02873nas a2200577   4500000000100000008004100001260001600042653002100058100001500079700001600094700001300110700001400123700001500137700001300152700001600165700001500181700001600196700001600212700001400228700001300242700001400255700001200269700001300281700001300294700001200307700001600319700001200335700001500347700001600362700001600378700001400394700002000408700001600428700001800444700001200462700002100474700001500495700001000510700001500520700001200535700001400547700001300561700001800574700001300592245008400605856007500689300001400764490000800778520149500786022001402281       2022                            d  bElsevier BV10aGeneral Medicine1 aAbubakar I1 aDalglish SL1 aAngell B1 aSanuade O1 aAbimbola S1 aAdamu AL1 aAdetifa IMO1 aColbourn T1 aOgunlesi AO1 aOnwujekwe O1 aOwoaje ET1 aOkeke IN1 aAdeyemo A1 aAliyu G1 aAliyu MH1 aAliyu SH1 aAmeh EA1 aArchibong B1 aEzeh AC1 aGadanya MA1 aIhekweazu C1 aIhekweazu V1 aIliyasu Z1 aKwaku Chiroma A1 aMabayoje DA1 aNasir Sambo M1 aObaro S1 aYinka-Ogunleye A1 aOkonofua F1 aOni T1 aOnyimadu O1 aPate MA1 aSalako BL1 aShuaib F1 aTsiga-Ahmed F1 aZanna FH00aThe Lancet Nigeria Commission: investing in health and the future of the nation  uhttps://www.thelancet.com/action/showPdf?pii=S0140-6736%2821%2902488-0  a1155-12000 v3993 a<p>Health is central to the development of any country. Nigeria's gross domestic product is the largest in Africa, but its per capita income of about ₦770 000 (US$2000) is low with a highly inequitable distribution of income, wealth, and therefore, health. It is a picture of poverty amidst plenty. Nigeria is both a wealthy country and a very poor one. About 40% of Nigerians live in poverty, in social conditions that create ill health, and with the ever-present risk of catastrophic expenditures from high out-of-pocket spending for health. Even compared with countries of similar income levels in Africa, Nigeria's population health outcomes are poor, with national statistics masking drastic differences between rich and poor, urban and rural populations, and different regions.</p>

<p>Nigeria also holds great promise. It is Africa's most populous country with 206 million people and immense human talent; it has a diaspora spanning the globe, 374 ethnic groups and languages, and a decentralised federal system of governance as enshrined in its 1999 Constitution. In this Commission, we present a positive outlook that is both possible and necessary for Nigeria to deliver equitable and optimal health outcomes. If the country confronts its toughest challenges—a complex political structure, weak governance, poor accountability, inefficiency, and corruption—it has the potential to vastly improve population health using a multisector, whole-of-government approach.</p>
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