US to boost Christian hospitals in Nigeria amid efforts to protect believers from violence

The United States has signed a $5.1 billion, five-year bilateral health agreement with Nigeria, directing substantial new funding toward Christian faith-based healthcare providers to expand health services and protect vulnerable Christian populations.

The move marks a new phase in U.S.-Nigeria cooperation under the America First Global Health Strategy.

The memorandum of understanding, formalized over the weekend, commits nearly $2.1 billion from the U.S. government toward prevention and treatment of HIV, tuberculosis, malaria, polio and maternal and child health, according to the U.S. State Department.

Nigeria has pledged an accompanying $3 billion in domestic health investment over the same period, the largest co-investment made by any nation under the strategy to date.

Of the U.S. funding, around $200 million will go to more than 900 Christian health facilities operating across Nigeria. These clinics and hospitals serve over 30% of the population, despite representing just 10% of healthcare providers, the U.S. Mission in Nigeria said in a statement.

The agreement ties U.S. support to recent Nigerian government reforms aimed at protecting Christian populations from targeted violence. It includes provisions to expand integrated services for infectious diseases and maternal and child care at Christian-run facilities.

Northern Nigeria is predominantly Muslim, with many states enforcing Sharia law alongside federal law, and religious police like the Hisbah regulating public morality. The south is largely Christian, with no religious law and a strong presence of churches and Evangelical movements. This divide influences politics, education and social life, while the central Middle Belt region remains religiously mixed and often experiences violent clashes rooted in both faith and ethnicity.

Tens of thousands of Nigerian Christians have been killed in the last decade, while many others have been displaced amid the rise of Islamic extremist groups like Boko Haram and the Islamic State in the northeast and the increase of attacks carried out by radicalized Fulani militias against predominantly Christian communities in the Middle Belt states.

The global Christian persecution watchdog Open Doors has warned in recent years that more Christians are killed in Nigeria for their faith annually than in all other countries.

The State Department said these investments are designed to complement public-sector efforts and strengthen Nigeria’s overall health infrastructure.

The MOU was signed in the context of a larger U.S. push to recalibrate global health assistance toward bilateral cooperation models.

Principal Deputy Spokesperson Thomas Pigott said the agreement is part of a new strategy that seeks increased financial participation from partner nations and a stronger focus on healthcare system resilience.

Nigeria’s maternal and child health indicators remain among the worst globally, with the country accounting for 30% of the worldwide malaria burden.

The State Department said the U.S. president and secretary of state retain authority to pause or end assistance programs that no longer align with national interests.

U.S. officials said they expect continued progress from Nigeria in addressing extremist violence affecting Christian communities.

The America First Global Health Strategy, launched in September, covers countries receiving U.S. health assistance.