Public health experts have raised concerns over the poor availability of essential medicines in primary healthcare centres, warning that millions of Nigerians in rural communities are at risk of preventable deaths following new data showing that only 36.2 per cent of essential drugs are available at the primary care level nationwide.
Findings from the National Health Facility Survey released by the National Bureau of Statistics showed significant gaps in access to medicines at PHCs, which serve as the first point of contact for most Nigerians.
The report indicated that while national availability of essential drugs improved marginally to 37.4 per cent in 2025, up from 35.0 per cent in 2023, secondary health facilities recorded 60.6 per cent availability compared to 36.2 per cent in primary facilities, highlighting a wide disparity in access to care.
It further showed regional differences, with the South-West recording the highest PHC drug availability at 42.3 per cent, while the North-West recorded the lowest at 31.0 per cent.
The survey also revealed that availability of basic medical equipment stood at 36.9 per cent nationally, with 34.8 per cent in PHCs and 76.8 per cent in secondary facilities.
In interviews with PUNCH Healthwise, physicians described the figures as a reflection of a dysfunctional drug distribution system that disproportionately disadvantages rural communities, despite their heavy reliance on PHCs.
They explained that essential medicines are expected to be readily available for common conditions, but persistent shortages force patients to resort to self-medication, traditional care, or long-distance travel to urban centres, often worsening outcomes.
According to them, the lack of essential drugs delays treatment of common illnesses such as malaria, diarrhoea and infections, while in emergencies such as severe infections or pregnancy-related complications, it can result in avoidable deaths.
The experts identified weak distribution systems, ineffective drug revolving schemes, poor rural supply chains, and concentration of medicines in urban areas as key factors driving the shortages.
They also noted that the situation has contributed to low morale among health workers, who are often unable to treat patients effectively due to stockouts, while also worsening rural-urban migration of medical personnel.
The physicians called for urgent reforms in supply chains, revitalisation of drug funding mechanisms, increased government investment, and expansion of local drug production to ensure consistent availability.
According to the World Health Organisation, essential medicines are those that satisfy priority healthcare needs of the population and must be available at all times in functional health systems, in appropriate dosage forms, assured quality and at affordable prices.
Despite existing funding mechanisms under the Basic Health Care Provision Fund, which earmarks 20 per cent of facility financing for essential drugs, vaccines and consumables, shortages persist in PHCs nationwide.
Under the framework, 45 per cent of the fund is channelled through the National Primary Health Care Development Agency to states, local governments and facilities, with 35 per cent disbursed directly to PHCs as Decentralised Facility Financing.
Commenting, a Professor of Public Health at the University of Ilorin and former President of the Association of Public Health Physicians of Nigeria, Prof Tanimola Akande, said the findings reflect a failure in Nigeria’s drug distribution system.
He said, “Essential drugs are meant to be available at all times because they address the health needs of the majority. Unfortunately, most PHCs do not have them, which shows that drug distribution is not rational.”
Akande added that rural dwellers are often forced to either seek alternative care or travel long distances at higher cost when medicines are unavailable at nearby facilities.
“Delay in access to essential drugs can lead to complications and even death,” he warned.
The don explained that PHCs are expected to stock basic life-saving medicines such as antimalarials, antibiotics, analgesics, antihypertensives and antidiabetic drugs.
On maternal health risks, he cited postpartum haemorrhage as a critical example where drug shortages can be fatal.
“Postpartum bleeding is an emergency. Without drugs, referral delays can lead to death,” he said.
Akande attributed the imbalance to weak supply systems, estimating that over 80 per cent of drugs are concentrated in urban areas.
He also warned that poor drug availability affects health workers’ morale and could encourage unethical practices in some facilities.
A Professor of Community Medicine and Public Health at the University of Port Harcourt, Prof Best Ordinioha, said the impact is most severe during emergencies.
He said delays in accessing essential drugs in PHCs often result in complications or deaths from otherwise treatable conditions such as malaria and diarrhoea.
“These are common diseases that should not cause deaths if drugs are available at the primary level,” Ordinioha said.
Ordinioha noted that the drug revolving fund system, designed to ensure continuous supply, has largely collapsed due to poor implementation.
He called for its revival, improved funding, government support, and partnerships with donor agencies to stabilise drug availability at the primary healthcare level.
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