The inauguration of the National Health Technology Assessment Steering Committee marks a new phase in how Nigeria can decide what health interventions to fund, for whom and at what cost.
For years, the central question in health financing has been how to mobilise enough resources to provide healthcare for a growing population. But as resources remain limited and the cost and range of health technologies continue to rise, another question becomes increasingly important: how does the health system decide what to spend those resources on?
That is where Health Technology Assessment, or HTA, enters the picture.
Nigeria is now moving to institutionalise HTA as part of the country’s wider health financing and strategic purchasing reforms, with the inauguration of the National HTA Steering Committee on September 16, 2026 marking a significant step in that process.
The significance of the development lies less in the creation of another committee than in the system it is intended to help build. HTA provides a structured way to assess the clinical, economic and wider value of health technologies and interventions before decisions are made about coverage, reimbursement, pricing and resource allocation.
For the National Health Insurance Authority (NHIA), this has a direct connection to its core function. Its mandate to attain Universal Health Coverage places strategic purchasing at the centre of how pooled health resources are converted into healthcare access and outcomes. Strategic purchasing, in turn, requires decisions about what services to purchase, for whom, from which providers, at what price and on the basis of what evidence.
The institutionalisation of HTA therefore represents an attempt to strengthen the evidence behind those decisions.
The journey has not begun with today’s inauguration. It has developed over several stages within NHIA, moving from the need to strengthen strategic purchasing to the creation of dedicated institutional capacity, development of methodologies and generation of Nigerian evidence.
In 2025, NHIA established its Strategic Purchasing Department, including a dedicated HTA Division. It subsequently developed the methodological, governance and procedural instruments required to conduct HTA in a consistent and transparent manner.
That work has included investment in specialised human capacity. Two PhD students and two Master’s students have received postgraduate HTA training at Mahidol University in Bangkok, building a pool of Nigerian expertise capable of conducting, interpreting and applying HTA.
NHIA has also developed the institutional framework within which such assessments can take place. The package includes an HTA Framework, Reference Case, Process Guidelines, Deliberative Process, Committee Terms of Reference, Conflict of Interest Policy and Stakeholder Mapping and Analysis. Together, these documents establish the methodological and governance foundations for a system that is intended to be credible and transparent.
Perhaps more importantly, the Authority has begun building an evidence base that reflects the Nigerian population rather than relying exclusively on evidence generated elsewhere.
Its Nigerian EQ-5D-5L valuation study produced locally appropriate utility weights, or value sets, that can be used to calculate Quality-Adjusted Life Years (QALYs) using preferences from the Nigerian population. The significance is straightforward: where decisions require an assessment of the value generated by different health interventions, Nigerian preferences and evidence can form part of the analysis.
The framework has also moved beyond theory.
NHIA commissioned and completed three pilot assessments addressing real policy questions. One examined kidney replacement therapy, including dialysis and kidney transplantation, through a cost-utility analysis. Another assessed alternative colorectal cancer screening strategies. The third was a rapid HTA of sorafenib for advanced liver cancer, undertaken to inform a time-sensitive coverage question.
These pilots matter because institutional capacity ultimately has to work on actual decisions. A framework becomes useful when it can help policymakers examine competing interventions, costs, outcomes and wider considerations in a structured way.
The broader policy environment has also been moving in the same direction.
At the National Health Financing Policy Dialogue held from September 1 to 4, 2025, government, policymakers, development partners, civil society, academia and the private sector considered sustainable and equitable approaches to health financing. HTA featured explicitly in discussions on evidence-informed priority-setting and the question of which interventions deliver sufficient value to justify scarce resources.
But the dialogue did not create NHIA’s HTA programme. Rather, it provided part of the wider national health financing environment in which the institutionalisation process has progressed.
A more decisive milestone came in October 2025, when the National HTA was approved by the Coordinating Minister of Health and Social Welfare, followed by approval of the HTA Steering Committee. Its inauguration now moves the process from an emerging institutional capability towards a formally governed national HTA system.
That distinction is important.
The Steering Committee is not itself the body that will make every health financing or coverage decision. Its role is to provide strategic oversight and guidance for the national HTA system, support credible and transparent prioritisation of HTA topics, strengthen methodological quality and safeguards around conflicts of interest, encourage stakeholder and citizen engagement, promote capacity development and help create pathways through which HTA findings can inform policy, benefit-package design, strategic purchasing and reimbursement.
The test, therefore, will come after the inauguration.
Institutionalisation cannot be measured simply by the number of assessments completed or committees established. Its practical value will depend on whether evidence becomes a routine input into decisions about scarce health resources; whether coverage and benefit-package decisions become more systematic and transparent; and whether clinical effectiveness, cost, equity, ethical considerations and health-system realities can be considered together.
This is particularly relevant as Nigeria seeks to expand health insurance coverage while protecting households from healthcare costs. Every new medicine, diagnostic technology, procedure or service that enters the health system competes, directly or indirectly, for limited resources. The question is not simply whether an intervention works. It is also what it costs, what alternatives exist, who benefits, what outcomes it produces and what Nigeria can afford without displacing other important health needs.
HTA does not eliminate those difficult choices. It provides a more disciplined basis for making them.
For NHIA, that makes HTA more than a technical addition to its institutional structure. It is part of the Authority’s effort to strengthen strategic purchasing and align coverage, equity, quality and sustainability with evidence. The same strategic direction also recognises the importance of citizen engagement, data and technology, and organisational capacity.
Nigeria’s HTA journey has consequently moved through several stages: recognising the need for stronger evidence in strategic purchasing, building institutional capacity within NHIA, developing Nigerian expertise and evidence, testing the methodology against real policy questions, securing national policy approval and establishing a governance structure.
The inauguration of the Steering Committee brings those strands together.
The larger objective is not to make healthcare decisions more complicated. It is to make them more deliberate: to ensure that when Nigeria spends scarce health resources, the decisions rest increasingly on evidence about value, need, equity and outcomes.
That is ultimately what turns HTA from a technical discipline into an instrument of health-system reform.
