Introduction
Public health emergencies represent a profound challenge to national governance, testing the resilience of legal frameworks and healthcare infrastructures alike. In Nigeria, the recent Ebola outbreak of 2014 and the global COVID-19 pandemic starkly underscored the country’s vulnerabilities in managing such crises. These events revealed the inadequacies of Nigeria’s public health legal and policy frameworks, which, although piecemeal provisions exist, fail to offer a cohesive or robust strategy for managing complex health threats. The lack of a comprehensive National Health Security Law capable of responding holistically to public health emergencies has left Nigeria vulnerable to future threats.
A legislative vacuum in public health security, evidenced by outdated laws such as the Quarantine Act of 1926, complicates Nigeria’s capacity to mount swift, coordinated responses to emerging threats. This article advocates for the development of a modern, all-encompassing health security law that incorporates international obligations under frameworks like the International Health Regulations (IHR) of 2005, and lays out clear mandates for preparedness, coordination, and accountability during public health emergencies. Such legislation is not merely a legal necessity but a moral imperative in safeguarding national health and security.
Public health security is predicated on the ability to prevent, detect, and respond to catastrophic health events. These emergencies can arise from both natural and human-made events, such as pandemics, environmental disasters, bioterrorism, or infectious disease outbreaks. The scale and complexity of public health emergencies are often exacerbated by factors such as political instability, climate change, and inadequate healthcare infrastructure.
The World Health Organization (WHO) defines a public health emergency as an extraordinary event that poses a risk to human health, requiring immediate action. Public health emergencies can be broadly categorized into infectious disease outbreaks (e.g., Ebola, COVID-19), natural disasters (e.g., floods, earthquakes), and human-made crises (e.g., chemical spills, bioterrorism). Each type of emergency requires distinct preparedness and response measures, but all underscore the necessity of a well-coordinated legal framework.
Nigeria’s position as a populous nation with diverse geographic and infrastructural challenges has made it particularly vulnerable to public health emergencies. The 2014 Ebola Virus Disease (EVD) outbreak in West Africa, for instance, placed Nigeria at heightened risk due to its role as a regional transportation hub. Although Nigeria’s swift response effectively contained the virus, the outbreak illuminated critical deficiencies in health security preparedness, including gaps in surveillance, healthcare worker training, and inter-agency coordination.
The COVID-19 pandemic further exposed systemic weaknesses, highlighting the limitations of legal frameworks that were ill-suited to address the scale of the crisis. Quarantines, lockdowns, and movement restrictions were implemented across the country, yet enforcement was often inconsistent, and the broader economic impacts of these measures exacerbated social vulnerabilities. Meanwhile, endemic diseases such as Lassa fever, cholera, and Mpox continue to pose persistent threats to public health, further illustrating the need for legislative reform. Despite the country’s experience with these recurrent outbreaks, Nigeria remains reliant on outdated statutes that are insufficient to address contemporary public health emergencies.
Importance of Legal Frameworks in Public Health
A robust legal framework is a prerequisite for an effective response to public health emergencies. It provides the government with the authority and mechanisms to swiftly enforce health measures, allocate resources, and protect civil liberties while balancing public safety. In Nigeria, the absence of a comprehensive National Health Security Law limits the country’s ability to address public health crises efficiently.
The existing legal instruments, such as the Quarantine Act of 1926 and the Public Health Law of 2004, are largely outdated and inadequate for addressing the complexities of modern public health challenges. The Quarantine Act, for example, focuses narrowly on the control of infectious diseases at entry points into the country, overlooking crucial elements such as emergency preparedness, rapid response systems, and interagency coordination that are essential in contemporary public health crises.
Furthermore, international legal frameworks like the International Health Regulations (IHR) of 2005 offer vital guidance for managing public health emergencies. However, Nigeria’s implementation of the IHR has been hampered by the absence of corresponding domestic laws that align with these international obligations. To fully comply with the IHR and strengthen its public health emergency response capabilities, Nigeria must enact legislation that aligns with international standards and supports a coordinated, multi-sectoral approach to health security.
International legal frameworks provide essential guidance for national governments in managing public health emergencies, ensuring that countries are equipped with the tools to prevent, detect, and respond to health threats. Foremost among these is the International Health Regulations (IHR) of 2005, a legally binding instrument adopted by 196 countries, including all WHO member states. The IHR establishes criteria for determining whether a health event constitutes a “Public Health Emergency of International Concern” (PHEIC) and mandates reporting obligations and response measures for signatories.
The Global Health Security Agenda (GHSA) also plays a critical role in promoting global health preparedness by encouraging countries to develop robust legal frameworks and capacities to manage public health threats. Its Legal Preparedness Action Package emphasizes the importance of legal mechanisms in supporting global health security. This is complemented by the WHO’s Framework Convention on Tobacco Control (2003) and the Rights of Persons with Disabilities Convention (2006), both of which address health security concerns within their specific contexts.
Nigeria, as a signatory to the IHR and a participant in the GHSA, bears a legal and ethical obligation to implement corresponding domestic legislation. However, the absence of a comprehensive national law that aligns with these global instruments has hindered Nigeria’s ability to fully engage with international health security standards. To rectify this, Nigeria must enact a National Health Security Law that aligns with global frameworks while addressing the country’s unique public health challenges.
Existing Legislative Framework for Public Health in Nigeria
Nigeria’s current legal framework governing public health emergencies is a patchwork of statutes, many of which are outdated and inadequate for contemporary health crises. Key pieces of legislation include the Constitution of the Federal Republic of Nigeria (1999), the National Health Act (2014), and the Nigerian Center for Disease Control (NCDC) Act (2018). While these laws establish some foundational principles for public health governance, they fall short in providing a cohesive strategy for addressing large-scale public health emergencies.
The Nigerian Constitution provides the foundational authority for legislative action on public health. Section 4 grants the National Assembly the power to legislate on matters relating to health, while Section 12 requires that international treaties, such as the IHR, must be domesticated to have legal effect within Nigeria. Section 45 allows for the derogation of certain fundamental rights, such as freedom of movement and association, when necessary for the protection of public health.
However, these constitutional provisions are limited in scope and do not provide a comprehensive legal framework for public health emergencies. For instance, while the Constitution permits the restriction of individual rights during health crises, it does not establish specific mechanisms for ensuring accountability or safeguarding the rights of affected individuals, such as those placed under quarantine or isolation.
The NCDC Act empowers the Nigeria Center for Disease Control to detect and respond to disease outbreaks and public health emergencies. However, the Act lacks comprehensive definitions of key public health terms, such as quarantine and surveillance, and does not establish a mechanism for notifying the WHO of health emergencies, as required by the IHR. Moreover, the Act fails to provide for sustainable funding for public health emergency preparedness, leaving the NCDC under-resourced in times of crisis.
As the primary law governing infectious disease control, the Quarantine Act grants the President authority to impose quarantine measures in response to public health threats. However, the law is grossly outdated, providing only minimal penalties for non-compliance and failing to address modern health emergencies, such as bioterrorism or chemical hazards. The lack of clear definitions and insufficient provisions for the protection of civil liberties make the Quarantine Act inadequate for addressing contemporary health challenges.
The National Health Act establishes a framework for the development and regulation of Nigeria’s health system, including the provision of healthcare services. While the Act outlines the roles of the Federal Ministry of Health and other stakeholders, it lacks specific provisions for managing public health emergencies. For instance, it does not mandate the creation of emergency response systems or the coordination of efforts between federal, state, and local authorities.
The National Assembly and its Agenda for Health Security in Nigeria
The 9th National Assembly played a pivotal role in shaping Nigeria’s legislative response to public health emergencies. Recognising the urgent need for legislative reform, the 9th Assembly focused on enacting laws that would bolster Nigeria’s capacity to respond to health crises. A key legislative initiative was the amendment of the National Health Act (NHA) to improve emergency preparedness and response.
The 9th Assembly also enacted the National Health Insurance Agency (NHIA) Act (2021), which sought to expand access to healthcare services, particularly during emergencies, by promoting universal health coverage. In addition, the Assembly passed the National Mental Health Act, which provides legal protections for individuals with mental health conditions and ensures that mental health services are included in the broader public health response to emergencies.
Despite these legislative efforts, critical gaps remain in Nigeria’s legal framework for public health emergencies. The absence of a comprehensive National Health Security Law continues to hinder the country’s ability to respond effectively to crises. The 10th National Assembly has an opportunity to build on the work of its predecessor by prioritising the passage of the Public Health Emergency Bill and enacting a comprehensive legal framework that addresses the full scope of health security threats.
The legislative agenda of Nigeria’s 10th National Assembly has a central focus on improving stewardship and accountability for Universal Health Coverage (UHC), reflecting a strategic shift towards addressing health system deficiencies. This agenda emphasises the need to ensure the full implementation of the National Health Act (NHA) and to prioritise legislative interventions that foster resource mobilisation and accountability in health service delivery. Importantly, the agenda is designed to reinforce laws that enhance preparedness for public health emergencies.
One of the core objectives of the 10th Assembly is the passage of a National Health Security Law that aligns with Nigeria’s international commitments under the International Health Regulations (IHR) and the Global Health Security Agenda (GHSA). The new legislative framework is expected to ensure that Nigeria can meet its obligations to build core capacities for detecting and responding to health threats while promoting collaboration between health and security sectors.
This Assembly’s legislative efforts include improving the Basic Health Care Provision Fund (BHCPF) and creating a National Public Health Emergency Fund to ensure timely and equitable access to healthcare during emergencies. Moreover, the 10th Assembly seeks to introduce legislation that strengthens the roles of federal and state governments in ensuring a coordinated public health response during emergencies, reducing administrative bottlenecks, and enhancing accountability mechanisms.
Key Elements of a Comprehensive National Health Security Law
A National Health Security Law must serve as the legal backbone for managing public health emergencies in Nigeria. Drawing on international best practices and the specific needs of Nigeria, such a law should incorporate the following elements:
Centralized Coordination Between Public Health and Security Sectors: An essential feature of the law should be the explicit mandate for collaboration between public health and security agencies. The legal framework must define the conditions under which the security sector is engaged in public health responses, particularly in scenarios involving large-scale quarantine enforcement, bioterrorism threats, or outbreaks of high-consequence pathogens.
Clear Mandates for Federal, State, and Local Authorities: A well-structured legal framework must delineate the roles and responsibilities of various governmental tiers in managing public health emergencies. The law should establish a comprehensive incident management system that integrates federal, state, and local authorities, ensuring swift and coordinated action during health crises. This clarity is crucial in averting jurisdictional conflicts and ensuring that each level of government plays its part in safeguarding public health.
Modern Legal Principles on Surveillance, Privacy, and Human Rights: The law should grant public health officials sufficient authority to conduct investigations, enforce quarantines, and track disease vectors, all while balancing these powers with protections for civil liberties. Surveillance systems should be legally mandated, with clear protocols for data sharing and privacy protections in line with international human rights law. The principles of necessity, proportionality, and non-discrimination should guide the exercise of emergency powers, adhering to frameworks like the Siracusa Principles.
Sustainable Funding Mechanisms for Health Security: A critical shortfall in Nigeria’s current legal framework is the absence of stable funding for public health emergencies. The new law must establish dedicated funding streams, ensuring that preparedness activities and routine health security operations are financially supported year-round. Additionally, the law should create a flexible mechanism for emergency funding that can be rapidly deployed during crises, without bureaucratic delays.
Legal Framework for Rapid Response to Public Health Threats: The law must mandate the creation and maintenance of a real-time disease surveillance system, capable of providing early warnings of potential public health threats. It should also streamline regulatory processes to allow the expedited procurement of medical supplies, protective equipment, and other essential resources during emergencies. This provision should include the legal authority for quarantine and movement restrictions, as well as clear guidelines for ensuring the fair and humane treatment of affected individuals.
Legal Authority to Mobilize Resources Across Sectors: Any comprehensive law must enable multi-sectoral coordination, ensuring that resources from various governmental and private sectors are mobilized swiftly in response to public health emergencies. This includes integrating One Health approaches, which involve collaboration between public health, animal health, and environmental sectors to prevent zoonotic diseases and other health threats.
Recommendations and Next Steps Towards Achieving a National Health Security Law
The establishment of a comprehensive National Health Security Law in Nigeria is essential for improving the country’s capacity to manage public health emergencies. Given the current gaps in Nigeria’s legislative framework and the growing global health security threats, immediate and strategic action is required to move from legislative intention to reality. Below are key recommendations and practical next steps to ensure the timely enactment and implementation of such a law:
Fast-track the Passage of the Public Health Emergency Bill: The proposed Public Health Bill, which is currently pending before the National Assembly, provides a critical starting point for establishing a legal framework for health emergencies. Legislative stakeholders, including relevant committees in both chambers of the National Assembly, should prioritise the passage of this bill. Advocacy by civil society organizations (CSOs), public health experts, and international partners can help keep this issue on the legislative agenda. The leadership of the 10th National Assembly should facilitate accelerated hearings and review processes to ensure that the bill is passed without unnecessary delay.
Conduct Comprehensive Stakeholder Consultations: To ensure broad-based support and the practical viability of the proposed law, comprehensive consultations with key stakeholders are essential. This includes representatives from federal, state, and local governments, health professionals, law enforcement agencies, civil society organisations, and the private sector. Stakeholders from these sectors must have input on the design of the law, especially in areas concerning resource mobilisation, emergency preparedness, and inter-sectoral coordination. Ensuring that voices from both public health and national security sectors are represented will also enhance the practical implementation of the law.
Incorporate International Best Practices and Standards: The law must align with Nigeria’s international obligations, including those under the International Health Regulations (IHR) and the Global Health Security Agenda (GHSA). As part of the drafting process, Nigerian lawmakers should examine the health security laws of countries with robust public health legal frameworks, such as the United States’ Public Health Emergency Act and South Korea’s Infectious Disease Control and Prevention Act. Incorporating provisions that emphasise early warning systems, real-time data sharing, and cross-border collaboration will ensure that Nigeria’s law is equipped to meet the standards of global health security.
Establish a National Public Health Emergency Response Fund: A major limitation of the current legal framework is the lack of sustainable funding mechanisms for health emergencies. The proposed law must include provisions for the establishment of a dedicated National Public Health Emergency Response Fund. This fund would guarantee the immediate availability of resources during emergencies and cover the operational costs of response activities such as quarantine enforcement, medical treatment, and procurement of emergency supplies. The fund should be replenished annually as part of the national budget and be supported by international development partners where possible.
Enhance Interagency Coordination and Define Roles: A National Health Security Law must clearly delineate the roles and responsibilities of various government agencies involved in public health responses. The law should formalize coordination mechanisms between federal, state, and local authorities, ensuring there are no overlaps or gaps in responsibility. Furthermore, it should mandate the integration of law enforcement and security agencies in the enforcement of public health measures, especially in scenarios where public compliance with health directives is necessary, such as during lockdowns or quarantine.
Capacity Building and Training Programs: Even with a robust legal framework in place, successful implementation depends on the capacity of stakeholders to act effectively in emergencies. Therefore, the law must include provisions for continuous training and capacity-building programs for public health workers, law enforcement officials, and emergency response teams. These programs should focus on crisis management, epidemiological surveillance, and rapid response strategies. Cross-training between health and security agencies should also be a key component of these efforts to foster seamless collaboration during health crises.
Strengthen Public Communication and Trust: A public health emergency law must also address public communication, providing a framework for transparent and effective communication between the government and the public during crises. The law should mandate the creation of official channels for disseminating accurate information, debunking misinformation, and ensuring public trust in the government’s response. Engaging community leaders, religious groups, and the media as part of the communication strategy will ensure that public health measures reach all corners of society.
Periodic Review and Amendment of the Law: Given the evolving nature of public health threats, the law must include a provision for periodic reviews and amendments to keep it current with emerging global health challenges. A legal framework that is rigid or outdated could fail to address future pandemics or biosecurity risks. By instituting mandatory reviews every five to ten years, lawmakers can ensure the law remains flexible, adaptive, and responsive to new developments in health security and international best practices.
Next Steps for Implementation:
Immediate Legislative Action: Lawmakers must prioritize the Public Health Emergency Bill, ensuring that it undergoes timely debate and approval by the National Assembly. Stakeholders should lobby for its quick enactment to address existing legal deficiencies.
Establishment of an Interim Task Force: While legislative processes are underway, an interim task force composed of representatives from key ministries, such as the Ministry of Health, Ministry of Justice, and security agencies, should be established to begin coordinating efforts to operationalise the law once enacted. This task force should work on setting up emergency response structures and initiating capacity-building exercises.
Strategic Partnership with International Donors and Agencies: Securing partnerships with international organisations such as the World Health Organization (WHO), the African Union’s Africa Centres for Disease Control (Africa CDC), and the Global Health Security Agenda (GHSA) will be crucial in mobilizing technical and financial resources to implement the law effectively. International partnerships will also help build Nigeria’s capacity to respond to cross-border health emergencies.
Conclusion
Nigeria’s response to public health emergencies has been constrained by an outdated and fragmented legal framework that fails to adequately address the complexities of modern health threats. The Quarantine Act of 1926, though still in effect, is grossly insufficient for managing contemporary emergencies, leaving the country vulnerable to future crises. The COVID-19 pandemic exposed systemic weaknesses in the healthcare system and underscored the urgent need for a comprehensive National Health Security Law.
Such a law must go beyond crisis management, providing a robust legal foundation for preparedness, response, and recovery. By aligning Nigeria’s domestic legal framework with international obligations under the International Health Regulations (IHR) and adopting a multi-sectoral approach to health security, Nigeria can enhance its resilience against future public health threats. The proposed Public Health Bill (SB 210) is a step in the right direction, but its swift passage is imperative to ensure that Nigeria is equipped to protect the health of its population in the face of emerging global threats.
A National Health Security Law, grounded in clear legal mandates, sustainable funding, and respect for human rights, will not only bolster Nigeria’s capacity to respond to health emergencies but will also affirm its commitment to global health security.
In view of the obvious facts and stark reality challenging the populace, NBA has a role and National Assembly has a role too. So that this will not be just another treaty, there should be a working handshake to make this observation an action point.