When COVID-19 hit Nigeria in 2020, Bose Adeosun, a 30-year-old wheelchair user who resides in Esuyare, Modakeke-Ife in Osun State, was left with a sense of uncertainty. Her life, like many others, was at a standstill.
Adeosun depended heavily on friends as aides to help her navigate her environment with her wheelchair. Unfortunately, moving around became extremely difficult. Accessing the clinic for routine check-ups became impossible as clinics were overcrowded and transportation was scarce.
Ultimately, a lockdown was declared. Daily sustenance became a difficulty for Adeosun as her petty grinding business stopped receiving patronage. Worse still, she did not benefit from the government’s distribution of palliatives to residents of the state.
The COVID-19 outbreak in 2020 exposed significant gaps in Nigeria’s health system and underscored the country’s lack of readiness for a large-scale epidemic. When the first case was reported in February 2020, the government was caught off guard, struggling to respond to the rapidly escalating crisis. This led to a lot of mis- and dis-information related to the pandemic, causing additional health crises.
It was glaring that years of underinvestment in health infrastructure, insufficient epidemic preparedness funding, and weak public health policies left the country ill-equipped to handle the challenges posed by the pandemic.
Interestingly, since the COVID-19 outbreak in 2020, Nigeria has made some progress in health emergency preparedness. The government expanded the Public Health Emergency Operations Centers (PHEOCs) to all 36 states and the Federal Capital Territory and enhanced the country’s diagnostic and surveillance capacities for infectious diseases. Training programmes for health workers, improved data systems, and local production of medical supplies have been significant steps forward.
Most significantly, the members of the 9th Assembly, working with partners such as the Legislative Initiative for Sustainable Development (LISDEL), developed five different legislations proposed to address the inadequacies in the existing legal and institutional frameworks to address large-scale epidemics and pandemics in Nigeria.
The bills namely: the Nigeria Centre for Disease Control (NCDC) Act (Amendment) Bill, which includes additional functions for NDDC, an operational structure for emergency operation centers and an emergency preparedness fund; the Public Health Emergency Bill, which will create an effective national framework for the control of outbreaks of infectious diseases and other events endangering public health and requiring public health emergency measures; and the Quarantine Act Repeal and Reenactment Bill (2022); which makes provisions relating to quarantine and make regulations for preventing the introduction into and spread in Nigeria of dangerous infectious diseases.
The other bills are: the National Health Act 2014 Amendment Bill, which makes provision for the amendment of the Basic Health Care Provision Fund (BHCPF) as it relates to the proportion allocated to health emergencies, among others; and the Animal Diseases Control Act 2020, a law that deals with the control of zoonotic diseases and their management, particularly their interrelationship with humans.
Of all the five bills, only the Animal Diseases Control Act was signed into law during the last administration, the Public Health Emergency Bill was passed by the 9th Assembly but was never signed into law before the expiration of the last administration, while others were at various legislation stages in the National Assembly when the 9th Assembly wound down.
Considering the importance of these legal and institutional frameworks for health security, It is therefore pertinent that these bills are quickly reconsidered, passed by the current (10th) Assembly and signed into law, to build Nigeria’s preparedness and resilience in cases of health emergencies.
Emphasising the urgent need for legal reforms to address the gaps in the country’s health security infrastructure, Ibrahim Lamido, Chairman of the Senate Committee on Primary Health Care and Disease Control, during a dialogue on strengthening Nigeria’s emergency preparedness and response through legislative reforms organised by the National Assembly with support from LISDEL’s Global Health Advocacy Incubator (GHAI) Prevent Epidemics (PE) Project, highlighted the importance of decisive action to improve public health laws and policies.
Lamido who was represented by his deputy, Senator Dr Tony Nwoye, while addressing other lawmakers in attendance, proposed that “we conduct a comprehensive review of our public health laws and policies, engage stakeholders in developing evidence-based legislative reforms, allocate sufficient resources and funding for public health initiatives, support research and innovation in healthcare, and ensure effective implementation and monitoring of reforms.”
Such reforms are not only a matter of good governance but are also critical for national health security. Lamido further pointed out the importance of the Public Health Emergency Bill (2023), which aims to create a structured and responsive framework for health emergencies.
Lamido further implored stakeholders to ensure that the bill is enacted and ready to be implemented when the need arises, saying, “The importance of this bill to public health cannot be overemphasised. I implore us as stakeholders to ensure that it sees the light of the day.”
Supporting Lamido’s views, Dr. Ibrahim Oloriegbe, Chairman of the Senate Committee on Health in the 9th National Assembly, reinforced the need for a comprehensive health security law.
He said, “Health security is a critical part of the health system, and getting it right is essential, not only for universal health coverage but for national security and economic viability.
“Health security legal reforms are necessary for an effective, efficient, and functional health security system and intervention. A comprehensive health security law is essential for effective response to epidemics, pandemics, and emergency preparedness.”
Dr Jide Idris, Director General of the Nigeria Centre for Disease Control and Prevention (NCDC), stressed the importance of legislative action to support and strengthen the country’s disease control infrastructure.
He said, “National and legislative networks have a crucial role to play in strengthening Epidemic Preparedness and Response through strategic legal reforms, resources appropriation for EPR, redressing citizen’s engagement and constituent engagement on building a resilient health system; increase budgetary allocation to the NCDC and EPR budgets for states.”
He elaborated on the need for legal and policy frameworks and added that “enacting the Public Health Emergency Bill and supporting subnational legislative networks to enact legal reforms to strengthen EPR; addressing other determinants of health through appropriate bills can be the best way to prevent epidemics; and collaboration across all sectors and proactive measures are critical to ensuring an effective EPR system in Nigeria.”
To drive home his points, Dr Idris said “When emergencies arise, being ready allows you to respond quickly. That’s why legislation is critical; it can provide additional resources. Right now, we’re discussing the need for an emergency health bill because, without it, we lack the necessary framework.
“Infrastructure, human resources, data management, surveillance, detection, and laboratory capabilities allow for a faster emergency response once in place. But without funding, you can’t carry out your activities or recruit the necessary facilities. That’s why legislative reforms are crucial,” he said
In another development, during a citizen-led Policy Dialogue to Strengthening Health Security in Nigeria organized by a foremost civil society coalition – the Health Sector Reform Coalition (HSRC) in partnership with LISDEL, Prof. Muhammed Ali Pate, the Coordinating Minister for Health and Social Welfare in his keynote address said “the government recognises the need for health laws that will reflect current realities; from managing infectious diseases to addressing mental health, non-communicable diseases, and health inequities.”
The Coordinating Minister, who was represented at the dialogue by Dr Nneka Orji, the Deputy Director in the Department of Planning, Research and Statistics, said, “without a strong legal framework, we lack the tools to protect our communities effectively, especially during health crises, which leaves our communities vulnerable.”
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Approving the pending bills is vital as Nigeria’s capacity to effectively combat epidemics depends not only on national legislation but also on the legislative frameworks at the state and local levels. Ensuring that all tiers of government are aligned in their commitment to health security will enhance the nation’s overall preparedness.
Without a legally binding framework, responses to health emergencies can be fragmented, underfunded, and reactive rather than proactive. The establishment of comprehensive health security laws would enable Nigeria to address gaps in its preparedness systems, as well as surveillance and response capacities.
As Damilola Ademuyiwa, Programme Director at the Legislative Initiative for Sustainable Development (LISDEL), said, “Laws and policies form the backbone of any effective epidemic preparedness system; they provide the framework for mobilising resources, coordinating multi-sectoral responses, and ensuring accountability at all levels.
“Without a robust legal and policy structure, we risk reactive, disjointed efforts during health emergencies. Proactive legislative action can safeguard public health, protect the vulnerable, and strengthen our capacity to mitigate future outbreaks.”
The role of policy and legislation in epidemic preparedness in Nigeria is undeniable. Legislative actions, such as the passage of the pending bills, will lay the foundation for long-term investments in public health infrastructure.
By enacting and funding these critical policies, Nigeria can ensure its readiness for future health emergencies, safeguard the well-being of its citizens, and protect itself from the devastating impacts of epidemics.
The Nigerian government must prioritise health security legislation as a matter of urgency, ensuring that future generations are better prepared for the health challenges ahead. The National Assembly hence, must immediately reconsider and pass the pending health security bills, while the Presidency must sign them into law as soon as the National Assembly transmits them.