From a health financing perspective, I believe this transition presents a significant opportunity to strengthen domestic resource mobilization, improve the efficiency of health expenditure, and institutionalize evidence-informed decision-making. In Nigeria, technical support partnerships should prioritize areas such as health financing policy, public expenditure tracking, strategic purchasing, health economics modelling, and value-for-money analysis. Equally important is the deliberate engagement of local health economists, researchers, and technical experts who understand the country’s health system and can provide context-specific solutions while strengthening government capacity.

Ultimately, the success of these partnerships should not be measured merely by the number of technical experts deployed or the volume of funding mobilized, but by the extent to which they build sustainable local capacity, improve health system performance, and deliver measurable health outcomes. Nigeria’s emerging model offers an important opportunity to demonstrate how coordinated technical assistance can support health sector reforms while reducing long-term dependence on external expertise. The real test of country-led technical support is whether it leaves countries with stronger institutions, better financing systems, and the capacity to sustain progress long after external funding ends.

Thanks so much David for that important comment. I do agree that one of the most important things for governments to figure out is what expertise they need to have in-house and what is most efficient to outsource. That balance will change over time as institutional capacity increases, so I appreciate your point about making capacity transfer and local innovation explicit components of technical-support partnerships. Thank you very much for contributing to this discussion!

Making capacity transfer and local innovation explicit components of technical-support partnerships could help ensure that external expertise leaves behind stronger local institutions and sustainable technical capacity.