PERHAPS, as part of efforts towards rapprochement and strengthening US-Nigeria relations after weeks of diplomatic row, a new health deal between the two countries was sealed and made public on 21 December 2025.
However, there are concerns over the content and spirit of the pact, which many have described as biased and skewed against Nigeria, despite the fact that Nigeria is paying more.
In the busy month of December, when attention was focused on Christmas and New Year activities, a stealthy and somehow discriminatory MoU capable of disenfranchising half of the Nigerian populace came into effect.
In the $5.1 billion five-year health agreement, the MoU is expected to “advance America First Global Health Strategy.” Meanwhile, the health cooperation, going by its content and spirit, is capable of further undermining Nigeria’s cohesion, harmony and unity, and sectionalising it along religious divides.
Out of the $5.1 billion “joint venture,” US support amounts to $2.1 billion while Nigeria contributes $3 billion, targeting “domestic funding to strengthen Nigeria’s health system, focusing on disease surveillance, outbreak response, HIV/AIDS, TB, malaria, and maternal/child health.”
This seemingly innocuous “co-investment” health innovation agreement sounds positive on the surface, but when viewed closely, it comes with a caveat of “specific attention to faith-based providers.” In other words, Nigeria is paying more but will hold the short end of the stick, while the US determines how the fund is dispensed.
Hence the concern that if Nigeria is carrying much of the cost, which money belongs to the public, fairness and justice demand that Nigeria should ensure its even allocation and not America insisting that the Nigerian government spends $200 million to fund 900 Christian faith-based hospitals.
All hospitals do the same work—save lives and heal the sick. Ailments do not discriminate on the basis of religion, and health needs cut across all regions, belief systems and locations. We expect the US to think of humanity first and put sentiments aside. The news item was first published on usembassy.gov, but was largely ignored by many local news sites, probably because of its sensitivity. In a highly polarised country like ours, this is understandable, but does not erase the fact of it.
Ever since President Donald Trump designated Nigeria a country of particular concern where Christian genocide exists, the Nigerian government has been walking on eggshells, doing America’s bidding or conveniently keeping quiet on issues that are likely to offend Trump, such as the invasion of Venezuela and the kidnap of President Nicolas Maduro, now being tried in a New York court. Nigeria could not even invoke its non-aligned status as contained in its early foreign policy in the Venezuela case.
It is true that Christians are being targeted in some parts of the country. It is also true that the murderers profess Islam, but obviously there is no state-supported killing of anybody. Moreover, Christians as well as Muslims have been victims of these murderous groups. As late as last month, a suicide bomber targeted and detonated his bomb in a mosque in Maiduguri, where five Muslim worshippers were killed. That, though, does not excuse the killing of Christians or anybody for that matter.
The consequences of years of insurgent activities, Boko Haram and banditry in the country have produced many IDPs across the country, with the North-east and North-central harbouring the highest numbers at 2.3 million and 1.3 million respectively. So, we are all casualties who need succour.
Do these IDPs and millions of Nigerians need urgent healthcare intervention? Of course they do. So do others, regardless of their faith. Why then should Nigeria be a party to a health MoU that seeks to marginalise, segregate and prejudice one faith against the other, when ailments do not discriminate?
For more clarity on the subject matter, here is what the US Embassy and Consulate Nigeria says on its website: “The MOU places a strong emphasis on Christian faith-based healthcare providers, recognising their indispensable role in delivering care to communities in need,” the MoU noted.
It observed that “Nigeria’s more than 900 faith-based clinics and hospitals serve more than 30 percent of the country’s 230 million people, often in areas where healthcare facilities are limited or absent. The MOU provides approximately $200 million in dedicated support to strengthen and support these Christian facilities, enhance workforce capacity, and expand access to integrated HIV, TB, malaria, and maternal and child health services. Investments in Christian faith-based health institutions are uniquely positioned to complement public-sector facilities and reinforce Nigeria’s overall health infrastructure,” the US Mission revealed.
The Mission’s emphasis on those who should get these services is most unfair. Health is universal, and any form of health assistance should cover all, and be uniform too. No patient goes to any Nigerian hospital and starts by asking whether the doctor to treat him is a Muslim or Christian. Conversely, I do not know any doctor in the world who seeks to know the identity of their patients before treatment. In my days in Kaduna, I had once been admitted to the faith-based St Gerard Hospital; no one asked me about my faith.
This is in contrast to the disparity Trump seeks to introduce into our health system. To divide us along religious lines, create acrimony and use the same to manipulate us as further evidence of our failure is not helpful.
Additionally, the MoU was said to have been “negotiated in connection with reforms undertaken by the Government of Nigeria to prioritise the protection of Christian populations from extremist violence. As with all U.S. foreign assistance, the President and Secretary of State retain the right to pause or terminate programs that do not align with U.S. national interests, and the United States expects Nigeria to continue making measurable progress in combating religiously motivated violence against Christian communities.” Honestly, this is strange. Many are not aware that President Tinubu’s so-called Muslim-Muslim ticket places more value on the lives and health of Christians than people of other faiths.
If the Trump administration chooses America First and discriminates against us, why should we do the same to ourselves? I do not want to believe that Tinubu will accept Trump’s prescription on who should benefit from shared health contributions, whether Muslims or Christians.
If President Tinubu prioritises the health of only Christians, what happens to the rest of us? Insecurity is pervasive all over the country. How Tinubu will protect and serve one group against the other, using Trump’s template, remains to be seen.
The timing of the MoU, its discriminatory approach, and the near blackout of the information from the public, as well as President Tinubu’s quick acquiescence to anything America does, make one wonder whose interest he is serving the Nigerian people and the electorate, or Trump’s America?
- Okino, is Chairperson of Blueprint Editorial Board, a fellow of the Nigerian Guild of Editors (FNGE), her syndicated column appears on News Point Nigeria newspaper on Thursday. She can be reached via: zainabokino@gmail.com.