Health

By Dahiru Kasimu Adamu

Every morning at Shantan Old Garage along Western Bypass, hundreds of young men armed with shovels and hoes descend into metre-deep pits, searching for buried treasure. But they are not hunting for gold or ancient artefacts, they are digging for scrap iron.

The abandoned garage, once a bustling hub for roadside mechanics, has become an unlikely source of livelihood for youth aged 15 to 40. As traditional labour opportunities have dwindled, these young scavengers have discovered that the ground beneath the old garage contains valuable iron scraps left behind when the site was operational.

“We thank Allah for this opportunity,” said Modi Sanusi, a scavenger in his late twenties. “Just this morning, scavenging materials worth over N125,000 were sold, all from this ground.”

The work is gruelling and dangerous, but profitable. Scavengers can earn between N20,000 and N40,000 daily, depending on their finds—a significant sum in an economy where formal employment remains scarce. Among those who have embraced this unconventional livelihood are former Tsangaya pupils who once begged for food.

Seventeen-year-old Kabiru explained how the earnings have transformed his life: “We earn income, buy food, give some to our parents, and save.”

The phenomenon is not confined to Shantan. Reports indicate that scrap metal collection has become one of Nigeria’s “millennium jobs,” with thousands of youth now reportedly earning substantial incomes from the trade.

But the work comes at a cost. Sharp objects buried in the soil cause frequent injuries, and landslides have resulted in fractures. Muhammad, another scavenger, recalled sustaining a leg fracture when earth collapsed on him. “After I recovered, I came back in the field as I can’t leave this work,” he said.

Health experts have raised alarm about additional risks. Buried iron from old vehicles could be contaminated with lead or other toxic chemicals. Open wounds from injuries risk infection, particularly given the lack of basic first aid facilities at the site.

Despite these hazards, the scavengers remain undeterred. Observers say the phenomenon highlights both the resilience of Nigerian youth and the urgent need for job creation and safety regulations. Advocates call for government intervention through new strategies and laws to regulate the business, as well as leadership within scavenging communities to organise safety campaigns.

For now, the digging continues at Shantan Old Garage. As unemployment persists and metal prices remain attractive, more youth are likely to join the ranks of those turning Sokoto’s buried past into their economic future—one shovelful at a time.

By Oladoja M.O

Nigeria’s new tax law arrives at a moment when questions of domestic resource mobilisation have moved decisively from the margins of fiscal discourse to its centre. The reform is ambitious in both scope and intent. It consolidates previously fragmented statutes, modernises tax administration, strengthens compliance mechanisms, and expands the state’s technical capacity to mobilise revenue in an increasingly constrained macroeconomic environment. 

Read on its own terms, the law represents a serious effort to stabilise public finance and reduce long-standing inefficiencies in the tax system. But tax laws, particularly of this magnitude, should not be mere instruments of collection, but rather reflections of what a state understands taxation to be for. 

When examined from the perspective of national health financing, Nigeria’s new tax law reveals not hostility to health, nor ignorance of its importance, but striking institutional restraint, a deliberate decision to keep taxation largely neutral to the direct financing of public health.

This neutrality is especially significant because it runs counter to the evolving global understanding of domestic resource mobilisation. In contemporary public finance, DRM is no longer conceived simply as the ability of a state to raise revenue, but as its capacity to do so in a manner that deliberately underwrites social protection, safeguards human capital, and reduces long-term economic vulnerability, where health occupies a central place. 

Ill-health is not a random misfortune but a predictable social risk, one that drives household impoverishment, reduces labour productivity, and places sustained pressure on public finances. For this reason, many countries have increasingly integrated health financing into their tax systems, whether through general taxation, earmarked levies, or hybrid arrangements that link tax administration directly to social insurance and prevention financing.

It is against this backdrop that Nigeria’s new tax law must be read. 

The law unquestionably strengthens the means of mobilisation. A unified tax administration framework, enhanced enforcement powers, clearer compliance obligations, and improved data coordination substantially upgrade the state’s fiscal machinery. In theory, this expanded administrative capacity could support innovative approaches to financing social sectors, including health. In practice, however, the law exercises marked caution. Health appears within the tax framework, but only at the margins, and only in forms that preserve the traditional separation between revenue mobilisation and social sector financing.

This pattern becomes evident when examining how health-related elements are treated across the law. Contributions to the national health insurance scheme are recognised as allowable deductions for personal income tax purposes. This recognition is not insignificant; it affirms health insurance contributions as socially legitimate expenditures deserving of fiscal relief. Yet the logic remains passive. The tax system responds only after individuals have already contributed. It does not actively mobilise resources for health, nor does it deploy its collection infrastructure to expand coverage, pool risk, or subsidise access. The fiscal relationship ends at recognition, not generation.

A similar logic governs the treatment of consumption taxes. Essential medicines, pharmaceuticals, and certain medical equipment continue to benefit from favourable VAT treatment. These provisions are defensible on equity grounds, particularly in a system where out-of-pocket spending remains high. But from a financing perspective, their effect is limited. They shield households from additional burden, yet they do not generate fiscal space for the health system. Again, health is insulated from taxation, not financed through it.

The clearest illustration of this restrained approach lies in the treatment of excise duties on tobacco, alcohol, and sugar-sweetened beverages. These taxes are frequently framed as “sin taxes,” ostensibly justified by their potential to alter harmful consumption patterns. In principle, excise taxation is meant to operate through a behavioural channel: higher prices reduce consumption, lower consumption reduces disease burden, and reduced disease burden lowers long-term health expenditure. In Nigeria’s case, however, this logic remains largely theoretical.

First, the excise rates themselves are modest. The levy on sugar-sweetened beverages, for instance, is widely recognised as too low to produce a meaningful price shock that would alter consumption behaviour. Similar concerns apply to alcohol and tobacco, where cultural entrenchment, affordability, and illicit trade further blunt the intended deterrent effect. 

Second, there is no publicly available evidence demonstrating that consumption of these products has declined since the introduction or adjustment of excise duties. On the contrary, available market indicators and anecdotal trends suggest that consumption has increased. Crucially, the state does not appear perturbed by this outcome. Higher consumption translates into higher excise revenue, and excise duties, in practice, function as reliable inflows to the general federal pool.

This reveals a deeper truth about how sin taxes are governed in Nigeria. Despite their rhetorical association with public health, excise duties are not treated as health instruments. They are treated as revenue lines. There is no systematic effort to measure behavioural change, no routine publication of consumption data linked to tax policy, and no formal evaluation of health impact. In policy terms, a behavioural instrument that is not measured is indistinguishable from a revenue instrument. 

The absence of evidence of reduced consumption is not merely a data gap; it indicates that behavioural change is not being actively pursued as an objective.

From a health financing perspective, this has serious implications. Excise taxes generate revenue, yet none of that revenue is structurally linked to health financing. No portion is dedicated to prevention programmes, health insurance subsidies, or system strengthening. The public bears the health consequences of continued consumption, rising non-communicable diseases, increasing treatment costs, and productivity losses, while the fiscal gains accrue centrally, unconnected to the sector that absorbs the burden. In effect, Nigeria taxes harm, tolerates its persistence, and finances neither its prevention nor its consequences through the tax system.

This outcome is unlikely to be accidental. The new tax law is too carefully constructed for its silences to be incidental. Rather, it reflects a broader fiscal philosophy that prioritises flexibility, central discretion, and revenue pooling over sector-specific commitments. Earmarking, even in its softer forms, constrains the treasury’s freedom to allocate resources across competing priorities. From a public health financing standpoint, this caution is costly. It leaves health structurally dependent on discretionary budgets, weak insurance enforcement, donor support, and household spending, even as the state’s revenue-collection capacity improves.

The result is a growing asymmetry. Nigeria now possesses an increasingly sophisticated tax apparatus, but lacks a corresponding approach to financing social risk. Revenue mobilisation is advancing, but allocation logic remains largely unchanged. Health remains acknowledged but peripheral, recognised, accommodated, and indirectly supported, yet excluded from the core architecture of taxation.

None of this implies that the new tax law should have transformed itself into a health financing statute. No! Tax laws cannot, and should not, bear the full weight of social policy. But in an era where domestic resource mobilisation is increasingly framed as a means of financing development rather than merely sustaining government, the continued treatment of health as fiscally incidental is striking. The administrative infrastructure now exists to do more than collect revenue efficiently. What is missing is the institutional decision to deploy that capacity deliberately to protect households from the economic consequences of ill-health.

The most important lesson of Nigeria’s new tax law for national health financing, therefore, lies not in what it includes, but in what it leaves unresolved. The law strengthens the state’s ability to mobilise resources, yet remains silent on whether that capacity should be harnessed to address one of the most predictable and economically damaging social risks. As Nigeria deepens its commitment to domestic resource mobilisation, the critical question will not simply be how much revenue can be raised, but how intentionally that revenue is aligned with protecting human capital. A tax system that improves efficiency without strengthening social purpose risks becoming technically impressive but socially thin.

Oladoja M.O writes from Abuja and can be reached at: mayokunmark@gmail.com.

By Uzair Adam

The Kano State Hospitals Management Board has ordered a comprehensive investigation into the death of a Kano-based housewife, Aishatu Umar, following allegations of medical negligence linked to a surgical procedure carried out at the Abubakar Imam Urology Centre.

The Daily Reality recalls that the incident first came to public attention through a Facebook post by a family member, who alleged that Aishatu died as a result of negligence after undergoing surgery at the specialist hospital.

Aishatu Umar, a mother of five, reportedly died around 1:00 a.m. on Tuesday. In the Facebook post, her brother-in-law, Abubakar Mohammed, said she had fallen ill several months earlier and underwent surgery at the Abubakar Imam Urology Centre in September.

According to him, Aishatu began experiencing persistent and severe abdominal pain shortly after the operation.

He alleged that she returned to the hospital several times to complain about her worsening condition but was repeatedly given pain-relief medication without a clear diagnosis.

Mohammed claimed that it was only two days before her death that medical tests and scans were eventually conducted. The results, he alleged, revealed that a pair of scissors had been left inside her body during the September surgery.

“The woman you see here is Aishatu Umar. She was my sister-in-law. She passed away around 1:00 a.m. She is survived by her husband and five children,” Mohammed wrote in the post.

He added that preparations were underway for a corrective surgery on Tuesday, but Aishatu died before the procedure could be carried out.

Describing the incident as “pure negligence,” he questioned how surgical instruments could be forgotten inside a patient and called on the authorities to investigate the matter.

The family has also appealed to the Kano State Government and relevant health regulatory bodies to probe the circumstances surrounding Aishatu’s death and ensure justice for the deceased.

Reacting to the development, the Public Relations Officer of the Kano State Hospitals Management Board, Samira Suleiman, said the Board’s Executive Secretary, Dr. Mansur Mudi Nagoda, has ordered an immediate and thorough investigation into the alleged incident.

In a statement issued on Tuesday, the Board expressed sympathy with the family and assured the public that the investigation would be transparent, impartial, and professional.

“The Management of the Kano State Hospitals Management Board, under the authority of the Executive Secretary, Dr. Mansur Mudi Nagoda, has taken note of the distressing report concerning the late Aishatu Umar. We extend our deepest condolences to her family and loved ones,” the statement added.

It added that appropriate action would be taken in line with established regulations if any negligence is established, stressing that patient safety remains a top priority and that the Board is committed to upholding high standards of healthcare delivery in Kano State.

By Sabiu Abdullahi

A Kano resident, Aishatu Umar, has reportedly died after what her family described as suspected medical negligence following a surgical procedure carried out at the Abubakar Imam Urology Center in Kano State.

Aishatu, who was married with five children, passed away around 1:00 a.m. on Tuesday, according to a Facebook post by a family member, Abubakar Mohammed.

In the post, Mohammed said Aishatu had fallen ill several months ago and underwent surgery at the specialist hospital in September.

He stated that after the operation, she began to experience persistent and severe abdominal pain.

According to the account, Aishatu reportedly returned to the hospital on several occasions to complain about her condition. Mohammed claimed that during these visits, she was given only pain-relief medication, while the cause of her suffering remained undiagnosed.

He further alleged that medical tests and scans were eventually conducted just two days before her death. The results, he said, revealed that a pair of scissors had been left inside her body during the September surgery.

“The woman you see here is Aishatu Umar. She was a sister in-law to me, She passed away yesterday around 1:00 AM. She is survived by her husband and five children,” Mohammed wrote.

He added: “Just two days ago, tests and scans were finally conducted, revealing that a pair of scissors had been left inside her body during the September operation.”

Mohammed said preparations were being made to carry out a corrective surgery on Tuesday, but Aishatu died before the procedure could take place.

He described the incident as “pure negligence” and called on relevant authorities to investigate the matter.

“Is this not pure negligence? Truly, every soul has its appointed time, but how can professional doctors forget scissors inside a patient?” he wrote.

The family has called on the Kano State Government and health regulatory bodies to investigate the circumstances surrounding the death and take appropriate action, while also demanding justice for the deceased.

As of the time of filing this report, the management of the Abubakar Imam Urology Center and the Kano State Ministry of Health had not issued an official statement on the allegation.

By Sabiu Abdullahi

The Joint Health Sector Unions (JOHESU) has instructed its members across federal health institutions to commence an indefinite withdrawal of services following a new directive from the Federal Ministry of Health that enforces a “No Work, No Pay” policy.

Reports on Saturday indicated that the directive prompted the union’s latest decision, which affects workers in federal hospitals and other government-owned medical facilities nationwide.

In a statement circulated to members, a JOHESU leader, Comrade Abubakar Sani Aminu, said the policy was introduced without prior consultation with the union. He described the action as a unilateral step that violates workers’ rights and undermines the principles of collective bargaining.

According to the statement, Chief Medical Directors and Medical Directors of federal health institutions have received instructions to enforce the policy. JOHESU said the move represents an attempt to weaken the union while industrial action continues.

“This decision was made without prior consultation or dialogue with the union, showing a disregard for the collective voice of health workers,” Aminu said.

He cautioned members to remain calm and firm, noting that the policy was designed to weaken the unity of the union. He described the directive as “the final weapon” that the government intends to use to undermine JOHESU’s resolve.

Following the development, the union directed all members to vacate their duty posts with immediate effect. It ruled out the provision of skeleton services or any form of compromise.

“There should be no skeleton services, no attempt to help out, or compromise in any way,” the statement read. “Our collective action is the key to securing our rights.

”The leadership of the union said unity among members remains critical. It warned that allowing the policy to stand would create what it described as a dangerous precedent for future labour disputes in the health sector.

“This is the time for us to stand together, strong and united, until our demands are met,” Aminu said. He added that solidarity among members would shape the outcome of the ongoing dispute.

JOHESU restated its commitment to a campaign for fair treatment of health workers and urged members across the country to remain resolute while discussions with the federal government continue.

As of the time of filing this report, the Federal Ministry of Health had not released an official response to the union’s directive.

The possible effect of the strike on public health services remains uncertain. Past JOHESU actions have led to major disruptions in federal hospitals across the country.

By Mujahid Nasir Hussain

On 14 November 2025, the world marked World Diabetes Day, and a familiar message rang out across hospitals, communities, and workplaces: Africa must “know more and do more” to confront the rising tide of chronic diseases. It is a message that feels especially urgent here in Nigeria, and in cities like Kano, where the realities of modern life have dramatically reshaped how people live, move, work, and stay healthy. For many families, this year’s theme was not merely a global campaign. It reflected what they witness daily—more people living with diabetes, hypertension, kidney disease, stroke, obesity, and joint disorders than ever before.

The World Health Organisation has warned that Africa will soon face a dramatic shift in its health landscape. By 2030, deaths from non-communicable diseases are projected to surpass those from infectious diseases. This is a striking transformation for a continent historically burdened by malaria, tuberculosis, and HIV. Nigeria, Africa’s most populous nation, is at the centre of this shift, with cities such as Kano experiencing a rapid rise in chronic and progressive conditions. The reasons are both complex and straightforward: changing diets, prolonged sitting, stressful work environments, reduced physical activity, environmental pollution, and limited access to preventive healthcare.

Yet amid these alarming trends, one therapeutic tool stands out: exercise. For many years, exercise has been treated merely as a wellness activity or an optional lifestyle choice. But in reality, it is one of the most powerful and scientifically proven therapies for slowing the progression of chronic diseases. When the body moves consistently, it undergoes profound biological changes: insulin works better, blood vessels become healthier, the heart becomes stronger, inflammation decreases, and harmful fat around organs begins to shrink. These benefits are not cosmetic; they are therapeutic.

However, there is a critical truth that the public often misunderstands: exercise is powerful medicine, and like any medicine, it must be prescribed correctly. It is not something people with chronic diseases should “start doing” without guidance. The mode, frequency, intensity, and duration of exercise must be tailored to the individual’s medical condition, age, fitness level, and risk factors. What is safe and effective for one person may be dangerous for another. This is why professional guidance is so essential. For instance, a person living with uncontrolled hypertension should not begin intense aerobic workouts without clearance from a doctor, because sudden spikes in blood pressure could lead to complications.

Someone with diabetic neuropathy may not feel injuries in their feet, making certain activities unsafe without supervision. Individuals with chronic kidney disease need specific exercise prescriptions that do not strain the cardiovascular system or accelerate fatigue. People recovering from stroke require structured rehabilitation overseen by physiotherapists to prevent falls or further damage. Even patients with obesity, osteoarthritis, or long-standing back pain need tailored, gradual programs to avoid joint overload. This is why exercise should not be approached casually, especially in a context like Africa, where many chronic conditions are undiagnosed or poorly monitored. Before starting an exercise program, individuals living with progressive diseases should consult qualified professionals. Doctors provide medical clearance and identify risks. Physiotherapists design safe movements that protect joints and nerves. Exercise physiologists prescribe evidence-based routines that align with the patient’s goals and limitations. Their role is to ensure that exercise becomes therapy, not a trigger for complications.

In Kano State, this issue is especially relevant. The city has undergone a rapid transition from physically demanding lifestyles to sedentary routines. Many residents now spend long hours sitting in shops, riding motorcycles, or working in offices. Combined with high consumption of energy-dense foods and limited awareness of disease symptoms, progressive illnesses have become deeply entrenched. Yet awareness of safe, guided exercise therapy remains low. Many people begin rigorous routines abruptly, driven by social pressure or misinformation, only to injure themselves or exacerbate their conditions. Others avoid exercise entirely because they fear doing the wrong thing. Both extremes are harmful.

To confront this, a cultural shift is needed, one that recognises exercise as a vital part of medical care. Hospitals and clinics across Nigeria must integrate exercise counselling into routine visits, especially for patients with diabetes, hypertension, kidney issues, and obesity. Something as simple as a doctor explaining which movements are safe, or a physiotherapist demonstrating gentle routines, could prevent years of complications. Exercise physiologists, though still few in number, should be incorporated into more healthcare teams to design personalised programs grounded in scientific evidence.

At the community level, awareness must grow that exercise therapy is not a one-size-fits-all approach. It is a carefully structured health intervention. Encouraging early-morning walking groups, promoting workplace movement breaks, and organising community fitness sessions are valuable, but they must be paired with safety education. Leaders—traditional, religious, and educational—can play a vital role by emphasising the importance of seeking professional guidance before starting any intense routine, especially for those already living with chronic diseases.

It is also worth acknowledging the emotional dimension. People battling progressive diseases often feel overwhelmed, frightened, or uncertain. Exercise offers not just physical healing but a sense of agency. It improves mood, relieves anxiety, supports sleep, and helps people feel that they are actively shaping their health. This psychological benefit is powerful, especially in societies where chronic diseases still carry stigma. But again, confidence grows stronger when people know they are exercising safely and correctly under the guidance of trained professionals.

Nigeria’s future health outcomes depend on coordinated action. Families must embrace a culture of safe movement. Workplaces must reduce prolonged sitting and encourage healthy routines. Schools must restore physical activity as a normal part of the day, not an afterthought. Healthcare institutions must treat exercise as a formal therapy, not a casual suggestion. And individuals must understand that professional guidance is the foundation of safe and effective exercise therapy. The WHO’s projections are indeed alarming, but they are not destiny. Africa still has the opportunity to change its trajectory. But to do so, we must shift how we view health, how we integrate movement into daily life, and how we approach treatment of chronic diseases. Exercise will play a central role in this transformation, but only if it is approached with the same seriousness and medical supervision as any other form of therapy.

In the markets of Kano, the offices of Abuja, the streets of Lagos, and the rural communities of northern and southern Nigeria, the message must be clear: movement heals, but only when guided, intentional, and safe. The global call to “know more and do more” continues beyond 14 November. This is a reminder that Africans must not only embrace exercise as therapy but also do so with professional guidance to protect the body and preserve long-term health. Our path forward lies not just in treating disease, but in transforming lifestyles with knowledge, with care, and with the understanding that the right kind of movement, at the right intensity, prescribed by the right professional, can change the story of health for a generation.

Mujahid Nasir Hussain is an exploratory researcher in biomedicine, deeply passionate about public health, chronic disease prevention, and evidence-based community health interventions.

By Uzair Adam

Journalists have been urged to treat emergency reporting as a life-saving public service, given the powerful role of the media in shaping public understanding and behaviour during health crises.

The call was made at a two-day Emergency Risk Communication workshop for journalists organised by the Kano State Centre for Disease Control (KNCDC) with support from the FCDO–Lafiya Programme, aimed at strengthening ethical and responsible health reporting during public health emergencies.

Delivering a session on Emergency Reporting and Ethical Guidelines for Public Safety during Health Crises, media expert and editor with The Daily Reality Newspaper, Malam Aisar Salihu Musa, said information often spreads faster than disease during outbreaks, stressing that the way journalists report emergencies can either reduce harm or fuel fear and panic.

“Where trust is strong, public health succeeds. Where trust is weak, fear becomes the real outbreak,” he said, noting that trust remains the most valuable currency during health emergencies.

He explained that journalists serve as information gatekeepers, with a responsibility to verify reports that could affect public health outcomes and to collaborate closely with health authorities in sharing credible information.

According to him, emergency reporting presents ethical challenges, including balancing urgency with accuracy, avoiding sensational headlines, and protecting the dignity and privacy of patients and their families.

Musa urged journalists to communicate risk clearly and proportionately, translate medical terms into simple language, and always include practical steps the public can take to protect themselves.

“Words can either save lives or cause harm,” he said, adding that responsible, transparent and empathetic journalism strengthens public trust and supports effective public health response.

He concluded by calling on journalists to see themselves as partners in public health, committed to countering misinformation, promoting preventive behaviours and reporting emergencies in ways that protect lives and strengthen society.

By Uzair Adam

The Director General of the Kano State Centre for Disease Control (KNCDC), Prof. Muhammad Adamu Abbas, has urged journalists to prioritise responsible and ethical reporting during public health emergencies to prevent the spread of misinformation and public panic.

Prof. Abbas made the call during a two-day Emergency Risk Communication workshop organised to strengthen media engagement and information management during disease outbreaks and other health emergencies.

He stated that the workshop followed the identification of critical gaps in Risk Communication and Community Engagement during recent Joint External Evaluation and multi-hazard preparedness assessments conducted in the state.

“This workshop was designed to address the gaps identified during the Joint External Evaluation and multi-hazard preparedness assessment,” Prof. Abbas said, adding that the media remains a key partner in managing public health emergencies.

The Daily Reality reports that the workshop, with support from the FCDO–Lafiya Programme, revolved around improving media engagement during outbreaks, ethical emergency reporting, managing misinformation, strengthening collaboration between journalists and health authorities, and developing a media-focused Emergency Risk Communication plan for Kano State.

The DG further stated that journalists have a responsibility to prevent the spread of false information, correct myths and harmful practices, and promote evidence-based decision-making that strengthens public trust in official health guidance.

He added that responsible media engagement should also encourage preventive behaviours such as hand hygiene, vaccination, safe food practices and environmental sanitation, while reinforcing official public health advisories.

The workshop was attended by journalists from print, broadcast and online media organisations, alongside public health officials and communication experts.

By Oladoja M.O

The Ministry of Health convened a timely, critical, and necessary gathering earlier last month: the National Health Financing Dialogue. A gathering with so much relevance and significance to address the almost comatose state of the Nigerian health sector. Reflecting on all said during the “dialogue,” there are just many thoughts creeping in here and there, which I feel compelled to just put up here for public consumption, and hopefully get across to the rightful authority to pick one or two important things. 

The dialogue, as noted earlier, was undeniably timely. I was not disappointed at all at various thematic areas buttressed on, ranging from health financing, health out-of-pocket spending (OOP) reduction, call for increment of the Basic Health Care Provision Fund (BHCPF), accountability and budgeting, over reliance on external health funding, insufficient resources as needed in the health sector, the need for proper, timely data to guide government decisions, the role of the media, and civil society organization in health sector, and holding government accountable, inclusivity of citizens in the budgeting process, budget execution, status of LG autonomy, the gap between research and policy making, establishment of proper framework for mental health in Nigeria, amongst many other things the dialogue rallied around. Reiteratively, all of these are core and vital to ensuring a positive paradigm for the national health sector state and to delivering on the interests of the citizen at large. Indeed, it was a worthwhile and insightful meeting. 

Though we still have quite a long way to go, I cannot help but acknowledge the works of the government of today on how far we’ve come in policies, increased allocation, investment in facilities, equipment, and a healthy workforce as regards health, captured in my work “Tinubu’s Healthcare Reforms: A Turning Point or Déjà Vu?”. During the course of the dialogue, a lot of observations kept creeping in, questions, suggestions, which there was not enough time to even express.

On observation

(1) We are unprepared to solve the country’s health problems, especially the issue of LG autonomy. The government focuses on superficial solutions instead of addressing root causes. LG autonomy is treated lightly compared to its importance. Primary care, which, if improved quickly, could significantly boost our health status. Unfortunately, the government is unable to do so. When I talk about autonomy, I mean actual, constitutionally granted autonomy, not superficial gestures like the Supreme Court’s jamboree. My writings, “LG: The Employed Man with no Office” and “Federalism and the Paradigm of Healthcare Accessibility,” elaborate on my views on this. The primary health issue affects p

(2) Make us talk truth, behind the blinking good intentions, health-related matters are often used for political publicity rather than long-term structural impact. Hence, many government interventions in healthcare are politically motivated rather than development-driven. 

(3) Still on the LG thing, I am more than disappointed at the way and manner in which the ALGON representatives at the dialogue spoke. What do you mean that you, as a stakeholder, come to such a stage to complain like every other person?? Basically, no form of cognitively presented way forward or suggestion, just another “we are being victimised” rhetoric. So Shameful! I was expecting them to flare up, demand something meaningful, but chai! My expectations were shattered. I thought they would speak about actual autonomy, driven by the constitution, not some half-baked, almost non-enforceable liberation.

In fact, the LG people present were just disappointed. We are talking about how to mobilise money, generate revenue for development, generate more liquidity to fund health, fund infrastructure, and none of them could make a meaningful comment on how funds can be generated rather than “if the autonomy sets in, we will ensure that all the allocation from the FG will be fully maximised.” As cool as that sounds, it was just another “we cannot do anything aside from what the FG says” kinda statement, and it only made me feel like this autonomy thing sef fit be another set-up… God abeg…. 

(4) On the role of media, it is crucial to even lean towards the perspective that the media is a culprit for where we are. Unfortunately, many media outlets and media handles are so fixated on just saying something, rather than saying something correct, and something from a knowledgeable stance, which to me, is even more dangerous than no information at all. Notably, the media are failing to pass information effectively. Especially the way they handle headlines. It is unfortunate, but it is the reality of our Nigerian populace that we have less of a reading habit. Hence, it is easy just to pick a headline, usually different from the content of the post, and run with it. Which is causing more harm to available information in the media space? Careless or sensational headlines have the potential to mislead the public, especially regarding sensitive policies such as those related to health. The issue of meaningless government secrecy is another thing I observed… and much more the issue of partisanship in politics by various media platforms and handling is another very obvious issue, causing every bit of information, especially unfinished policies or updates that are still in the pipeline, to be twisted for “political goals.” 

(5) In research, I observed that independent researchers and young passionate individuals in public health are often ignored, not encouraged, nor recognised, despite the need for data provision to help the government in setting priorities on health, and assisting in policy-making. 

(6) There’s just little or no innovative lawmaking pursued to fix systemic problems, especially wasteful constituency projects.

(7) Also, there seems to be too much focus on “there’s limited of…” What happened to the effective and efficient usage of the ones available?? Both in resources and in data.

And upon all the gbogbo atotonu of the dialogue, I was able to curate some suggestions which might be found useful;

(1) One of the major highlighted themes of the dialogue is the need for health insurance. It cannot be overemphasised that the importance of awareness still needs to be emphasised, especially to get the informal sector on board, because even among the small number of health insurance adopters, the major participants are those in the formal sector, with government employment. This awareness is not just something that will be around; “there is health insurance, and it is good for you.” But down to explaining various packages and what they cover, which can help guide expectations, correct misconceptions, and promote positive word-of-mouth about health insurance.

To meet up the ambiguous target of 40 million by 2030 and get more people from the informal sector onboard, I think a referral model (like those used in Ponzi schemes or digital marketing) could be adopted, making Civil servants primarily to act as “agents of change” or in this case, referral ambassadors, with promise of small tokens as reward for each successful referral. Because these civil servants are friends of people in communities, and even in places where government jingles and banners cannot reach, they help propagate.  No matter how we put it, the mouth-to-mouth campaign remains a powerful promotional strategy.

Another strategy is to tie health insurance enrolment to certain civic entry points, such as marriage registration. It can be mandated as part of the requirement to be submitted to the registry, where intending couples must show evidence of insurance. Procedural inefficiencies and bottlenecks should be removed to improve efficiency and ease the process, because I believe they are part of what discourages enrollees. Because even some who are already on health insurance coverage sometimes, because of long processes, delays, and stress, abandon the health insurance thing and pay out-of-pocket to get “sharp sharp” attention to their need. These negative experiences contribute to negative user feedback, and it spreads faster to non-users, worsening perceptions of health insurance enrollment.

(2) Though it may feel morally vexing, I suggest that health subsidies be tied to individual health behaviours. Those with risky lifestyles (alcohol, smoking) could face different treatment costs compared to people with unavoidable illnesses or accidents. This could encourage preventive lifestyles and behavioural change.

(3) On constituency projects, motorcycles, tricycles, food items… even outreaches) seems wasteful. I would suggest that a ban be placed, or at least regulations be given to what exactly these funds can be used to do… but then, who are those to impose that ban or restrictions, other than the actual people guilty of the bad behaviour? By direct analysis, these funds can be used to build facilities instead… whether school, or even hospitals, in this regard, left to the management of an independent body to be used efficiently and be used productively to generate money, money that can even be enough to run the operations and cover costs on its own, at least, and since the focus is to be able to generate liquidity to operationalize the facilities, the cost would be meager. They should not be free but rather run like a private entity to promote productivity. The billions lavishly spent on those meaningless things, if used in this manner, will result in more than 5–10 facilities at the senatorial district level or at whatever level of representation. Imagine if this number of facilities joined what we have??

(4) On the failure of some states in meeting their counterpart funding for BHCPF, they should not receive interventions from the FG. FG should publicly announce those states, carry the citizens along, and allow them to hold such state(s) accountable. There’s not enough funding. Therefore, the one we have must be spent in a way that is strictly tied to value and commitment.

(5) It is my suggestion that stronger media regulation be deployed to curb the spread of harmful and incorrect information (such as more dangerous than no information). And there should be a regulation/restriction on every journalist’s participation in politics. The place of media is quite sensitive, and they must remain sterile and neutral. Involvement in politics should be punishable by a ban on practising. This will give credibility to the profession and what their position is in the process of building a better state of the nation.

(6) On mobilisation of funds for health, I would suggest that the FG create something like a Health Bond, similar to commercial papers, to mobilise funds for health.

(7) Research should be given all the support it may ask for. A nation without accurate data is one with a lack of radar for progress… and I think one of the ways the government can support young, enthusiastic researchers (especially to gather young brains who are ready to help the government generate actual data for purpose of health policy and priorities) is to create access to platforms to show their works, something like a journal. We all know how much publications mean to researchers, and for young fellas like that, it can boost morale, knowing that their work is not wasted and is seen, whether it is to publish for free or at a very subsidised cost.

Lastly, I have been, and I remain, an advocate for the proper integration of the traditional health care system into the general healthcare system in Nigeria, especially at the grassroots level (Primary Health Care). My advocacy and thoughts are captured in some of my writings on Blueprint and HealthDigest. Health is people; people are culture. Nothing screams culture more than the traditional health care system. We cannot only tech-chase ourselves into a proper healthcare system in Nigeria.

Yes, technology is excellent, and AI is great, but the actual health burden we face requires that we not focus solely on these technologies. To me, I ask: why are we running? There’s a system that has been in place all this time; it should not be ignored. Many big economies have this included. The place of this traditional health system is beyond just provision of care (because, yes, a lot needs to be moderated). Still, these people can be brought in as agents, and their already established, patronised platforms can be used to promote government activities. Yes, they can assist in care provision. In fact, they have to. Knowledge of healing from generation to generation should not be neglected or allowed to die out.

Oladoja M.O writes from Abuja and can be reached at: mayokunmark@gmail.com.

By Isah Kamisu Madachi

On Thursday, 4th December 2025, my cousin Tajuddeen bade us farewell on his way to Lafia, Nasarawa State. They left early in the morning in a Hummer bus. Around 10 a.m., they had a terrible accident in a town near Bauchi metropolis. All the passengers in the vehicle were badly injured. Tajuddeen, along with the bus driver and two others, instantly slipped into coma.

Other passengers were either with more than one fracture or several wounds. On the evening of 6 December, the driver’s suffering came to an end as he passed away. The following day, another one of the passengers in the coma also died. On 8 December, the third victim in coma breathed his last, leaving my cousin still in the ICU section of the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi.

The cause of the accident was tyre failure. While they were on the road hoping to reach Jos in the afternoon, their back tyre burst and the bus somersaulted several times. The primary cause of the tyre failure was actually overload. Coincidentally, as I was on a phone call with a friend, he narrated how another terrible accident occurred close to my hometown as a result of tyre issue which instantly claimed two lives and left others badly injured.

I was really shocked and worried because not long ago, on a trip to Lagos, our own bus was carrying two commercial vehicles in addition to overloaded luggage of passengers and waybills. Even before the vehicles were brought, one had to ask whether humans would still get a seat after such loads were mounted. Lo and behold, the vehicles were arranged in a way that you couldn’t even see them inside the boot.

Last month, on our way back home from Kano, we witnessed another accident around Shuwarin town in Jigawa State. It was a jam-packed hummer bus obviously heading to either Damaturu or Maiduguri. They also had a tyre failure which resulted in several deaths. By the time we arrived at the accident scene, out of more than 20 passengers including the driver, only two people were still alive. The rest appeared lifeless.

If I were to narrate all the road accidents I have witnessed, most of them caused by tyre failure, I would have to write a book of a hundred pages. Road accidents are too many across Nigeria. Less than one week ago, I saw a picture on social media that stirred wide reactions. A commercial bus was overloaded to the extent that if one wanted to go out at a transit point, they had to pass through the boot as the doorway was blocked by bags. Even in the case of an emergency, no one could use the door because luggage completely covered the entrance. Many people commented that this is common in Nigerian motor parks.

When we talk about things that claim the lives of Nigerians, I believe road accidents is of course one of the biggest culprits, even more than insecurity in some cases. Anyone who travels widely by road knows this fact. And most of these accidents are avoidable if only we take transport safety seriously.

To bring to an end or at least reduce the intensity of the problem, we need a comprehensive transport policy that tackles overload and the abuse of luggage space. Parks should be mandated to use dedicated cargo buses. If a passenger’s luggage is above 10kg, it should automatically be transferred to a cargo vehicle, not stuffed into a bus carrying humans. For waybills, there should be separate buses whose only function is to transport goods from one state to another; especially the popular routes between Northern and Southern Nigeria or even within the North along routes like Kano-Borno, Taraba-Kaduna, Abuja-Adamawa and others.

Another important solution is the deployment of safety personnel to every major park. Their only job should be to inspect buses and car tyres to ensure they are in good condition before departure. Once there is no compliance, the driver must not be allowed to go. Of course in Nigeria some people may try to offer bribes to bypass checkpoints. To address that, these safety officers should not be local staff. They should report directly to an independent transport safety unit with strict oversight, rotating officers frequently to reduce compromise.

Still, digital systems can be introduced. Each bus should be scanned and cleared through an electronic checklist linked to a central database. If a bus fails safety checks, it should not receive the clearance code required to leave the park. With this kind of structure, even bribery becomes difficult to offer because safety approval will depend on digital authentication, not an individual officer’s discretion.

Nigeria needs to take road safety as seriously as other deadliest national issues. The number of lives cut short on our roads is heartbreaking. Families are losing loved ones every day due to accidents that could be prevented if we enforce discipline, regulate overload, inspect tyres, and treat transport safety as a matter of policy, not luck. 

Isah Kamisu Madachi is a policy analyst and development practitioner. He wrote from Abuja, and can be reached via: isahkamisumadachi@gmail.com