In a press statement released today, 5th May 2025 in commemoration of the 2025 World Asthma Day holding on May 6th, Prof. Chiwuike Uba, Founder of the Amaka Chiwuike-Uba Foundation (ACUF), called for urgent and coordinated action to tackle Nigeria’s growing asthma crisis.
Prof. Uba, a development economist and passionate health advocate, recounted the painful loss of his wife, Amaka, in 2016 due to a preventable asthma attack—an event that inspired him to establish ACUF and dedicate his efforts to improving asthma care across Nigeria and Africa.
This year’s World Asthma Day theme, “Make Inhaled Treatments Accessible for ALL,” as announced by the Global Initiative for Asthma (GINA), resonates deeply with ACUF’s mission.
Prof. Uba stressed that the ability to breathe should not be a privilege but a basic human right. “Inhaled corticosteroids—the cornerstone of asthma management—must be within reach of every Nigerian, regardless of their income level or where they live,” he said.
Asthma prevalence in Nigeria ranges between 5.12% and 14.7%, with projections indicating a continued rise. Across Africa, the prevalence is even more varied, ranging from 1% to as high as 53% depending on the region and age group. Urbanization, increasing air pollution, and inadequate healthcare infrastructure have compounded the issue.
In Nigeria, asthma accounts for 5–10% of emergency room visits, with recent data indicating rising disability-adjusted life years (DALYs) and asthma-related mortality rates, particularly in under-resourced areas. Some urban tertiary hospitals report mortality rates as high as 6% among admitted asthma patients.
Prof. Uba highlighted the human cost of this crisis—children missing school, breadwinners forced to choose between food and medication, and the elderly suffering in silence due to a lack of accessible care. He warned that these silent battles often go unnoticed but are all too real for millions of Nigerians.
The cost of managing asthma is another major barrier. A basic SABA inhaler (e.g., salbutamol) costs between ₦5,000 and ₦8,500, while ICS medications (e.g., budesonide or beclomethasone) and combination ICS/LABA therapies can cost up to ₦70,000. Given that Nigeria’s minimum wage is ₦70,000, many patients must spend their entire monthly income—or more—on a single inhaler. Such conditions, Prof. Uba said, are “not only unjust but inhumane.”
Contributing to the crisis is the depreciation of the Naira, the exit of multinational pharmaceutical firms like GSK, and Nigeria’s heavy dependence on imported medicines. These factors have inflated medication costs and restricted supply. Compounding the problem is Nigeria’s broken healthcare system. Of the country’s 40,400 health facilities, 85.1% are Primary Health Care (PHC) centers, but more than 80% of these are not functional due to poor infrastructure, staff shortages, and lack of essential supplies. Only 12% of Nigerian doctors work in PHCs, while the private sector—which comprises just 27% of health facilities—employs 74% of practicing physicians.
The Essential Medicines List (EML) in Nigeria remains outdated, prioritizing oral medications like salbutamol tablets, which are associated with harmful side effects including tremors and cardiac issues.
In contrast, modern WHO-recommended inhaled therapies remain largely inaccessible. Moreover, Nigeria lacks a comprehensive national asthma management guideline, leaving healthcare providers without clear, evidence-based protocols. Environmental pollution—from vehicle emissions to gas flaring—continues to worsen respiratory health outcomes.
Out-of-pocket expenses account for 76.6% of total health expenditures in Nigeria, with health insurance coverage reaching less than 3% of the population. Public spending on health is also abysmally low. Despite committing under the 2001 Abuja Declaration to allocate at least 15% of the national budget to health, Nigeria’s 2025 allocation is only 5.2%—₦2.48 trillion—far short of what is needed. As of 2018, government expenditure made up just 14.9% of total health spending, with external aid at 7.86% and health insurance contributing a meager 0.76%.
To meaningfully address Nigeria’s escalating asthma crisis, Prof. Uba emphasized the urgent need for systemic policy reforms that go beyond token gestures and tackle the root causes of poor asthma care. A critical first step, he said, is updating Nigeria’s Essential Medicines List (EML) to reflect modern treatment standards.
The current list still includes outdated oral asthma medications such as oral salbutamol and corticosteroids, which are no longer recommended by the World Health Organization due to serious side effects and limited efficacy. These obsolete drugs must be replaced with inhaled corticosteroids (ICS), short-acting beta-agonists (SABA), and combination therapies that include long-acting beta-agonists (LABA), in line with global best practices.
Making these modern medicines available is not enough—they must also be affordable. Prof. Uba called for the subsidization of essential asthma medications through government funding and their inclusion in the benefit package of the National Health Insurance Authority (NHIA). By ensuring that vulnerable populations have access to these life-saving treatments at little or no cost, the government can significantly reduce asthma-related hospitalizations, improve quality of life, and prevent avoidable deaths.
Another critical reform is the development and implementation of a national asthma management guideline. Nigeria currently lacks a standardized, evidence-based framework for asthma care, leaving health professionals to rely on inconsistent and often outdated practices. A national guideline would provide clear diagnostic criteria, treatment protocols, and follow-up recommendations, enabling healthcare workers across all tiers—from primary health centers to tertiary hospitals—to deliver consistent and effective care.
Prof. Uba also highlighted the urgent need to revitalize Nigeria’s Primary Health Care (PHC) system. With over 85% of the country’s 40,400 health facilities classified as PHCs—many of which are non-functional due to neglect—the opportunity for widespread, community-level care is being squandered. The government must invest in renovating these facilities, equipping them with essential diagnostic tools and medicines, and recruiting and training adequate personnel. Telemedicine, he noted, could also be leveraged to bridge healthcare gaps in remote or underserved areas.
To reduce Nigeria’s reliance on costly imports and improve medication availability, the country must also build capacity for the local production of asthma medicines. This will require the creation of incentives for pharmaceutical companies, the establishment of public-private partnerships, and meaningful regulatory reforms to encourage sustainable domestic manufacturing. Local production will help stabilize medication prices, reduce supply chain vulnerabilities, and support long-term access to essential drugs.
Environmental reform is another area requiring immediate government attention. Prof. Uba emphasized the importance of enforcing existing environmental laws, particularly those relating to air pollution and gas flaring. The country must adopt and promote cleaner household fuels and industrial technologies, while ending the harmful practice of flaring gas in oil-producing regions. Improving air quality is a direct way to reduce the incidence and severity of asthma attacks, especially among children and vulnerable populations.
Finally, Prof. Uba reiterated that increasing public investment in health is non-negotiable. Nigeria must honor its Abuja Declaration commitment by allocating at least 15% of the national budget to the health sector. Current spending levels—just 5.2% in the 2025 budget—are far below this benchmark and leave the majority of Nigerians exposed to financial hardship in the face of illness.
Expanding health insurance coverage through strategic pooling of funds and innovative financing mechanisms will further help to reduce out-of-pocket health expenditures, which currently stand at a staggering 76.6%.These reforms, Prof. Uba concluded, are not optional. They are necessary if Nigeria is to reverse the tide of asthma-related suffering and death. He called on the government, legislature, private sector, and civil society to rise to the moment and ensure that no Nigerian is denied the basic right to breathe.
In closing, Prof. Uba issued a passionate plea to all Nigerians, including policymakers, civil society organizations, and corporate leaders, to rally behind the cause. “Asthma does not discriminate,” he said. “Ironically, we only seem to discover how many of our politicians are asthmatic when they are arrested. Let them be part of this movement now—not out of compulsion, but from compassion and foresight.”
“As we mark World Asthma Day 2025, let us remember that no one should die simply because they cannot afford to breathe. The time to act—for the air we breathe, the health we deserve, and the lives we can still save—is now.”
God is with us!
By Prof. Chiwuike Uba, Ph.D., Development Economist and Founder, Amaka Chiwuike-Uba Foundation (ACUF)
