By Sola Ogundipe
Ganiat Ojo believed the headache would eventually disappear. The 55-year-old petty trader had lived with the pain for months, brushing it off as the price of long days at the market and the constant struggle to provide for her family. Like many Nigerians, she hardly ever checked her blood pressure. There was always another bill to settle, another customer waiting and yet another reason to put off a trip to the hospital.
Then, one afternoon, she collapsed in her shop. Neighbours thought she had simply been overwhelmed by exhaustion, but they rushed her to hospital anyway. Doctors later confirmed she had suffered a massive stroke caused by severe, uncontrolled hypertension. She never regained consciousness and died the following day, leaving behind four children.
Stories like hers play out quietly across Nigeria every day. Most never make the headlines. Yet taken together, they expose one of the country’s biggest public health tragedies: millions of Nigerians are dying years, and sometimes decades, earlier than they should.
Estimates from the United Nations Population Division and the World Bank put life expectancy at birth in Nigeria at about 54 years, among the lowest anywhere in the world. The global average, by comparison, now exceeds 73 years, according to the World Health Organization (WHO). In countries such as Japan, Switzerland and Singapore, living into one’s 80s or even 90s is no longer exceptional.
Health experts say the reasons stretch well beyond medicine. Poverty, weak health systems, poor nutrition, environmental hazards, chronic stress, limited access to healthcare and widening social inequalities all shape how long Nigerians live.
Life expectancy reflects how well a country protects the health and wellbeing of its people from birth through old age. At independence in 1960, a Nigerian could expect to live for about 37 years, according to World Bank estimates. Infectious diseases were widespread, child mortality was extremely high and healthcare services were scarce, especially outside major towns and cities.
Today, average life expectancy has risen by almost two decades. Advances in public health mean more children now survive birth and early childhood than in the past. Yet, 57years can not be good enough. Expanded immunisation programmes have cut deaths from vaccine-preventable diseases. Better maternal healthcare has helped more women survive pregnancy and childbirth. Improvements in malaria control, nutrition and sanitation have also played an important role in extending lives.
Even so, Nigeria’s progress has lagged behind that of many comparable countries. Although life expectancy has continued to rise, the country remains among those with the shortest lifespans in the world. At the same time, the health burden has shifted. Infectious diseases no longer dominate as they once did. Instead, non-communicable diseases such as hypertension, diabetes, stroke, heart disease, chronic kidney disease and cancer are becoming increasingly common.
According to the United Nations World Population Prospects 2026, analysed by GeoRank, a Nigerian who reaches the age of 65 can expect to live to about 77.2 years. Someone who reaches 70 is expected to live to around 79.4 years, while a person who turns 75 can expect to live to approximately 82.1 years. For those who celebrate their 80th birthday, average life expectancy increases further to about 85.2 years.
These figures do not mean everyone will live to those ages. Instead, they show that once people survive the highest risks of infancy, childhood and middle age, their remaining life expectancy increases significantly.
Nigeria’s relatively low life expectancy is driven less by the biology of ageing than by deaths that occur decades before old age. Complications of pregnancy, infectious diseases, uncontrolled hypertension, diabetes, road traffic injuries, violence and other largely preventable causes continue to claim lives far too early.
As the WHO points out, life expectancy reflects far more than the performance of hospitals. It is also a measure of how effectively a country protects its people through good nutrition, clean water, education, safe roads, economic opportunity, environmental protection and access to quality healthcare throughout life.
Nigeria’s relatively low life expectancy cannot be traced to a single disease or one failure within the health system. It is the cumulative result of many factors acting over a lifetime, beginning with where people are born and the care they receive in childhood, and extending to whether they can afford treatment as adults.
A person’s chances of living a long and healthy life are shaped not only by medicine, but also by income, education, nutrition, housing, access to clean water, proper sanitation, safe roads and quality healthcare.
Where Nigerians live can have a profound effect on how long they are likely to live. People in major cities generally have better access to specialist hospitals, diagnostic centres, pharmacies and emergency care. In many rural communities, the picture is very different. Health facilities are fewer, journeys to seek treatment are longer and shortages of skilled health workers are far more common. As a result, illnesses are often diagnosed much later, medical emergencies take longer to receive appropriate care and preventable deaths occur more frequently.
The Director-General of the WHO, Dr Tedros Adhanom Ghebreyesus, has repeatedly argued that “where a person is born should never determine how long they live.” He maintains that persistent gaps in life expectancy are driven by unequal access to healthcare, poverty and inadequate investment in public health.
Global health expert and Group Chief Executive Officer of Amref Health Africa, Dr Githinji Gitahi, echoes that view. “People do not die simply because hospitals are unavailable; they die because the social conditions needed for healthy living are absent.”
His observation reflects a growing consensus among public health experts that hospitals alone cannot deliver longer lives. Good health also depends on safe communities, nutritious food, quality education, clean environments and economic opportunities that enable people to make healthier choices.
Non-communicable diseases, including hypertension, diabetes, stroke, heart disease, chronic kidney disease and cancer, now account for an increasing share of illnesses and premature deaths in Nigeria.
Unlike many infectious diseases, these conditions often develop quietly. High blood pressure, diabetes and kidney disease may produce few, if any, warning signs until irreversible damage has already occurred.
By the time many patients finally seek medical care, they are already dealing with complications such as stroke, heart failure or kidney failure, conditions that are far more difficult and expensive to treat. Yet many of these illnesses can be prevented, delayed or effectively managed through routine screening, early diagnosis and continuous care. Prevention, however, remains one of the weakest links in Nigeria’s health system.
The Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, has consistently argued that many of the conditions responsible for premature deaths can either be prevented or successfully treated if they are detected early.
He has also stressed that improving life expectancy demands far more than treating disease. Strong primary healthcare, effective disease prevention, better nutrition, education, sanitation and broader social development are all essential to improving population health.
WHO Representative in Nigeria, Dr Walter Mulombo, has likewise identified financial hardship as one of the biggest barriers to healthcare. “People should not have to choose between feeding their family and seeing a doctor,” he said. For millions of Nigerians, however, that remains an everyday reality.
Another major challenge is the steady loss of Nigeria’s health workforce. Every year, thousands of doctors, nurses and other health professionals leave the country in search of better pay, safer working conditions and greater career opportunities abroad. The impact is felt across the entire health system.
Hospitals struggle to replace departing staff. Waiting times grow longer, specialist services become harder to access and those who remain are often expected to care for far more patients than recommended, placing enormous strain on an already overstretched workforce.
Without enough skilled health workers, the system becomes trapped in a cycle that feeds on itself. Delayed diagnosis, interrupted treatment, overcrowded facilities and preventable deaths continue to shorten the lives of many Nigerians.
For many Nigerians, the greatest threats to a long life are woven into the fabric of everyday living. They are found in the daily struggle to make ends meet, hours lost in traffic, rising food prices, insecurity, polluted air, unsafe roads, poor housing, limited access to healthcare and the constant uncertainty of what tomorrow may bring.
Public health experts describe these as the social determinants of health, the conditions in which people are born, grow, work and grow older. Together, they shape not only the quality of people’s lives, but also how long they are likely to live.
