Sustaining gains in laboratory systems, HIV, malaria, tuberculosis programs amidst declining international funding: Key considerations for health integration

The efforts to eradicate HIV/AIDS, and other diseases of poverty- Malaria and Tuberculosis have consumed a significant proportion of financial allocation for healthcare. For over two decades, Nigeria has received support from international funding such as the President's Emergency Plan for AIDS Relief (PEPFAR) and other donor agencies. These funds have been used to strengthen Nigeria’s clinical laboratory system, combat the HIV/AIDS epidemic, improve HIV testing and treatment, and reduce HIV-related mortality and morbidity. Declining external funding poses a significant challenge to sustaining these hard-won gains, especially in a nation where budgetary allocation for healthcare is below the projected average. This paper examines the critical challenges that may arise from the reduction or withdrawal of donor funding for HIV and other programs, and provides suggestions on alternative sources of financing. The tips, when integrated into the national health system and implemented, could help to sustain the gains made so far in clinical laboratory systems, the fight against HIV/AIDS, Malaria, and Tuberculosis. • Combating diseases of poverty has heavily strained healthcare funding in Nigeria. • Declining external funding threatens progress in disease control and health access. • The budgetary allocation for healthcare in Nigeria still falls below 15% • Donor exit offers Nigeria a chance to take ownership of its healthcare programs and services.