Folarin Kehinde

In Nigeria, industrial action by medical practitioners remains a persistent challenge. For weeks, conflicting narratives, accusations, and counter accusations have stalled progress toward resolving the strike declared by the National Association of Resident Doctors. This deadlock is a serious setback for an already distressed healthcare system.

Indeed, this strike has placed the entire public health system in jeopardy, which Nigerians cannot afford.

The Joint Health Sector Union, which consists of key health unions, have joined the industrial action. This escalation demands urgent attention.

For three weeks and counting, patients and families have endured the excruciating physical and emotional trauma of being denied access to healthcare, even in critical cases, because there are no doctors. This is disgraceful.

The strike has paralysed 91 hospitals, including federal teaching hospitals, specialist institutions, and federal medical centres, disrupting medical services across the country. Nigeria should not be allowed to become another Gaza.

Therefore, the government must show sincerity and commitment in addressing the contentious issues, while resident doctors and other medical practitioners must be ethical in their approach.

The government has a responsibility to comprehensively address the doctors’ demands and get them back to work in the public interest.

Sound public health systems and individual well-being are intrinsically linked to both personal wealth and national economic prosperity, and must therefore be prioritised.

Basically, the NARD declared “a total, comprehensive, and indefinite strike” effective October 31 after the expiration of a 30-day ultimatum issued to the Federal Government and a five-day warning strike on September 12, which was suspended within 24 hours on the orders of the NEC of the association.

The doctors’ 19-point demand includes tackling the brain drain in the sector; urgent upgrade and maintenance of infrastructure and medical equipment, and welfare.

The brain drain syndrome worsens by the year. The NARD reported that Nigeria lost 18,949 doctors to the brain drain owing to poor welfare, inadequate equipment and insecurity between 2005 and 2024.

In 2024 alone, Nigeria lost 4,193 doctors to other countries, especially Saudi Arabia, the United Kingdom, the United States and Canada.

This has left health care at home in a shambles. The Nigerian Medical Association estimates that Nigeria has a doctor-to-patient ratio of between 1:3,474 and 1:10,000. This is far below the World Health Organisation’s recommendation of 1:600.

It results in burnout for medical practitioners. Some have dropped dead on duty.

In addition, experts estimate that over 60 per cent of Nigerian doctors practice abroad.

The PUNCH reports that health workers’ migration overseas surged by 200 per cent across all cadres between 2023 and 2024.

To escape the mess, the elite resort to medical tourism in India, Europe, the US and the Middle East. Yet, most Nigerians cannot even afford certain basic treatments.

According to the Nigerian Medical Association, Nigerians spent $2 billion annually on medical tourism. This is money badly spent.

In its defence, the Minister of State for Health and Social Services, Adekunle Salako, claimed that the government has addressed most of the 19-point demands of the NARD.

He said the two major demands: rescinding of the approval of the appointment of non-doctors to the consultant cadre and the withdrawal of a circular by the Office of the Salaries, Income and Wages Commission in respect of approval of salary increments negotiated by one segment of the health workers, have been done.

On the issues of unregulated work hours and prolonged call duties orchestrated by the shortage of manpower, Salako said, “…in 2024 alone, the Federal Minister of Health, using a special waiver mechanism that no other sector employs, we were able to engage 14,444 health workers across 64 federal tertiary health institutions. (About) 78 per cent of those workers are clinical staff. Out of those clinical staff, 908 are consultants.” This makes sense.

However, the NARD has refuted the government’s claims that most of its demands have been met.

The NARD said a review of the government’s claims by the Extra-Ordinary National Executive Council meeting had confirmed that, contrary to the ministry’s claims, none of its core claims had been met.

“What the ministry characterises as progress is, in fact, unfulfilled promises, non-commenced payments, and newly formed committees — a familiar cycle of delay and deception that prompted this strike in the first place,” it said.

“We wish to set the record straight for the benefit of the Nigerian public that, on payments and allowances, the ministry’s claim that payment for the 25 per cent/35 per cent CONMESS review and 2024 accoutrement allowances has commenced up to December 2024 is, at best, an anticipation of action, not action itself.”

NARD says it remains open to “results-oriented dialogue,” but insists: “The nationwide, total, indefinite, and comprehensive strike action, which commenced on November 1, 2025, continues. As resolved by our NEC, the strike will persist until our minimum demands, which constitute the barest minimum for a dignified and sustainable medical practice in Nigeria, are met.

“Our patience has been exhausted by years of conciliatory meetings that yield nothing but press releases filled with hollow victories.”

The grim state of the country’s health sector and the appalling state of the doctors are not matters for accusations and counter accusations, but issues for urgent and sincere action.

Patients suffer the most. The indigent ones cannot afford the steep costs at private hospitals and resort to spiritualism and quack treatments that mostly worsen their conditions.

The Ali Pate-led Federal Ministry of Health should heed the directive of President Bola Tinubu to “do everything possible and legitimate to ensure that doctors are brought back to their duty posts.”

The country’s healthcare delivery system is already near total collapse. While many primary healthcare centres lack the facilities to treat minor ailments, tertiary hospitals are short-staffed.

Besides, while Nigeria refuses to prioritise health, allocating a paltry percentage of the budget annually, contrary to the 15 per cent of the annual budgets agreed by African countries in Abuja in 2001.

The US spent 17.5 per cent of its GDP on health in 2019, 19.5 per cent in 2020, 18.3 per cent in 2021, and 17.6 per cent in 2023.

The UK spent 11.0 per cent of its GDP on health in 2023 and 11.1 per cent in 2024.

Source: Punch