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Transforming Nigeria’s Health Sector

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Where does one start analysing the recent claim by the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, that Nigeria is becoming a hub for quality health care and a destination choice for patients from the West African subregion and other parts of the world? Is it from the fact that as at the time he was making the statement on Tuesday, the number one citizen of the country, President Bola Tinubu was almost ready for a private visit, (believed by many to be health check related) to Paris, France the following day? Or, that the minister did not explain what he meant by “quality healthcare” nor did he tell the State House correspondents the number of patients that come to Nigeria from the USA and the UK for treatment and why.
Are they Nigerians in the diaspora visiting Nigeria and receiving treatment? Do the so-called people from all over the world come to Nigeria for medical treatment because Nigeria offers the best medical care better than anywhere in the world? No doubt, there may be some people who visit hospitals in Nigeria, maybe for fertility treatment due to certain restrictions in the countries they reside, who come to consult some particular health experts or those that find the treatment of certain ailments cheaper in Nigeria. There also exist some specialised hospitals in the country, particularly in Lagos and Abuja, who do attract patients from neighbouring West African countries for treatments in such areas as organ transplants, cardiology, fertility treatments, and advanced surgeries. But on a global scale, can Nigeria be regarded as a top destination for medical tourism? How did the minister arrive at that
And talking of quality healthcare, as earlier stated, it would have been nice if the Minister had given us the indices he used to arrive at his assertion and his own meaning of quality healthcare. Experts have defined quality healthcare as medical services that are effective, safe, timely, patient-centred, equitable, and efficient. It ensures that patients receive the right care at the right time, leading to better health outcomes. This means that, for healthcare to be considered quality, the treatments and interventions should be based on scientific evidence and best practices to improve patient health; it should minimise risks, errors, and harm to patients; patients should receive care without unnecessary delays; it should respect and respond to individual patient needs, values, and preferences; it should be accessible to all, regardless of socio-economic status, race, gender, or geographic location.
Above all, it should be efficient – resources should be used wisely to avoid waste and keep healthcare costs manageable. Are these the case in Nigeria? It is no hidden fact that many hospitals and clinics in the country, especially the public hospitals lack basic amenities like clean water, stable electricity, and modern medical equipment.  Rural areas suffer from a lack of healthcare facilities, forcing patients to travel long distances for medical attention. Many doctors, nurses, and other medical workers migrate abroad (japa syndrome) due to low wages and poor working conditions. The doctor-to-patient ratio is far below the WHO recommendation. Not once have we seen a doctor dozing off while consulting patients due to fatigue and heavy workload. All the doctors’ strike actions for these reasons have not brought about a significant change.
How easily do patients receive medical attention in our hospitals and clinics? In most government hospitals, patients spend almost a full day or more to see a doctor. When the doctor is a consultant, the waiting period will definitely be longer.  And how affordable are the treatments and the drugs? The National Health Insurance Scheme (NHIS) was established in 1999 in response to increased out-of-pocket payments and the call for a movement towards Universal Health Coverage (UHC). Since the scheme started its operations in 2005, how many people have enrolled in the programme? The current Minister for Education, Dr. Tunji Alausa, while serving as the Minister of State for Health in May 2024 said that the government had allocated dedicated funds and initiated collaborations to enhance primary healthcare services and expand health insurance coverage and that the president had mandated them to increase coverage from about seven million then to about 50 million people.
Today, records show that only a small percentage of the citizens are still covered by the scheme. According to a report by the Journal of Global Health Economic and Policy, less than 5 percent of Nigerians are enrolled in NHIS, while 70 percent still rely on out-of-pocket payments, making healthcare unaffordable for the poor The challenge of poor drug regulation, counterfeit medicine, inadequate funding, poor emergency response, inconsistent government policies and corruption, poor sanitation and hygiene are yet to be dealt with. How then do we have quality healthcare in Nigeria? What about the careless and nasty attitude of healthcare providers towards the patients. Many Nigerians are left with permanent scars and disabilities due to the negligence of so-called healthcare experts who treated them.
Sure, medical negligence is not peculiar to Nigeria but it has become a constant occurrence in our health facilities and must be looked into by the Medical and Dental  Council of Nigeria, the Nigeria Medical Association and other relevant authorities. To take the nation’s healthcare system to the desired eldorado, a combination of policy reforms, increased funding, infrastructure development, workforce enhancement, attitudinal change among the healthcare providers and reduction of corruption in the health sector is necessary. Pate on Tuesday revealed that federal government has approved the sum of N12 billion for Magnetic Resonance Imaging, an advanced diagnostic equipment, across six tertiary health institutions in addition to Nigeria’s ratification of the African Medicines Agency (AMA) Treaty, which aims to harmonise medical regulatory standards across the continent.
That is a commendable step by the government if only the government will ensure that the money when released will be used for the stated aim and the right equipment purchased and regularly maintained. It is also important that the government allocates at least 15 percent of the national budget to health, as recommended by the Abuja Declaration. They should explore public-private partnerships (PPPs) to attract investments in healthcare infrastructure. There is also the need to upgrade and equip existing hospitals with modern medical technology, establish more primary healthcare centers (PHCs), especially in rural areas and invest in digital health solutions such as telemedicine to improve access. The issue of shortage of healthcare workers must be addressed through improved salaries, benefits, and working conditions.
Incentives (such as scholarships, housing, and career growth opportunities) should be regularly offered to retain healthcare professionals. Other important measures to be taken include expansion of the NHIS to cover more citizens, including the informal sector; introduce community-based health insurance programmes to increase access to affordable healthcare; the government, both federal and states, should subsidise low-income families to reduce out-of-pocket expenses.The authorities should strengthen immunisation programmes to prevent disease outbreaks and promote health education campaigns on sanitation, hygiene and healthy lifestyles. The National Agency for Food and Drug Administration and Control (NAFDAC) should be empowered to monitor and regulate pharmaceutical products more effectively, while the law enforcement agencies should do more in the area of enforcing stricter penalties for drug counterfeiters.
Implement technology-driven tracking systems to detect and remove fake drugs from circulation.The government should also increase funding for medical research and encourage local drug production. Partnership with universities and research institutions to develop innovative health solutions will certainly be productive. Government should also consider supporting the development of traditional medicine through scientific validation. As Africans, many Nigerians in the diaspora believe in the potency of herbs. A story was recently told of how some Nigerians make money by sending herbal medicine to Nigerians abroad. So, developing and properly regulating this sector might be the major attracter of patients. To have people come from all over the world to Nigeria, with the assurance that they will get the best of medical care here is the wish of many Nigerians.
Maybe that will reduce the president’s trip to France and save the nation some money. But achieving that goes beyond rhetorics or making political statements. Let there be more actions than words

 

Calista Ezeaku

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One Attack Too Many 

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Quote: “Ogoniland does not need leaders competing over who can destroy another’s platform; it needs leaders competing over who can create more opportunities, empower youths and build a better future.”

The latest attack by Chief Gani Topba on the President of KAGOTE and Chief Executive Officer of Giolee Global Resources Ltd, Chief Lesi Maol, appears to have opened another troubling chapter in the politics of leadership and influence in Ogoniland. While disagreements are inevitable, the frequency and manner of attacks directed at individuals or organisations contributing to Ogoni development should concern every stakeholder. The concluded extraordinary meeting of Ogoni stakeholders in Bori was convened to deliberate on challenges confronting the people, including insecurity, farmers-herders clashes, youth disunity, education and development. It also considered harmonising the numerous youth organisations operating across Ogoniland under a strong and representative umbrella capable of giving Ogoni youths a more coordinated voice. One would have expected such an initiative to attract constructive contributions, especially from those with reservations about it.

Instead, the gathering and its organisers have come under criticism, raising a fundamental question: what exactly is wrong with Ogoni stakeholders coming together to discuss problems affecting their people? If there are legitimate concerns about the meeting, its organisers or resolutions, such concerns should be supported by facts and subjected to constructive engagement rather than personalised attacks. Leadership is demonstrated through service, sacrifice, participation and results. If Chief Gani Topba believes the stakeholders’ meeting was unnecessary or lacked legitimacy, nothing prevents him from convening another meeting and demonstrating that he can attract traditional rulers, professionals, academics, clergy and youths. Different approaches to development should therefore be allowed to compete on their merits.

The proposal for a unified youth platform should equally not be presented as an attempt to silence Ogoni youths. Rather, it should be examined against the reality of numerous organisations claiming to represent different segments of Ogoni youths. Too many competing organisations can create confusion, weaken collective bargaining power and make it difficult for genuine concerns affecting young people to receive coordinated attention. A credible umbrella body, if properly constituted and broadly accepted, could strengthen the voice of Ogoni youths and provide an organised platform for employment, education, skills acquisition, security and governance. Ogoniland has experienced enough institutional fragmentation. Its history contains painful lessons about divisions that allow personal interests, leadership struggles and competing platforms to overshadow collective objectives. The present generation should learn that destroying institutions one does not control damages society.

The question should be: who benefits when Ogoni youths remain divided and every attempt at unity is interpreted as rivalry? Against this background, KAGOTE deserves objective scrutiny rather than blanket condemnation. Any organisation with influence must be accountable, but accountability is different from a campaign aimed at delegitimising initiatives associated with its leadership. Chief Lesi Maol’s activities through KAGOTE and Giolee Global Resources Ltd have attracted attention in areas including skills development, education, youth empowerment and community support. Such interventions should be assessed on their impact and encouraged where they serve the public good. Those who believe Chief Maol is not doing enough should not stop at criticism. They should show Ogoni what they can do better. Where are the alternative skills programmes? Where are the educational interventions? Where are the youth empowerment schemes? Where are the community development initiatives?

It is easy to criticise someone who is building; it is harder to mobilise resources and sustain programmes that benefit ordinary people. This is not to suggest that Chief Maol or KAGOTE should be immune from criticism. No leader or institution should be beyond scrutiny, and legitimate questions about accountability must be welcomed. But responsible criticism should be based on facts, evidence and alternative ideas. Personal attacks and attempts to destroy initiatives simply because their leadership is not controlled by particular interests cannot provide the solutions Ogoniland needs. What is unfolding is bigger than one meeting, one statement or even two individuals. It reflects a broader contest over influence and leadership. If anyone believes KAGOTE is taking Ogoni in the wrong direction, the response is to present a better direction. If anyone believes Lesi Maol is not doing enough, the answer is to demonstrate what more can be done. Ogoni does not need leaders competing over who can destroy another’s platform; it needs leaders competing over who can create opportunities, improve education, promote security, empower youths and contribute to development.

The people are looking beyond rhetoric. They are examining records, observing programmes and measuring results. No individual owns the permanent right to speak for Ogoni or determine which organisation must survive or collapse. Ogoni must replace the politics of personal control with a culture of ideas, service, accountability and measurable achievement. Differences should produce better alternatives, not destruction. Every Ogoni leader and stakeholder should ask whether his actions are strengthening the region or deepening divisions. Ogoni needs people who can build bridges, institutions, opportunities and hope. Those who genuinely love Ogoni should support what is good, correct what is wrong and offer better alternatives. The future of Ogoni will not be secured by destroying its builders, but by encouraging more people to build.

onest people can reach different conclusions based on different experiences and information. Public debate should therefore remain respectful, evidence-based and open to correction. Truth is strengthened by honest examination, not insults, suspicion or personal attacks. The phrase “Truth has no agenda” carries a powerful message. Truth does not belong to any political party, ethnic group, religion or ideology. It cannot be permanently owned or manipulated by those in power. Governments change, institutions rise and fall, and public opinion shifts, but truth remains indifferent to popularity.The real test of character comes when speaking honestly threatens influence, privilege or personal advantage. It is easy to defend justice when there is nothing to lose. It is far more difficult when the truth may cost us something. That is when conscience must rise above convenience.

Society must therefore cultivate a culture where integrity is valued more than comfort and accountability is welcomed rather than feared. Leaders should learn to accept criticism without hostility, while citizens should express disagreement responsibly. Progress becomes difficult when honest questions are treated as acts of disloyalty. Ultimately, every society must choose the future it desires. A nation built on silence cannot sustain justice, while a community where comfort consistently outweighs conscience risks making injustice ordinary. But people committed to truth, even when inconvenient, lay the foundation for stronger institutions, trustworthy leadership and lasting progress. The call is not to condemn those who succeed or to glorify perpetual criticism. It is to remember that privilege should never silence principle, influence should never replace integrity, and personal gain should never outweigh the public good. Truth has no hidden agenda. It seeks neither applause nor favour. It simply asks to be spoken, defended and lived. When truth is silenced by comfort, everyone eventually pays the price.

By:  King Onunwor
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When Comfort Silences The Truth  

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Quote: “Privilege should never silence principle, influence should never replace integrity, and personal gain should never outweigh the public good.”

There is an old saying that truth does not fear investigation. Genuine truth neither depends on applause nor seeks permission to exist. It remains constant whether celebrated or rejected, defended or ignored. Yet, in today’s society, truth often competes with comfort, convenience, loyalty and personal interest. This raises an important question: Can a person remain objective after beginning to benefit from the very system he once criticised? Throughout history, reform movements have been driven by courageous individuals willing to challenge injustice despite personal risks. Their commitment to truth sometimes cost them popularity, comfort, freedom and even their lives. History has also recorded instances where influential voices became quieter after receiving appointments, promotions, contracts, political favours or other advantages.

While motivations cannot always be known, such patterns remind us that personal benefit can sometimes influence public conviction. Human beings naturally seek security, stability and opportunities for themselves and their families. There is nothing wrong with success or advancement. The concern arises when personal comfort replaces public responsibility, or privilege becomes a reason to ignore problems affecting others. One of the greatest dangers facing society is not only corruption or poor governance but the normalisation of silence. Systems rarely collapse overnight. They deteriorate gradually when people who know better decide that speaking the truth is no longer worth the personal cost. Every society therefore depends on citizens willing to ask difficult questions, demand accountability and defend justice, regardless of who benefits or feels uncomfortable.

A person who benefits from a broken system may become less inclined to challenge it. This is not true of everyone, and individuals should not be judged without evidence. Many principled people continue to advocate reform while working within imperfect institutions. Nevertheless, personal interests can sometimes soften criticism, dilute conviction or redirect attention from uncomfortable realities.Perhaps the greatest threat to truth is not open opposition but quiet compromise. Censorship is easy to recognise; silence purchased through convenience is harder to detect. When people gradually stop asking questions, demanding transparency or defending principles they once considered important, society should ask whether something has changed. Perspectives may genuinely evolve with new information, but incentives can also influence what people say—or choose not to say.

This is why citizens should not place blind trust in personalities. Ideas, principles and actions should be examined independently. Loyalty to individuals must never exceed loyalty to truth. Political affiliation, professional status, financial success or social influence should not exempt anyone from accountability. A healthy democracy depends on independent thinking, not unquestioning allegiance.The responsibility to speak truth does not belong only to journalists, activists, judges, religious leaders or opposition politicians. It belongs to every citizen. The teacher who refuses to manipulate facts, the public servant who rejects corruption, the business owner who acts with integrity, the parent who teaches honesty and the young person who chooses principle over popularity all contribute to a more just society. However, defending truth also requires humility.

We must not assume that everyone who disagrees with us has been compromised.

By: Michael  Abraham

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Poor Federal Roads: The Oshiomhole’s  Outburst

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Quote:”Although the Federal Ministry of Works is responsible for road construction and rehabilitation while the Federal Roads Maintenance Agency (FERMA) oversees maintenance, road maintenance has consistently taken a back seat”

The recent outburst by the lawmaker representing Edo North Senatorial District, Senator Adams Oshiomhole, over the deplorable condition of federal roads in Edo and Delta states has once again drawn national attention to one of Nigeria’s most persistent infrastructure challenges. During Senate plenary last Wednesday, Oshiomhole criticized the Minister of Works, David Umahi, accusing the Federal Ministry of Works of neglecting major federal highways in Edo and Delta while prioritizing new road projects. According to him, the government should focus on rehabilitating existing roads that have become impassable before embarking on new construction. He identified the Benin-Warri, Benin-Asaba, Benin-Auchi and Auchi-Okene highways as strategic economic corridors that have deteriorated to alarming levels, making travel difficult for commuters and motorists while increasing the cost of transporting goods and services.

The senator also alleged that road projects affecting Edo and Delta states were repeatedly omitted from budgetary provisions and that some interventions were only undertaken following directives from President Bola Tinubu. Ironically, the Federal Government has consistently reiterated its commitment to reconstructing and rehabilitating federal roads across the country. The Minister of Works has repeatedly assured Nigerians that the government is deploying reinforced concrete technology to build more durable highways capable of withstanding the country’s climatic conditions. Despite these assurances, vast sections of federal road across the country remain in deplorable condition. The consequences are enormous. Federal highways serve as the backbone of the nation’s economy, carrying more than 90 per cent of passengers and freight.

They connect ports, airports, industrial centres, state capitals and agricultural belts, facilitating the movement of food, fuel, cement and manufactured goods. When these roads fail, the entire economy suffers. Although the Federal Ministry of Works is responsible for road construction and rehabilitation while the Federal Roads Maintenance Agency (FERMA) oversees maintenance, road maintenance has consistently taken a back seat. The result is a recurring cycle in which newly completed roads quickly deteriorate while existing ones are left to collapse. The economic consequences are severe. Bad roads increase transportation costs, contribute to food inflation, delay the movement of goods from ports to markets, increase vehicle maintenance expenses and lead to avoidable road crashes that claim countless lives every year.

To address these challenges, the Federal Government has introduced initiatives such as the Highway Development and Management Initiative (HDMI), which seeks to attract private investment into road maintenance through concessions and tolling. While the initiative holds promise, public acceptance will depend largely on visible improvements in road quality and transparent management of toll revenues. Similarly, the Road Infrastructure Tax Credit Scheme is designed to encourage companies to finance the reconstruction of strategic highways in exchange for tax credits. While the scheme has shown promise, its ability to address road infrastructure challenges equitably across the country remains to be seen. Other countries facing similar infrastructure challenges have demonstrated that sustainable road management requires a different approach.

Rwanda and Morocco, for instance, have prioritized dedicated road maintenance funds, performance-based contracts that reward quality rather than kilometers constructed, and policies that allocate a significant proportion of road budgets to maintenance instead of new construction. Nigeria can draw useful lessons from these experiences. Maintenance funding should be increased and protected because preventive maintenance is far cheaper than complete reconstruction. Public-private partnerships should be expanded with adequate safeguards, transparent tolling policies and independent monitoring. Development finance institutions should support contractors with affordable financing to minimize disruptions caused by delayed government payments. Road designs should withstand heavier rainfall and flooding, while compensation and right-of-way issues must be resolved before projects begin to avoid unnecessary delays.

FERMA should also prioritize durable, high-quality road maintenance over the shoddy repairs that have become all too common. Ultimately, Nigerians are not asking for perfect roads; they simply want roads that are safe, durable and properly maintained. While new highways are desirable, a well-maintained five-kilometer stretch is often far more valuable to road users than a much longer road that quickly falls into disrepair. The media, civil society, the National Assembly and Nigerians must continue to hold the government accountable by monitoring road projects and demanding better results. Good roads are not a privilege but a right of every citizen. With tax credit schemes, concessions and other funding mechanisms already in place, what is now required is political will, transparency and consistent implementation. However, Senator Oshiomhole’s criticism also invites legitimate public reflection. 

Many Nigerians have asked what the condition of these same federal roads was during his eight-year tenure as Governor of Edo State. Several governors, including those of Rivers State at different times, undertook repairs on critical federal roads within their states and subsequently sought reimbursement from the Federal Government. It is therefore fair to ask whether similar interventions were pursued during Oshiomhole’s administration. Public officials, whether serving or former, should be judged by the same standard. Constructive criticism is essential in a democracy, but it carries greater weight when matched by a demonstrable record of action. Nigerians expect those entrusted with public office to address pressing challenges while they have the authority to do so, rather than becoming vocal critics only after leaving office

By:  Calista Ezeaku
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