Nigeria, Aug. 11 -- For much of the past three decades, global health financing rested on the expectation that external assistance would continue to expand alongside the health needs of developing countries. That expectation is now less certain, as fiscal pressures in donor countries, changing political priorities and recent disruptions to established programmes reshape how health partnerships are financed and managed. Nigeria must prepare for that change without surrendering the gains those partnerships have helped to achieve.

The implications are especially clear in immunisation, where nearly 10 million children are born in Nigeria each year. Each cohort must be reached with the vaccines already in the national schedule, while new vacc...