(This article is a two-part series. Read Part 1: Moving corporate impact in Nigeria’s healthcare from donations to investments (1)

The good news is that models for meaningful corporate health investment already exist in Nigeria and are generating measurable, replicable, and scalable results.

The Adopt-a-Healthcare Facility Programme (ADHFP), co-founded by Aliko Dangote, Jim Ovia, and Aigboje Aig-Imoukhuede under the Private Sector Health Alliance of Nigeria, represents perhaps the clearest articulation of what investment rather than donation looks like in the Nigerian healthcare context. Under this model, companies commit to fully revitalising specific primary healthcare facilities over a multi-year period. In September 2024, a landmark milestone was reached when multiple revitalised PHCs under the programme were formally commissioned; not donated to and forgotten, but systematically rebuilt, staffed, and operationalized.

MTN Foundation, under the What Can We Do Together Initiative, revitalized over 50 PHCs across 36 states in Nigeria in 2025. Chevron Nigeria’s approach earned the company PSHAN’s Health Impact Award in 2024, not for the scale of its spending, but for the sustainability of its model, integrating health investment with education and socio-economic development across its operational communities.

The lesson is that strategic health investment begins by asking: what unique capacity does my company possess that could amplify healthcare access?

At the institutional finance level, the February 2026 commitment by the International Finance Corporation and the Nigeria Sovereign Investment Authority to deploy $24.5 million (₦14.2 billion) in local-currency financing for NSIA MedServe signals something significant: sophisticated institutional capital is moving purposefully into Nigerian healthcare infrastructure, targeted at underserved communities rather than urban centres already served by private hospitals.

At the subnational level, the 2024 Primary Healthcare Leadership Challenge administered by the Nigeria Governors’ Forum demonstrated that even government-led health systems can transform when the right accountability incentives are in place. Anambra and Yobe states each won $1.2 million for measurable PHC performance improvements. Kaduna won $500,000. Abia won $400,000. The lesson for corporate investors is powerful: the enabling environment for partnership exists.

The ESG dimension: Beyond box-ticking

As international capital markets increasingly apply Environmental, Social, and Governance (ESG) frameworks to investment decisions, the health investment practices of Nigerian companies are becoming material to stakeholders beyond the domestic market.

Under ESG frameworks, health outcomes fall primarily within the ‘Social’ pillar, one of the most scrutinised dimensions for institutional investors in the post-pandemic era. Companies are now expected not merely to report their community health spending, but to demonstrate measurable health outcomes attributable to that spending. The distinction between activity-based reporting and outcome-based reporting is, in the language of ESG, the distinction between a company that takes its social obligations seriously and a company that is ticking boxes.

A 2025 analysis noted that while Nigeria’s ESG directional shift is encouraging, weak impact measurement remains the most critical weakness in Nigerian CSR practice. Many organisations continue to report activities rather than outcomes, a pattern that will become increasingly untenable as investor scrutiny intensifies.

“If your company’s health CSR strategy can fit on an Instagram post, you don’t have a strategy, you have a photo opportunity. Real health investment takes five years, not five minutes.”

Should institutional investors require health impact metrics as a condition of capital deployment? The answer is yes; and the most forward-thinking investors already do. The question is whether Nigerian companies are prepared to meet that standard, or whether they will wait to be compelled by regulatory requirement before treating health outcomes as a reportable business metric.

INNOVATIVE FINANCING INSTRUMENTS: THE ROAD AHEAD

Moving corporate health engagement from the charity ledger to the investment portfolio will require, in addition to mindset shifts, the development of financial instruments specifically designed to make health infrastructure investment both accessible and attractive to the corporate sector.

Social Impact Bonds (SIBs) offer one such instrument. Under an SIB structure, private investors provide upfront capital for health programmes, with returns paid by government or international donors if pre-agreed outcome targets are met. The mechanism transfers delivery risk from government to private investors and has already been successfully deployed across Africa for HIV services, maternal health, and cataract surgeries. Nigeria’s health financing ecosystem is ready for a serious pilot of this model at scale.

Health Infrastructure Bonds, specifically designed for corporate subscription, represent another untapped frontier. Under this model, corporations subscribe to government-backed bonds with proceeds ring-fenced exclusively for PHC construction, renovation, and equipment. Returns are tax-advantaged, tenors align with corporate planning cycles, and quarterly outcome reports provide the accountability that corporate treasurers require.

The tax incentive architecture must also evolve to reward long-term infrastructure investment more generously than short-term donations. A reformed framework offering enhanced deductibility of 150 percent for three-year-plus PHC infrastructure commitments, and 200 percent for investments with verified health outcomes, would meaningfully shift the corporate calculus in favour of sustained strategic investment.

The imperative of accountability

Any serious conversation about expanding corporate health investment must address the question that ordinary Nigerians will ask before any other: Why should we trust this?

The trust deficit in Nigerian healthcare is deep and historically earned. Citizens have watched drugs donated to public facilities disappear into private markets. They have seen equipment rust in PHC waiting rooms for want of maintenance. They have encountered health programmes that flourished in election cycles and withered in the years between. The cynicism is not irrational; it is the reasonable response of a population that has been repeatedly disappointed.

For corporate health investment to transcend this environment of legitimate distrust, it must be built on an accountability architecture that is more robust than anything Nigeria’s healthcare sector has previously attempted. This means independent oversight boards comprising corporate donors, government representatives, community members, and civil society organisations, with quarterly published inspection reports.

It means public-facing dashboards displaying real-time facility utilisation data. It means community co-management structures in which citizens have genuine decision-making power over facility governance. It means technology-enabled tracking: biometric staff attendance, blockchain supply chains, and AI-powered anomaly detection.

This accountability is not a burden. For companies genuinely committed to impact, it is a differentiator.

The choice before corporate Nigeria

Nigeria spends approximately 3.8 percent of GDP on healthcare, one of the lowest ratios in sub-Saharan Africa and significantly below the 15 percent commitment made by African governments under the 2001 Abuja Declaration. The infrastructure gap this chronic underfunding has created is not one that government revenues alone will close in any foreseeable timeline. The private sector’s involvement is not a policy option, it is a structural necessity.

But the nature of that involvement is a choice. Corporate Nigeria can continue writing annual cheques for medical outreaches that generate photographs and change nothing. Or it can make the more difficult, more demanding, and ultimately more rewarding decision to treat health infrastructure as a strategic asset, one that protects workforce productivity, stabilises communities, satisfies investor expectations, and compounds in value over time.

The Dangotes and Ovias and Aig-Imoukhuedes who founded PSHAN did not do so because philanthropy compelled them. They did so because they understood something that every serious business leader eventually discovers: You cannot build a prosperous business on a sick population. The health of the communities that supply your labour, patronise your products, and sustain your social licence to operate is not separate from your business interests. It is inseparable from them.

The question before every corporate leader in Nigeria today is not whether they can afford to invest in healthcare. The data on productivity loss, workforce instability, and investor sentiment has already answered that question. The question is whether they can afford not to.

Muyiwa Olowoporoku is the Head of Membership & Partnerships at the Private Sector Health Alliance of Nigeria (PSHAN).