For the 50th consecutive day, public hospitals across Nigeria stand paralyzed, their corridors silent and wards emptied by a total and indefinite strike.
The ongoing industrial action by the Joint Health Sector Unions (JOHESU) and the earlier strike by the Nigerian Association of Resident Doctors (NARD) have brought an already fragile healthcare system to its knees, exposing a deep-seated crisis of governance, funding, and vision.
This breakdown is occurring against a stark global backdrop where the blueprint for resilient, equitable health systems is not only known but proven. It is a crisis of implementation, not imagination.
The health system is suffering.
The strike, rooted in the government’s failure to implement a long-promised adjusted salary structure (CONHESS) for health workers, has had catastrophic human consequences. Renowned pharmaceutical expert Olumide Akintayo quantified the damage: a loss of over N350 million in hospital revenue, alongside a 22.73% increase in infant and maternal mortality. Overall, morbidity has worsened by over 18%, and fatalities have risen by approximately 13%.
“The current administration’s handling of health matters is unprecedented in its failure,” Akintayo stated bluntly during an exclusive.
The demands echo years of neglect: payment of salary arrears, implementation of training funds, upgrades to crumbling infrastructure, and humane working hours. As Professor Mike Ogirima, former President of the Nigerian Medical Association, noted, the systemic rot runs deeper.
“We are training our health workers at a cheaper rate, while the developed countries are harvesting them,” he said, referencing the debilitating ‘Japa’ syndrome of mass medical emigration. He criticized state governments for chasing prestige projects like teaching hospitals while “forgetting that the primary health care centres and the general hospitals are the closest health facilities to the people.”
This collapse makes the contrast with a clear, alternative vision all the more devastating. Health experts globally assert that integrating public health with primary care is straightforward, requiring three fundamental commitments:
1. Bring care to people, not people to care. This means funding mobile, school-based, and street-clinical models as permanent health infrastructure.
2. Treat community health workers as essential providers. They are the irreplaceable bridge between institutions and community trust.
3. Align incentives with outcomes, not volume. An equitable system rewards the prevention of disease, not just the treatment of its complications.
“We know that integration works. We have seen it in refugee camps, in tribal nations, in the hardest-hit neighborhoods of the pandemic,” the model’s advocates state.
“The question is not whether we can build the bridge. It is whether we have the courage to stop pretending the gap is someone else’s problem.”
A Weakened Global Landscape
Nigeria’s crisis is compounded by a shifting global aid environment. In 2025, the new U.S. administration under President Donald Trump slashed foreign aid budgets.
While a waiver protected flagship programs like PEPFAR, the overall contraction in global health funding adds another layer of vulnerability for systems dependent on external support.
The Fork in the Road
Nigeria now faces a defining choice. One path continues the cycle of crisis management: protracted strikes, worsening mortality, and the steady hemorrhage of its health workforce. The other requires the political will to fundamentally reimagine the system to move care into communities, empower frontline workers, and invest in keeping people healthy rather than only ministering to them when they are catastrophically ill.
The prescription for health equity is written. It is achieved, as the blueprint states, “on sidewalks, in shelters, in classrooms, in homes.” As Nigeria’s hospital gates remain locked, the urgent question is whether its leaders will finally have the courage to fill that prescription, or let the nation’s health continue to be the casualty of political inertia.
