ONE Africa calls on Nigeria to adopt a Fifth Birthday Guarantee, a nationally funded, publicly tracked commitment to the services that keep children alive.

ABUJA, Nigeria – 7 September 2026 – The ONE Campaign has called on the Nigerian government to make child survival a national priority funded from its own resources, after UNICEF Nigeria warned that aid cuts risk an unprecedented reversal in progress on child mortality.

UNICEF Nigeria has said that ensuring children reach their fifth birthday will be its top priority into the 2030s, and has confirmed that funding cuts have already reduced its capacity to deliver life-saving assistance. Roughly one in ten Nigerian children dies before the age of five, most from causes that are preventable and treatable: malaria, diarrhoea and pneumonia. Globally, 4.9 million children died before their fifth birthday in 2024; nearly six in ten of them in sub-Saharan Africa.

ONE’s position is that the aid cuts are exposing a deeper problem rather than creating it. The vaccines, treatments and health workers that keep Nigerian children alive have for too long depended on decisions made in other capitals. Research estimates that global aid cuts could lead to more than nine million additional deaths by 2030. The response cannot simply be to ask for that money back. It must be to reduce the vulnerability of essential services to decisions made elsewhere.

Serah Makka, Africa Executive Director of the ONE Campaign, said:

“One in ten Nigerian children may not live to see their fifth birthday. In 2026, that should be unthinkable. Aid cuts threaten to reverse hard-won progress. But the survival of a Nigerian child cannot depend on budget decisions made thousands of miles away.

Nigeria must make child survival a national priority, backed by its own resources, stronger primary healthcare and real accountability for results.

Reaching your fifth birthday should not be an achievement. It should be the minimum promise we make to every child.”

She has previously set out the case for fixing Nigeria’s health system in The Telegraph, and with ONE’s Director of Health Financing for Africa has argued for an African-led model of health financing that treats health as an economic driver rather than a cost.

ONE is calling for a Fifth Birthday Guarantee: not a promise that no child will die, which no government can make, but a commitment to fund and deliver the package of services that give every child the best chance of reaching five: immunisation, treatment for malaria, diarrhoea and pneumonia, trained health workers, essential medicines and outreach to remote communities. Government would cost the package and fund it through the national health budget or a clearly traceable programme envelope.

Accountability for money and results. Across Africa, ONE repeatedly sees the gap between money being needed, money being budgeted and money reaching services. Sometimes the allocation is inadequate. Sometimes it is allocated but never released. Government should publish what was budgeted, what was released and what was spent, alongside a small set of indicators showing whether services reached children. Nigeria has spent decades committing to percentages. It is time to commit to children.

Shared responsibility from partners and creditors. Scarcity is real. 3.4 billion people live in countries spending more on interest payments than on health or education, and high debt and the cost of capital mean responsibility cannot sit with African governments alone. Where Nigeria demonstrates verified increases in domestic effort, partners should reward it, including through matching finance. External support should strengthen the institutions and systems Nigeria needs to sustain these services itself, not substitute for them.

Health sovereignty is not self-sufficiency, and it is not the end of international solidarity. It means Nigeria having greater control, resilience and capacity to finance and deliver its own priorities, while continuing to cooperate where cooperation makes everyone stronger. Health threats do not respect borders.

Dr William Menson, Director of Health Financing for Africa at the ONE Campaign puts it this way:

“If that child were yours, would you accept that the vaccine was available, but the money was not released? That the treatment existed but did not reach the clinic? That somebody thousands of miles away changed a budget? There are no other people’s children. A fifth birthday should be unremarkable, and whether a child reaches it should not depend on a foreign budget.”

ENDS

About the ONE Campaign

ONE is a global, nonpartisan organisation advocating for the investments needed to create economic opportunities and healthier lives in Africa. Since 2004, we have helped secure more than $1 trillion in new investments to build a safer, more prosperous world. Our trusted advocacy combines hard-hitting data, grassroots activism and political engagement to influence decision-makers and drive lasting change. Learn more at ONE.org