Nigeria could lose access to a fresh $1.4 billion United States health and humanitarian assistance package if the Federal Government fails to demonstrate measurable progress in addressing violence against Christians, according to conditions contained in a bilateral Memorandum of Understanding between Abuja and Washington.
The agreement, signed on December 20, 2025, by the U.S. Department of State and the Nigerian government under the America First Global Health Strategy, commits the United States to providing nearly $2.1 billion over five years to support HIV, tuberculosis, malaria, maternal and child health, polio and other preventive and curative health services in Nigeria.
Under the agreement, Nigeria is also expected to increase its domestic health expenditure by nearly $3 billion during the five-year period, described as the largest co-investment under the AFGHS.
A substantial portion of the U.S. funding is expected to support Nigeria’s estimated 900 faith-based clinics and hospitals, which currently provide healthcare services to more than 30 per cent of the country’s population.
However, the agreement contains conditions tied to the protection of Christian communities.
The MOU states that it was “negotiated in connection with reforms the Nigerian government has made to prioritize protecting Christian populations from violence” and provides for “significant dedicated funding” for Christian health facilities.
It further states: “As with all foreign assistance, the President and Secretary of State retain the right to pause or terminate any programme which do not align with the national interest, and the Trump administration expects Nigeria to continue to make progress ensuring that it combats extremist religious violence against vulnerable Christian populations.”
The conditionality was further reinforced by the U.S. House of Representatives, which recently approved legislation seeking to tie American assistance to Nigeria to verifiable measures to address alleged Christian persecution.
The bill mandates Abuja to take concrete steps to facilitate the return of internally displaced persons to their ancestral communities and strengthen protection for persecuted Christians, particularly in the Middle Belt region.
Meanwhile, as part of the new assistance approved under the AFGHS, Washington allocated $1.4 billion to expand integrated health services through faith- and community-based hospitals and clinics across more than 20 countries.
Of the amount, $850 million will be provided through a Faith and Community Initiative Award to World Vision and local faith-based organisations to strengthen more than 2,500 faith-based hospitals and clinics across 17 countries. The initiative is also expected to train, equip and remunerate more than 30,000 community health workers.
An additional $570 million will be channelled directly to faith-based and community hospitals through bilateral memoranda of understanding with governments, including Nigeria.
The U.S. State Department also announced $538 million in humanitarian assistance for Samaritan’s Purse and a World Vision–Compassion International consortium to support approximately seven million people affected by 16 humanitarian crises.
More than $100 million of the humanitarian funding is expected to be made immediately available for disaster response in 23 countries considered vulnerable to disasters.
According to the State Department, the combined $1.4 billion health package represents the largest U.S. funding commitment to faith-based organisations in more than two decades, with at least 80 per cent of the resources expected to go directly to frontline services.
For Nigeria, the MOU places particular emphasis on Christian faith-based healthcare providers, describing them as “uniquely positioned” to complement government-owned health facilities.
With Washington increasingly directing resources towards faith-based healthcare providers in countries where they account for 40 per cent or more of health facilities, Nigeria’s access to the new funding could hinge on Abuja’s response to concerns raised by the U.S. government over violence against Christians.
The State Department said organisations including Samaritan’s Purse, World Vision and Compassion International were selected because of their experience deploying aid rapidly in conflict and disaster zones without lengthy bureaucratic processes.
