Nigeria could lose access to a significant share of a new United States health and humanitarian assistance package unless it demonstrates progress in tackling violence against Christians, according to a bilateral agreement between Washington and Abuja.
The warning follows the announcement of a new $1.4 billion US global health initiative, part of a wider funding strategy that places increased emphasis on faith-based healthcare providers.
At the centre of the issue is a Memorandum of Understanding (MoU) signed on 20 December 2025 between the US Department of State and the Nigerian government under the America First Global Health Strategy (AFGHS).
The agreement commits the United States to providing almost $2.1 billion over five years to support programmes addressing HIV, tuberculosis, malaria, maternal and child health, and polio. Nigeria is also expected to increase its own domestic health spending by nearly $3 billion during the same period.
A substantial proportion of the funding is intended to support Nigeria's network of faith-based hospitals and clinics, which currently serve more than 30 per cent of the population.
However, the agreement includes conditions linked to the protection of Christian communities.
According to the MoU, the agreement was “negotiated in connection with reforms the Nigerian government has made to prioritize protecting Christian populations from violence” and includes “significant dedicated funding” for Christian health facilities.
The document 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 conditions have also received support in the US Congress. The US House of Representatives recently voted to link aid to measurable progress in addressing the persecution of Christians in Nigeria.
Legislation approved by the House last month calls on the Nigerian government to take concrete steps to facilitate the return of internally displaced persons to their ancestral homes and improve protection for Christians in the country's Middle Belt region.
The latest US funding announcement includes $1.4 billion for integrated health services delivered through faith-based and community healthcare organisations in more than 20 countries.
Of that total, $850 million will be distributed through a Faith and Community Initiative Award to World Vision and local faith-based partners. The programme aims to strengthen more than 2,500 faith-based hospitals and clinics across 17 countries and support the training, equipping and payment of over 30,000 community health workers.
A further $570 million will be channelled directly to faith-based and community hospitals through bilateral agreements with participating governments, including Nigeria.
In addition, the US State Department announced $538 million in humanitarian assistance through organisations including Samaritan’s Purse, World Vision and Compassion International. The funding is intended to support seven million people across 16 humanitarian crises worldwide. More than $100 million has also been allocated for immediate disaster response in 23 countries vulnerable to natural disasters.
The State Department described the combined $1.4 billion health initiative as the largest investment in faith-based organisations for more than two decades, with at least 80 per cent of funding required to reach frontline services directly.
For Nigeria, the agreement places particular emphasis on Christian healthcare providers, describing them as “uniquely positioned” to complement public health services.
The development comes as the United States increasingly directs resources towards faith-based healthcare delivery in countries where such providers account for a significant proportion of health infrastructure.
As a result, Nigeria's ability to access future funding under the programme is expected to depend, in part, on whether the government can demonstrate progress in addressing concerns raised in Washington over violence against Christian communities.
The State Department said organisations such as Samaritan’s Purse, World Vision and Compassion International were selected because of their ability to deploy rapidly in conflict zones and disaster areas while delivering assistance directly to affected populations.
