By Saifullahi Attahir

If there was ever anything that gave me goosebumps and immense pleasure, it was being surrounded by intellectuals and mature minds absorbing facts and figures about governance, economics, public health, policymaking, national security, and international relations. In such situations I easily lose myself, forgetting almost all other things.

Even at medical school, my best lectures were those with frequent digressions, whereby the lecturer would discuss the pathogenesis of diseases for 30 minutes and later sidetrack into discussing politics, governance, or other life issues. I always enjoyed classes led by Prof. Sagir Gumel, Dr. Murtala Abubakar, Dr. Rasheed Wemimo, Dr. Aliyu Mai Goro, and co.

During such lectures, I often observed some of my colleagues disappointment for such deviation. I rather casually show indifference, for I was eternally grateful for such discussions due to the stimulatory effect they had on my mind.

After such classes, I sometimes followed up with the lecturer, not to ask about a medical concept I did not grasp, but to ask for further explanation on policy making, project execution, budgetary expenditures, why African countries are left behind, and similar pressing issues.

In situations where I can’t catch up with the lecturer, I jotted down the questions for further deliberation.

One of the manifest feature I know about my greediness was at reading books. I can open five different books in a day. I lack such discipline to finish up one before another. I can start reading ‘Mein Kampf’ by Adolf Hitler, and halfway through 300 pages, I would pick up ‘My Life’ by Sir Ahmadu Bello, and would have to concurrently read both until the end.

I often scolded myself for such an attitude, but I can’t help myself. The only way to practice such discipline was to at least read two different books in a day. Such was a triumph in my practice of self-discipline. This was apart from my conventional medical textbooks.

To some of my friends, I was called an accidental medical doctor, but actually it was a perfect fate guided by the merciful Lord that I’m studying medicine.

 For it was only medicine that makes reading books easier for you. Although time is precious in this profession, but  one finds it easier to do anything you are passionate about. The daily  interaction we have  with people at their most vulnerable state was another psychostimulant. Seeing humans suffering from disease conditions is heartache. Some of the causes are mere ignorance, poverty, superstitions, and limited resources.

The contribution one can give couldn’t be limited to just prescribing drugs or surgical procedures that end up affecting one person. It’s much better to involve one self in to position that may bring possible change to the whole society even in form of orientation.

What also motivated me more was how I wasn’t the first to traverse this similar path. Bibliophiles were common among medical students and medical professionals.

At  international level, the former Prime Minister of Malaysia, Dr. Mahathir Muhammad, was a physician.

Most of the current economic development of Malaysia was attributed to him. The South American revolutionary figure Che Guevara was a physician. Atul Gawande was an endocrinologist, health policy analyst, adviser to former President Obama, campaign volunteer to former President Bill Clinton, and adviser to USAID/WHO on health policies.

Frantz Fanon was another physician, psychiatrist, racial discrimination activist, and political writer. Dr. Zakir Naik was a renowned Islamic scholar, comparative religion expert, and physician.

At the national level, Prof. Usman Yusuf is a haematologist, former NHIS DG, and currently a political activist. Dr. Aminu Abdullahi Taura was a psychiatrist and former SSG to the Jigawa state government. Dr. Nuraddeen Muhammad was a psychiatrist and former cabinet minister to President Goodluck Jonathan.

During ward rounds and clinics, my mind often wanders to enquire not just  about the diagnosis but the actual cause of the disease condition; why would a 17-year-old multiparous young lady develop peripartum cardiomyopathy (PPCM)? Why would a 5-year-old child develop severe anaemia from a mosquito bite? Why would a 25-year-old friend of mine develop chronic kidney disease, and his family would have to sell all their belongings for his treatment? Why are our Accident and Emergency units filled with road traffic accident cases? Was it bad road conditions or lack of adherence to traffic laws and orders?

Why are African countries still battling with 19th century diseases like Tuberculosis, filariasis, and malarial infections? Why issues of fighting cervical cancer and vaccination campaigns are treated with contempt in our societies? Why access to basic primary healthcare in Nigeria was still a luxury 50 years after Alma Ata declaration?

The questions are never-ending…

Answers to these questions could be found not in the conventional medical textbooks like Robbins/Cotrand, Davidson, or Sabiston. Answers to these questions are there on our faces. Answers to these questions are tied to the very fabric of our social life, our public institutions, our culture, and our life perspectives.

In order to make any significant contribution towards the betterment of this kind of society, it would be quite easier as an insider rather than an outsider. You can’t bring any positive outcome by just talking or commenting. It was rightly stated that a cat in gloves catches no mice.

The real players in a game are always better than the spectators. A player deserves accolades despite his shortcomings, frequent falls, and inability to deliver as planned theoretically. For the player has seen it all, because so many things in public life are not as they appear. It’s only when you are there that the reality becomes visible. This is the reason why many leaders who have goodwill and enjoy public support appear to have lost track or contributed insignificantly when elected or appointed into office.

But despite all these challenges, one can’t decline to do something good just because something bad might happen. The risk is worth it….

Attahir wrote from Federal University Dutse

By Victor Benjamin

Health is wealth,” a common adage echoing through Nigerian communities, encapsulates the fundamental importance of well-being. President Bola Tinubu’s administration appears to have taken this sentiment to heart, demonstrating a bold commitment to revolutionising Nigeria’s health sector.

Through a multi-pronged approach focused on strengthening infrastructure, upskilling manpower, and ensuring efficient healthcare delivery, the administration is signaling a new era for healthcare in Nigeria. This ambitious agenda, backed by tangible initiatives and achievements, holds the promise of a healthier and more prosperous nation.

President Bola Ahmed Tinubu’s administration has launched a comprehensive and ambitious agenda to transform Nigeria’s healthcare sector, signaling a new era of progress and commitment to the well-being of the Nigerian people. This multi-pronged approach focuses on strengthening infrastructure, upskilling the healthcare workforce, enhancing system efficiency, and addressing critical public health challenges. The administration’s actions are demonstrably moving towards a more robust and accessible healthcare system.

A cornerstone of this transformation is the aggressive expansion and upgrade of healthcare infrastructure. The federal government’s decisive action to convert the General Hospital Kumo in Gombe State into a Federal Medical Centre (FMC) is a prime example. This strategic upgrade, the second federal medical institution in Gombe, will significantly improve healthcare delivery in the Northeast region. Moreover, the upgraded Kumo FMC will serve as a teaching hospital for the Federal University of Kashere and Lincoln University, Kumo, contributing to the crucial training of future medical practitioners.

Furthermore, the administration is committed to dramatically increasing the number of functional Primary Healthcare Centres (PHCs) from 8,809 to over 17,600 by 2027. This expansion aims to bring quality healthcare closer to communities, particularly in underserved areas. To support this, the Basic Health Care Provision Fund (BHCPF) is being redesigned to provide more Direct Facility Funding to healthcare facilities, increasing from N300,000 to N600,000-N800,000 per quarter. The federal government has also identified 577 primary healthcare centres for immediate revitalization, indicating a focused and actionable plan.

Recognising that a strong healthcare system relies on a skilled workforce, President Tinubu has prioritised investment in human resources for health. The approval of 774 National Health Fellows, selected from each local council, aims to foster sustained improvements and cultivate future healthcare leaders. The administration has also set out to train 120,000 frontline health workers over 16 months, with 40,240 already trained, addressing critical manpower gaps in PHCs.

Additionally, the enrolment capacity of accredited nursing and midwifery institutions is being increased to meet the growing demand for healthcare professionals. A community health programme is being redesigned to create 126,000 jobs for community health workers, extending essential health services to remote and underserved communities.

Strengthening healthcare systems and efficiency is another critical aspect of the administration’s agenda. The Nigeria Health Sector Renewal Investment Initiative (NHSRII), launched in December 2023, serves as a strategic blueprint to improve population health outcomes through primary healthcare and enhance reproductive, maternal, and child health services.

The National Primary Health Care Development Agency (NPHCDA) is developing a three-year digitalisation agenda, encompassing facility functionality, supply chain management, financial management, and the community health information system.

This initiative promises improved efficiency and data-driven decision-making. Nigeria’s active participation in the Collaborative Active Strategy (CAS) further streamlines health campaigns and strengthens the overall health system.

Addressing critical health challenges is also a priority. First Lady Senator Oluremi Tinubu’s strong advocacy campaign against tuberculosis (TB), declaring it a health emergency and committing an additional N1 billion through the Renewed Hope Initiative, highlights the administration’s focus on tackling significant public health issues. The nationwide rollout of HPV vaccination, with over 12 million girls vaccinated, demonstrates a proactive approach to preventive healthcare.

The international community has recognised the administration’s commitment. The World Bank has approved $1.57 billion to support the health sector in Nigeria, focusing on strengthening human capital through better health for women, children, and adolescents. This significant financial support underscores the global confidence in the administration’s vision and execution.

President Tinubu’s comprehensive health agenda promises substantial benefits for the Nigerian populace. Foremost, it aims to drastically improve access to quality healthcare, particularly at the primary level, ensuring that even remote communities receive essential medical services.

This is complemented by a concerted effort to build a more robust and better-trained healthcare workforce, effectively addressing critical manpower shortages and ensuring adequate staffing across facilities. Simultaneously, the administration is focusing on strengthening healthcare infrastructure and equipment, upgrading existing facilities and constructing new ones to provide healthcare providers with necessary resources.

Furthermore, the agenda prioritises the creation of more efficient and transparent healthcare systems through digitalisation and improved financial management, streamlining processes and optimising resource allocation. Crucially, it demonstrates a strong commitment to tackling critical public health issues, such as tuberculosis and immunisation, through focused attention and targeted interventions. These multifaceted efforts collectively pave the way for a healthier nation, enhancing the overall well-being of the Nigerian people.

This comprehensive approach underscores President Tinubu’s understanding of the critical role of a strong healthcare system in national development. By prioritizing infrastructure, workforce development, system efficiency, and targeted interventions, the administration is laying the foundation for a healthier and more prosperous Nigeria. This narrative presents a compelling story of progress and commitment in the Nigerian health sector, marking a significant step towards a brighter future for the nation’s healthcare.

Victor Benjamin is the West/South South Director for Young Professionals for Tinubu (YP4T)

By Chiamaka Happiness Madueke

What’s worse than being taxed? Being taxed invisibly and twice.

When the government tightens monetary policy; hikes taxes, and removes subsidies, all in one breath, you would expect the economy to breathe easier. But in Nigeria, the air seems to feel thinner.

Over the past few years, Nigeria has embraced a series of bold economic reforms; floating the Naira, removing fuel subsidies, and pushing revenue generation targets. These actions can generally signal fiscal discipline and long-term growth.

For example, the Nigerian government reportedly saved N3.6 trillion from subsidy removal in just the second half of 2023, but beneath the policy headlines lies a quieter story: one where debt servicing, inflation, taxation, and informal charges collide to create an invisible burden on everyday transactions.

Yes, between visible taxes, invisible inflation, and unofficial levies collected by everyone and no one, low-income Nigerians allegedly seem trapped in a system that squeezes them from every direction.

Let me digress for a second, but I’ll bring it back in a bit, I promise.

At first glance, taxation and inflation may seem like two separate forces: one a fiscal tool, the other a macroeconomic consequence. But in Nigeria’s current climate, they’re colliding in real time, shaping the daily experience of citizens and businesses alike.

The Taxation Puzzle

Nigeria’s tax-to-GDP ratio remains among the lowest globally; just 10.86 per cent as of 2022, according to the Federal Inland Revenue Service (FIRS). That’s well below the 15–25 per cent global average, and even lower than the African average. Yet, the informal economy, which contributes nearly 58 per cent to GDP, bears much of the untracked tax burden through local levies and fees.

This mismatch reveals a chronic revenue problem and this challenge becomes even more critical when you consider the growing cost of debt. But borrowing isn’t inherently bad; in fact, strategic debt can stimulate growth if channelled into things like power, roads, manufacturing, or digital infrastructure, projects that have a way of boosting the economy.

In an interview with Arise News, the CEO of Sterling Bank, Mr Abubakar Suleiman, said, “If you are not collecting enough revenue to service a debt, that is a problem”. But it is even worse when you’re not using that debt for productive, economic reasons; that’s a structural problem.

Then I ran the numbers, in 2022, Nigeria reportedly spent a large per cent of its revenue on debt servicing. That means most of what we earn do not go to schools, hospitals, or industrial development, they go to paying back interest. That’s like living on a credit card and using it to buy lunch, not build a business that would make profit.

In 2023, 64.5 per cent of the federal government’s total revenue was used for debt servicing, according to a BusinessDay analysis of data from the Budget Office.

Although this was higher than the 48.5 per cent in 2022, it was still less than the 71.8 per cent in 2021. In 2023, actual revenue was N11.88 trillion, slightly above the predicted N11.05 trillion, while actual debt service costs were N7.66 trillion, 16.9 per cent higher than the projected N6.56 trillion.

In comparison, Nigeria’s revenue for the fiscal year 2022 was N7.76 trillion, falling short of the N9.97 trillion projection. The fact that debt servicing increased to N3.76 trillion from an anticipated N3.69 trillion in spite of this shortfall shows that debt obligations are an unavoidable burden even in cases where revenues are below budget.

This pattern emphasizes how little financial flexibility the government has, particularly when it comes to financing infrastructure or social projects.

By September 30, 2024, Nigeria’s total public debt had climbed to N142.3 trillion, reflecting a N8.02 trillion increase from N134.3 trillion in June 2024. This 5.97 per cent rise was attributed not only to additional borrowing but also to the depreciation of the Naira, which significantly inflated the naira value of external debt.

The surge in debt has not been matched by a proportional increase in productive investment, raising questions about the sustainability and strategic intent of government borrowing.

Adding to the concern, the total debt service cost reached an estimated N3.57 trillion in just the third quarter of 2024 alone.

With limited income from formal taxation, the government allegedly struggles to adequately fund infrastructure, education, healthcare, and essential services.

In response, efforts are underway to:

• Widen the tax base by formalizing more of the informal sector,
• Improve compliance through digital platforms and data integration,
• Rationalize outdated and inefficient tax incentives.

However, increasing tax pressure and its enforcement especially now can be politically unpopular and economically dangerous. Why? Because inflation is already eating through household budgets.

The Inflation Squeeze

Nigeria’s inflation rate has remained stubbornly high, largely driven by the rising cost of food prices, currency depreciation, removal of fuel subsidy and Monetary policies like floating the Naira.

As of early 2024, inflation was between 28–30 per cent, with core inflation also climbing. This diminishes buying power, worsens poverty, and increases the expenses of conducting business.

Essentially, inflation operates as an unnoticed tax, one that hits the vulnerable the hardest, especially low and middle-income earners whose wages aren’t keeping pace.

One key statement caught my attention in recent times, “We must choose between Taxation or Inflation.”

At first, that sounded a bit extreme. But the more I thought about it, the more it made sense.

Taxation is visible, structured, and can be progressive. Inflation, on the other hand, is unpredictable and regressive, a silent thief that spares no one, but affects the poor more because they have less to spend.

For low-income Nigerians, a controlled tax system paired with targeted public investment, might be more manageable than the current wave of inflation that raises the price of garri, beans, and palm oil every other week for Aunty Onyeka and thousands like her.

The “Other” Taxes We Don’t Talk About

But this brings me to a creeping question. What about the unofficial taxes? The ones no one talks about?

How are the indirect taxes collected from public transporters by local levy collectors accounted for? The levies collected from Mama Basirat who hawks around Oshodi market selling cooked food has watched the price of palm oil jump three times in six months while still paying a N500 “market ticket” every morning before selling a single plate of rice. Who tracks that revenue?

Yes, the most shocking revelation for me has been realizing that even hawkers – hawkers, who sell sachet water or fruit walking down roads and the street corners are being taxed in some areas.

Or rather, charged daily levies by local agents. And no, I am not condemning that, just that this issue raises some serious questions in my head:

• Where does this money go?
• Is it remitted to any official government account?
• What public service is being provided in return?

If we zoom out, the irony becomes obvious. We keep saying Nigeria’s tax-to-GDP ratio is too low. Yet, many of the poorest Nigerians are already being taxed, just not in ways that show up in FIRS data.

They’re taxed by local councils, market unions, transport associations, and sometimes even self-appointed local revenue agents. Is this form of taxation? It’s neither progressive nor transparent, nor accountable.

So, What Are We Really Talking About?

When we push for increasing tax revenue, we often picture corporate profits or high-net-worth individuals. But the reality? Many of the levies, fees, and informal charges disproportionately hit those in the informal sector; drivers, traders, hawkers, the same people inflation is already punishing the most. It’s a vicious cycle.

Drivers hike transport fares to meet the levies. Hawkers bump up prices to stay afloat and somewhere in the middle, people start paying more for food, transport, and basic needs. So, yes, taxation may be more beneficial than inflation but only if it’s fair, formal, and genuinely

used to improve lives. Until then, we seem to remain stuck in a system where the poorest pay the most, twice over: Once through rising prices that their income can barely meet, and again through levies that don’t even show up in the books. The informal sector is already contributing indirectly through taxes and levies. But where that money goes, that’s the real mystery.

The discussion about taxation in Nigeria must expand beyond the official tax system to consider these informal levies. And that, more than anything, is what really got my thinking juices flowing.

Maybe the conversation shouldn’t just be about taxing more, but taxing better, and ensuring value for those already overburdened.