The decision by President Bola Tinubu to send 24 health amendment bills to the Senate signals urgency, but it also raises a hard question Nigerians must ask: will more laws fix a system that already fails women, children, and the poor?
Development Diaries reports that President Tinubu recently forwarded 24 health bills to the Senate for consideration.
According to media reports, Tinubu stated that the bills were developed following a review of existing health sector laws by the Attorney-General of the Federation and Minister of Justice, in collaboration with the Minister of Health and Social Welfare.
In a country where preventable deaths remain common and hospital bills push families into poverty, reform must be judged by results, not legislative activity.
President Tinubu’s decision is being presented as health sector reform, but we must ask a harder question: will these laws change lived health outcomes?
Nigeria still records very high maternal deaths, weak rural clinics, and families paying cash for care.
In the World Health Organisation’s (WHO) Trends in Maternal Mortality 2000-2023 report, Nigeria is listed among the countries with the highest maternal mortality ratios in 2023, with an estimated 993 maternal deaths per 100,000 live births and a very high share of global maternal deaths.
Laws alone do not heal people. Implementation does.
The system at stake is Nigeria’s public health system, financing, regulation, service delivery, and accountability. That system is already failing millions of citizens.
Over 70 percent of health spending is out-of-pocket, pushing households into poverty. Budget allocations remain below the Abuja Declaration’s 15 percent benchmark.
There is weak oversight of health agencies and funds, which is a governance gap, and there is a shortage of health workers and brain drain, which is a capacity gap.
Primary health care centres (PHCs) are underfunded, understaffed, and poorly equipped, even though they serve most Nigerians.
Health insurance coverage remains low, especially for informal workers and rural communities. These failures persist not because laws do not exist, but because funding is weak, oversight is poor, and responsibility is fragmented between federal and state governments.
Sending 24 amendment bills signals that the government knows existing health laws are not working, but Nigerians must ask what exactly is changing.
Do these amendments bring more money into the health system, or do they only rearrange boards and institutions? Do they strengthen PHC delivery where most women give birth, or expand federal bureaucracy in Abuja?
Health is not charity; it is a right. When women die in childbirth or children die from preventable diseases, it is a rights failure. If these 24 bills do not reduce preventable deaths and health costs, they fail the rights test.
A gender and equity lens makes the gaps clearer. Women continue to bear the highest burden of health system failure, especially during pregnancy and childbirth.
Rural poor communities rely on clinics without drugs, power, or staff. Persons with disabilities face inaccessible facilities and neglect. Informal workers still pay cash to survive illness.
If the bills do not clearly prioritise these groups, with enforceable obligations and funding, then the reform is cosmetic, not transformational.
It is time for citizens to interrogate outcomes. Which health indicators will improve within 12 to 24 months if these bills pass? How much new funding will follow? What sanctions exist for agencies or states that fail to implement them?
Nigerians should demand public hearings, track the bills, and ask senators how each amendment will reduce out-of-pocket spending and improve local clinics.
Furthermore, the Presidency and the Federal Ministry of Health and Social Welfare should publish a clear reform outcomes framework, including a simple public dashboard that tracks maternal mortality reduction targets, primary health care functionality indicators, and health insurance coverage milestones.
The National Assembly must tie legal amendments to real financing by committing to progressive increases in health budget allocations, rather than relying on legislative changes alone.
At the same time, strong accountability must be enforced: relevant federal and state health agencies, under the oversight of the Presidency, National Assembly, and Auditor-General, should face clear sanctions for misusing health funds or failing to meet agreed service delivery benchmarks.
Photo source: Bola Tinubu
