Health
Appraising and Re-tooling Nigeria’s Public Health Delivery Model in the Post COVID-19 Era
By Christopher Samuel
That the ravaging COVID-19 which has since the beginning of the year spread rapidly around the globe could leave a very serious public health crisis in its wake is no longer news.
In many parts of the world, attention is shifting to how to concretize local, regional and continental health partnerships that focus on not just how to successfully contain or tackle the virus, but, more importantly, to ensure that life-saving and essential health delivery services are sustained and maintained to entrench a robust system that maximizes the learnings gained from the current pandemic.
Like other developing countries, Nigeria now, more than ever before, has to seriously confront the challenge of creating a modern health services delivery system that guarantees efficient, fast and accessible solutions capable of curtailing fatalities associated with common diseases and their devastating impact on families, communities, and development.
While speaking recently on the threat of malaria in the country, the Minister of Health, Dr Osagie Ehanire, revealed that “though fever testing amongst children under 5 has increased consistently from 5% in 2010 to 11% in 2013, to 13% in 2015 and 14% in 2018, it is still very low when compared with the second objective of the Malaria Strategic plan which is to test all care-seeking persons with suspected malaria using RDT or microscopy.”
According to the World Malaria Report, Nigeria still accounts for 25% of the global malaria burden and 19% of global malaria deaths. Nigeria, it is estimated accounts for 81,640 annual malaria deaths – about 9 deaths per hour – and the situation is worsened by very low levels of investment in malaria elimination at both the sub-national levels and the private sector.
Apart from the frightening mortality and morbidity data on malaria, lack of access to functional health services delivery system has also been responsible for avoidable havoc caused by many other common but potentially deadly illnesses, such as STDs, diarrhoea, hypertension, and diabetes on a large segment of the 52% of the country’s population that lives in the rural areas.
To compound the situation, the country’s rural areas mostly lack good and functional infrastructure while the unavailability of competent healthcare personnel, coupled with high levels of poverty and illiteracy continue to make public health a daunting task in the country
Despite the country’s strategic position in Africa, it is highly underserved in the health care delivery sphere. Health resources such as facilities, personnel and medical equipment are inadequate, especially in rural areas.
Latest data from a survey of Africa’s 10 largest economies show that only Ethiopia has fewer hospital beds per capita than Nigeria. The most recent WHO data puts the number of hospital beds at only five per 10,000 people in Nigeria.
Beyond hospital beds, however, public healthcare delivery is hampered more by the inadequacy of healthcare resources particularly personnel, drugs and other medical equipment needed for holistic patient treatment.
For instance, the doctor to patient ratio is currently 1:6000. Most of the available qualified doctors are concentrated in urban cities and towns while the rural areas have next to nothing, thereby leaving room for quacks and other unqualified hands to tend to citizens’ health needs.
This poor picture makes the healthcare system particularly fragile and always at major risk of being overwhelmed at the breakout or in the aftermath of any pandemic with a serious presence in the country.
Yet, as an important element of national security, the need for public health is non-negotiable. Public health not only functions to provide adequate and timely medical care but also tracks, monitors, and controls disease outbreaks.
The Nigerian health care environment has suffered several infectious disease outbreaks year after year. Hence, there is a need to tackle the problem decisively now in order to forestall a repeat of the chaotic national response to the COVID-19 pandemic.
While the government has regularly come up with reforms to address the wide-ranging issues in the health care system, implementation has sadly been poor.
According to the 2009 communique of the National Health Conference, health care system remains weak as evidenced by lack of coordination, fragmentation of services, the dearth of resources, including drug and supplies, inadequate and decaying infrastructure, inequity in resource distribution, lack of access to care and a very deplorable quality of care. The communique also pinpointed a lack of clarity of roles and responsibilities among the different levels of government to have compounded the situation.
To further underline the fact that the Nigerian health care system is poorly developed, experts have often observed that there are no discernible and well maintained adequate and functional surveillance systems in the sector.
A successful modern-day health care delivery model requires routine surveillance and medical intelligence as the backbone of the health sector. This is because medical intelligence and surveillance represent a very useful component in the health care system and control of diseases outbreak.
The provision of timely information aimed at combating possible health menace among many other things is an important function of public health.
Hence, inadequate tracking techniques in the public health sector can lead to huge health insecurity, and thereby endanger national development, peace, and security.
There is, therefore, an increasing role of automated-based medical intelligence and surveillance systems to complement the traditional manual pattern of document retrieval in an advanced medical setting as seen in western and European countries.
Given the above prognosis, the primary challenge confronting the country’s public health today could, therefore, be framed as how to create and sustain an information-rich and patient-focused health care system that reliably delivers high-quality care.
Learning from experience is crucial, both for effective emergency response and to rebuild for the future.
Past experiences have shown that in the wake of health pandemics, the government has often been discovered to have diverted statutory health budget and resources to tackle the immediate challenge of the pandemic. This often leaves the healthcare services delivery sector more fragile, weaker and more overwhelmed, especially in the efforts to contain common citizen health needs.
For instance, in the aftermath of the Ebola crisis, many people died because of the inability of the overwhelmed health systems to treat malaria, HIV, and tuberculosis than from Ebola itself.
A similar trend can only be avoided in the aftermath of this fight against COVID-19 if efforts are geared towards putting in place a proactive, revolutionary and easily affordable and accessible health services delivery the model that can ride on the strong deployment of technology to strengthen healthcare accessibility at the grassroots.
Nigeria needs to urgently come up with an innovative approach to creating different layers of health services delivery model that can deliver effective and efficient medical services to the most vulnerable in society, to achieve the best health outcomes, such that location and socio-economic status will not be a barrier to accessing quality healthcare services. This need to also be done as cheaply as possible, given the dwindling economic fortunes of the country.
In this regard, the country needs to look towards the innovative and revolutionary community health hub idea which is capable of leveraging technology to offer a holistic solution to the identified gaps in the existing healthcare delivery systems, particularly in the underserved areas, as a way of maximizing the scarce human resources for health (HRH).
The best of this community health hub ideas is grounded on tele-healthcare model and not the anachronistic brick and mortar community healthcare facility model.
The growing popularity, spread, reach and utility value of mobile telephony and other digital devices should challenge health administrators and service providers to think out of the box in coming up with solutions that can deliver efficient health services to the majority of Nigerians, especially in the lower socio-economic cadre.
The current pandemic has demonstrated the central importance of health in our national life — without it, we have nothing. It has also shown how we can do things differently as regards to making our public healthcare system truly patient-focused.
We should not expect the world to stand still for us to move at a pedestrian pace when everybody else is sprinting to make their systems better.
Christopher Samuel is the Project Coordinator for Telehealth Nigeria Initiative (TENI) based in FCT, Abuja.
By Modupe Gbadeyanka
The federal government has urged global investors and innovators to tap into the Nigerian healthcare ecosystem, which is projected to grow by 7.1 per cent, reaching a market value of $161.7 million by 2027.
This advice was given by the Minister of State for Health and Social Welfare, Mr Isiaq Salako, at the opening of the World Health Expo (WHX in Lagos 2026), formerly known as Medic West Africa, on Tuesday in Lagos.
The broader West African market is expected to reach more than $11 billion, providing investors with an opportunity to get a good return on investment.
“Nigeria is open for healthcare investment. We want platforms like WHX in Lagos to serve as a critical conduit for translating this investment ambition into tangible technology access for our hospitals and patients,” the Minister, who declared the event open on behalf of President Bola Tinubu, said.
He praised the organisers of the expo, which welcomed over 8,000 healthcare professionals and 500 exhibitors spanning 40 countries, for growing the programme into a vital catalyst for West African healthcare transformation.
Addressing the stark reality that between 85 per cent and 99 per cent of medical equipment and in vitro diagnostics in West Africa are currently imported, Mr Salako outlined aggressive federal interventions designed to dismantle supply chain vulnerabilities and skyrocket local manufacturing capabilities.
He also spotlighted key presidential directives, including the Presidential Initiative to Unlock Healthcare Value Chains (PVAC) and the Presidential Executive Order for the Pharmaceutical and Allied Sectors, both engineered to catalyse health security, drive economic growth, and generate employment through strategic private-sector collaborations and Public-Private Partnerships (PPPs).
“Our commitment to improving access to modern equipment and technologies in hospitals is backed by concrete action. The government has inaugurated the $1.2 billion Sector-Wide Approach (SWAP) initiative, a comprehensive overhaul addressing financing, workforce development, and infrastructure.
“Furthermore, for the 2025 fiscal year, the Federal Government committed N402 billion specifically for health sector infrastructure investment,” he stated, also highlighting an expansive health infrastructure upgrade program in partnership with the Nigeria Sovereign Investment Authority (NSIA).
According to him, this phased initiative is actively delivering oncology and nuclear medicine centres across six tertiary hospitals, alongside establishing 22 modern medical diagnostic centres, seven cardiac catheterisation laboratories, and expanded radiology and clinical pathology capabilities distributed across Nigeria’s six geopolitical zones.
Also speaking, the chief executive of EHA Clinics, Dr Ifunanya Ilodibe, stressed the urgent need to support and unify fragmented growth within the healthcare system, noting that WHX serves as the precise ecosystem platform required to bring together policymakers, clinicians, and investors to move actionable strategies forward.
Also, the President of the Healthcare Federation of Nigeria (HFN) and Country Director of PharmAccess, Njide Ndili, said, “HFN bridges the gaps in health financing, opening up critical connections to achieve true health sovereignty,” praising Africa CDC’s historical intervention, particularly during the Ebola crisis and urged participants to utilise the WHX exhibition floor to forge collaborations capable of scaling locally produced medical equipment.
The Lagos State Commissioner for Health, Mr Akin Abayomi, on his part, highlighted the enforcement of the National Health Insurance Authority (NHIA) Act in Lagos State as a landmark regulatory milestone. The Act mandates health insurance for all residents, structuring the financial environment to guarantee medical protection across various socioeconomic levels.
Delivering the keynote address, the Special Regional Representative of the Director General of the Africa CDC Western Regional Coordinating Centre, Prof. Aliko Ahmed, called on leaders in geopolitical positions to enact liberating trade policies aligned with the African Continental Free Trade Area (AfCFTA) to shape the continental agenda, emphasising that the Africa CDC will fiercely prioritise building trust in locally manufactured healthcare products.
WHX in Lagos 2026 runs for three days, featuring accredited forums, cutting-edge product showcases, and high-level networking tracks designed to translate billions in public and private investment into immediate technology access for hospitals and patients.
By Adedapo Adesanya
The coroner’s inquest into the death of 21-month-old Nkanu Adichie-Esege, son of renowned author Chimamanda Ngozi Adichie, suffered a major setback on Wednesday after Euracare Multi-Specialist Hospital informed the coroner’s court that it had obtained an order of the Lagos State High Court staying further proceedings in the probe.
The matter came before Coroner Magistrate Atinuke Adetunji at Court 9, Igbosere Magisterial District, Yaba, Lagos, and was scheduled for the commencement of witness’ testimony.
Counsel to Euracare Multi-Specialist Hospital, Professor Taiwo Osipitan (SAN), told the court that the hospital had initiated judicial review proceedings challenging, among other issues, the jurisdiction of the Coroner’s Court to conduct the inquest in the absence of the deceased’s body.
He disclosed that the High Court had granted leave for the judicial review application and ordered that the leave operate as a stay of proceedings pending the determination of the suit.
The senior advocate also informed the court that although the Lagos State Attorney-General’s Office denied seeing the originating processes from the High Court, proof of service was available.
Responding on behalf of the family, Mr Kemi Pinheiro (SAN) confirmed receipt of both the originating processes and the High Court order.
While acknowledging the obligation of all parties to comply with court orders, he informed the coroner that the family had already filed four witness statements on oath, including that of Dr Ivara Esege, as well as statements from independent medical experts from Nigeria and the United States, who are expected to testify at the inquest.
Mr Pinheiro urged the court not to adjourn the matter indefinitely, but to a definite date after the court vacation to enable parties to report on developments in the High Court proceedings.
He also highlighted the need for transparency and public confidence in the fact-finding process, saying, “He who is innocent does not fear an open inquest.”
Counsel representing Atlantis Paediatric Hospital supported the request for a definite adjournment rather than an indefinite postponement.
Following submissions by counsel, the Coroner adjourned the matter until October 8, 2026, for a report on the status of the High Court proceedings.
By Modupe Gbadeyanka
About $50 million has been promised by Gavi, the Vaccine Alliance, through its First Response Fund (FRF), to support the response to the ongoing Bundibugyo ebolavirus outbreak.
A statement from the organisation made available to Business Post on Monday said up to $40 million would be available to enable accelerated access to investigational doses and, eventually, approved vaccines, while a further $10 million would support outbreak response and protection of routine immunisation services in impacted countries.
“We need to act now to ensure that, once one or more vaccine candidates are ready, manufacturers are in a position to start producing doses at scale,” the chief executive of Gavi, Dr Sania Nishtar, was quoted as saying.
“Leveraging this allocation, Gavi will work closely with CEPI and partners to design the right incentives to achieve this goal, exploring all options, including potential Advance Purchase Commitments.
“This effort, alongside ensuring emergency funds are on hand to support outbreak response and protect routine immunisation services in the communities impacted, is exactly what our First Response Fund was designed for,” Dr Nishtar added.
The First Response Fund is the only globally approved mechanism that allows “at-risk” financing for scaled-up production of vaccines under development. This means Gavi is able to make vital early investments even when development outcomes are uncertain.
The $40 million in immediate surge financing that has been approved today will enable manufacturers of the leading candidates of a vaccine against the Bundibugyo virus to directly commit to high-capacity manufacturing.
This, in turn, will ensure that, as soon as clinical trials demonstrate positive outcomes, investigational vaccine doses could be deployed rapidly to support outbreak response.
Looking to the longer-term, Gavi will also provide incentives for manufacturers to adopt the fastest pathways towards WHO Emergency Use Listing (EUL) and/or WHO Prequalification (PQ), which are critical global approvals that will enable the rapid use of these vaccines in future emergencies.
In the coming weeks, Gavi will finalise the design of a financial mechanism that leverages the $40 million FRF allocation to achieve these vaccine access goals, in close partnership with the Coalition for Epidemic Preparedness Innovations (CEPI) as well as WHO, Africa Centres for Disease Control and Prevention (Africa CDC) and UNICEF.
The final design will take into account the characteristics of individual vaccine candidates and the needs of their manufacturers and may include mechanisms such as Advance Purchase Commitments. Work will also be undertaken to ensure successful candidates from African-based vaccine manufacturers can benefit from accelerated support through Gavi’s African Vaccine Manufacturing Accelerator (AVMA) initiative.
In addition to these investments, Gavi will also immediately release US$ 10 million to support countries and partners with outbreak response.
This funding will support implementation of national outbreak response plans, including targeted investments to protect routine immunisation, protect health care workers and ensure readiness for future vaccines. Gavi will work closely with countries, partners including Africa CDC, WHO, UNICEF, World Bank, and donors to ensure these investments complement other efforts.
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