Progress in healthcare, anti-corruption, and human rights is essential to Nigeria’s growth, according to Ambassador Richard M. Mills, the U.S. Ambassador to Nigeria. 

In an op-ed marking World AIDS Day, International Anti-Corruption Day, and Human Rights Day, he acknowledged that the U.S. has significantly invested in Nigeria’s health sector. However, persistent corruption and rights violations continue to undermine efforts to provide equitable healthcare for vulnerable communities. 

“Positive health outcomes depend critically on good governance,” the ambassador noted, stressing that mismanagement, corruption, and the marginalisation of vulnerable communities must be addressed to ensure access to healthcare for all Nigerians.

Ambassador Mills’ remarks come at a crucial time, as Nigeria continues to face persistent healthcare challenges, allegations of corruption, and human rights violations — particularly in conflict-affected regions like the Northeast and Northwest, where displaced communities struggle with access to healthcare.

One of the most prominent aspects of U.S. support for Nigeria is its contribution to the fight against HIV/AIDS. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. government has invested over $8.3 billion into Nigeria’s health system over the past 20 years.

According to Ambassador Mills, this funding has provided life-saving antiretroviral treatment for more than 1.5 million Nigerians, improving their life expectancy and quality of life. It has also helped to strengthen Nigeria’s overall health infrastructure, benefiting other health services beyond HIV/AIDS care.

“In clinics across Nigeria, I’ve met dedicated healthcare workers who deliver HIV prevention, treatment, and care, supported by the resources of the American people,” Mills noted.

However, as donor funding decreases, concerns about Nigeria’s ability to sustain these health programmes are growing. The ambassador reveals that the United States has begun discussions with Nigerian health officials to ensure the country wholly owns these programmes. This shift in responsibility was reinforced during a recent visit by PEPFAR Global AIDS Coordinator, Ambassador John Nkengasong.

While the U.S. has significantly contributed to Nigeria’s health sector, corruption remains a major barrier to service delivery. Mills highlighted the ongoing issues of mismanagement of healthcare funds, diversion of medical supplies, and the circulation of counterfeit medicines, all of which endanger public health.

“When medical supplies are diverted, when healthcare workers go unpaid, when facilities buy dangerous, counterfeit medications or lack resources due to mismanaged funds, it costs lives,” he said.

HumAngle has consistently reported on the struggles of displaced residents in internally displaced persons (IDP) camps, where corruption has led to charges for healthcare services that should be free. Meanwhile, essential medicines intended for these communities are often diverted to private markets, leaving IDPs without access to critical care.

In response, the U.S. government has partnered with Nigerian authorities and civil society organisations “not only in the health sector, to enhance transparency and accountability in Nigeria,” Mills said.  This is “to strengthen fiscal responsibility with the goal of the state ensuring resources reach their intended beneficiaries.”

Referring to a recent survey by the United Nations Office on Drugs and Crime (UNODC), Mills stated that more Nigerians are refusing to pay bribes and reporting corruption incidents to investigative journalists and authorities. He said this shift in public attitudes signals the beginning of a cultural change, but sustained effort is required to maintain this momentum.

“Challenges remain,” Mills admitted, “but the work we’ve done together shows what could be possible on a larger scale across these crucial domains.”

Beyond health and governance, human rights are a crucial pillar of development. Ambassador Mills linked the denial of healthcare to human rights violations, especially when marginalised groups face discrimination or stigma in accessing treatment.

“When members of marginalised communities face discrimination in accessing healthcare, when citizens fear reporting blatant corruption like the need to pay for appointments or ‘free’ healthcare, or when vulnerable populations cannot advocate for their needs, development falters,” he wrote.

Mills adds that the U.S. government has invested in human rights programming to empower civil society organisations (CSOs) to advocate for marginalised communities. Mills noted that these CSOs are vital in creating awareness of health rights and ensuring that displaced people and other vulnerable groups are not excluded from critical health services.

He also stressed that health, transparency, and human rights are not isolated issues but interconnected pillars that support national development. When one area falters, the others are also affected.

For instance, health sector corruption leads to poor healthcare delivery, while human rights violations in healthcare settings prevent vulnerable communities from reporting corruption. Conversely, efforts to strengthen transparency and governance in health procurement can reduce the misuse of medical supplies and ensure that health workers are paid on time, thereby improving the quality of service delivery.

The ambassador cited examples of successful U.S.-backed initiatives that have positively impacted Nigeria. For example, improved pharmaceutical supply chains have reduced the theft of essential medicines, while the empowerment of civil society organisations has enabled better advocacy for marginalised communities. These efforts have increased access to healthcare and led to greater public trust in Nigeria’s health system.

“The success of these efforts rests on respect for human rights and civic engagement,” Mills noted. He urged Nigerian leaders to prioritise health, good governance, and human rights as interconnected objectives rather than separate policy goals.

The U.S. ambassador acknowledged the progress made, particularly in the health sector, but highlighted the urgent work that remains.

To maintain momentum, he called for “renewed commitment and action” from all stakeholders, including government officials, healthcare workers, and civil society. He pledged continued U.S. support for Nigerian efforts to achieve sustainable health outcomes, greater transparency, and human rights protections.

For displaced communities in Nigeria’s north, where the impacts of climate change and armed conflict have deepened the humanitarian crisis, these issues are not abstract goals but matters of survival. With many IDPs relying on aid for healthcare, the need for transparency, access, and accountability is more urgent than ever.