Industrial Harmony as a Catalyst for Nigeria’s Health Renaissance

Osaretin Igbemudia in this piece traces the history of industrial unions in the health sector globally and relates it to current efforts by the federal government to improve labour relations in the nation’s health sector.

The struggle between two critical pillars among the four factors of production—labour and entrepreneurship or leadership—is a historical constant. Across centuries, labour and leadership have repeatedly found themselves in cycles of disagreement and contestation.

In the health sector, particularly over the past 50 years, labour–management disharmony has been a recurring global phenomenon. Notable examples include the United Kingdom’s Consultants’ and Junior Doctors’ strikes of 1975; Canada’s Ontario Doctors’ Strike of 1986; and the United States’ California Physicians’ Strike of 1975, among others.

More recently, crippling labour actions have occurred even in some of the world’s most advanced healthcare systems. In 2023, the United Kingdom experienced the largest strike in the history of the National Health Service, involving nurses and ambulance workers. In October 2023, more than 40,000 Kaiser Permanente workers across four U.S. states embarked on a major strike. Overall, over 75,000 healthcare workers—including EMTs, nursing assistants, and pharmacists—participated across multiple states to protest wages and staffing levels. Similarly, nurses’ strikes have persisted in New York City over stalled contract negotiations.

These examples illustrate that labour–management conflict is not a discriminatory phenomenon; it is a global reality. The contrast becomes even more striking when healthcare spending in these countries is compared with Nigeria’s. For instance, the United States spends over $12,000 per person on healthcare, the United Kingdom about $6,700 per person, while Nigeria spends approximately $90–$100 per person.

Yet, despite this stark disparity in health expenditure, Nigeria is steadily building a more robust and resilient healthcare system, undergirded by improved infrastructure and an expanding pool of skilled manpower.

Under the Health Sector Renewal Initiative, several landmark programmes and reforms have been introduced. Primary and secondary healthcare facilities have been rehabilitated; strategic agreements to promote local pharmaceutical manufacturing have been signed; thousands of health workers have been trained and others newly recruited; and health infrastructure has received significant upgrades, including the establishment of new top-tier cancer centres across the geo-political zones. Hospitals have been revamped, and multiple turnaround policies have been implemented.

Nationwide, over 60,000 health workers have been trained, enhancing both confidence and quality of care delivery.

In parallel, the federal government has taken critical steps to improve labour relations within the health sector. A new hazard allowance for all health workers is currently being processed, while more than ₦10 billion owed under the 2025 Medical Residency Training Fund has been paid in recent months.

Furthermore, the government is institutionalising salary relativity adjustments demanded by health unions for CONHESS-aligned workers and CONMESS-aligned doctors. It has also fully paid the seven months’ arrears of the 25%/35% CONMESS adjustment, aside from minor omissions and bank-related errors that are already being addressed. Additionally, the 2024 accoutrement allowance for medical officers has been fully disbursed.

Recognising the critical importance of manpower, the Federal Ministry of Health and Social Welfare has granted more than 23,000 recruitment waivers for health professionals in federal hospitals. To further retain specialised skills, strengthen manpower capacity, and ensure employment security, the federal government has approved an upward review of the retirement age for skilled clinical health professionals in federal tertiary hospitals and centres—from 60 to 65 years of age, or from 35 to 40 years of service, whichever comes first.

It is important to emphasise that under the Tinubu administration, the 2024–2025 period heralded a historic pivot of our health sector towards a more self-reliant and industrialised system.

Despite the obvious challenges, Nigeria’s health sector continues to make significant progress and is considered a high-potential frontier among emerging peers like Brazil and Indonesia, principally owing to the strategic reforms that have resulted in over $2.2 billion in investment commitments as of late 2025.

Recently, Nigeria and Brazil signed a Memorandum of Understanding to strengthen local pharmaceutical manufacturing and industrial cooperation. The MoU was signed by the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC), EMS Brazil, and Oaks Medical Limited.

This MoU is one of over 20 that PVAC has recently signed with world-class companies to implement impactful projects.

Under PVAC, $1 billion in investment-guarantor financing has been secured from AFREXIMBANK, while the European Investment Bank’s Human Development Accelerator (HDX) is also providing a €1 billion pool for investments in the health sector.

With PVAC as the driving force, 84 new healthcare companies are in active discussions with international financiers for support in implementing various manufacturing and related investment projects.

According to the latest data released by the Central Bank of Nigeria, Nigeria’s spending on medical tourism recorded a significant decline to 96.2% in the first half of 2025 compared to the same period in 2024. This further affirms the impact of the Tinubu administration’s reforms and the return of confidence in Nigeria’s health sector.

Evidently, Nigeria while improving infrastructure and healthcare delivery is also making deliberate and bold efforts to improve the welfare of health professionals nationwide, in addition to strengthening government–labour relations.

Constructive and disciplined engagement—not militant actions or “japa”—remains the most viable path forward for labour and government in the health sector. There is more to gain in dialogue than in confrontation. Nigeria’s health sector is ours to build, and we must do so with patriotism, dedication, and a clear understanding that no system anywhere in the world is perfect. Through harmony, dialogue, and constructive engagement, however, excellence remains an attainable goal.

-Igbemudia writes from Abuja.