Coordinator, Dr. Abubakar Hamza, “The collaboration between GHAI, GCCDN and the Kano State Government—especially under the Nigeria Hypertension Control Initiative (NHCI)—is revolutionary in our battle against noncommunicable diseases. This partnership has enhanced access to domestic resource allocation and utilization that fortified our health system, and advanced our goal of having a more resilient and healthier populace throughout Kano State.”
The success of the GHAI-GCCDN partnership that has led to Kano State’s increased funding for hypertension and NCDs demonstrates that subnational and national governments can adopt this model by firmly establishing advocacy in solid government linkages while continuously proving the return on investment in NCD prevention. The approach offers a replicable framework for advocates working to secure domestic health funding in resource-constrained settings where chronic diseases represent growing public health challenges.
