[Review]: Enhancing Nigeria’s Legal Framework and Bill for Addressing Public Health Emergencies -By Caleb Onah

Public health emergencies pose significant challenges to governments worldwide, requiring swift and effective responses to protect the health and well-being of their citizens. In Nigeria, the need to strengthen the legal framework for responding to such emergencies led to the development of the public health emergency bill. This landmark legislation aims to enhance Nigeria’s ability to prevent, detect, and respond to public health crises by providing a comprehensive legal framework for emergency preparedness and response.

According to a report released by the Pharm Access Foundation, the Nigerian health sector faces significant challenges. As of 2015, the prevalence of HIV was reported at 3.1%, while diabetes affected approximately 4.04% of the population. Disturbingly, the under-five mortality rate and maternal mortality rate were higher than the sub-Saharan Africa average, standing at 1117 per 1000 live births and 560 per 100,000 live births, respectively.

Cardiovascular diseases were responsible for an estimated 12% of deaths in 2015, and the risk of developing cancer before the age of 75 was 10.4%. However, the most formidable obstacle remains malaria, with staggering statistics reported by the charity Malaria No More. Malaria accounts for 60% of outpatient visits and 30% of hospitalisations for children under the age of five, resulting in an annual cost of approximately $835 million for Nigeria.

Alarmingly, the country represents 23% of all global malaria cases, and the disease alone contributes to roughly one-third of all deaths. Given the diverse range and severity of these health issues in Nigeria, it is not surprising that life expectancy stands at a mere 54 years, which is four years lower than the regional average, as reported by the World Health Organisation (WHO).

Further, a strong legal framework is crucial for effective emergency response, as it provides the necessary authority and guidance for the government, public health agencies, and other relevant stakeholders to coordinate their efforts. Prior to the introduction of the Public Health Emergency Bill, Nigeria can rely on a patchwork and research of existing laws and regulations that were not specifically designed to address public health emergencies comprehensively. This lack of a consolidated legal framework hampered the country’s ability to respond adequately to outbreaks, such as the Ebola epidemic in 2014 and the COVID-19 pandemic.

In 2022, Ngozi Azodoh, the Director of Health Planning Research and Statistics (FMoT), highlighted the lessons learned from Nigeria’s experience with the Covid-19 pandemic. According to Azodoh, the collaborative approach involving the entire community and the government has proven to be effective and efficient. This approach was exemplified through partnerships with community and religious leaders, state governments, the private sector, donors, and civil society organisations.

However, Azodoh also acknowledged that Nigeria continues to face challenges in various areas. These challenges include a shortage of human resources, inadequate capacity to respond to public health emergencies within a 24 to 48-hour timeframe, logistical management issues, stockpiling of supplies, and fragmented implementation of initiatives. The remarks by Ngozi Azodoh shed light on the importance of community and government collaboration in addressing health emergencies. Despite the progress made, Nigeria recognises the need to address the existing challenges to enhance its response capabilities and ensure more effective public health interventions.

Key Provisions of the Nigeria Public Health Emergency Bill Definition and declaration of public health emergencies – the bill clearly defines what constitutes a public health emergency, outlining specific criteria for declaration. This ensures a consistent and transparent approach to determine when emergency measures are required.

Emergency powers and authorities: The legislation grants the government and relevant authorities the necessary emergency powers to mobilise resources, enforce quarantine measures, establish isolation facilities, and implement other necessary interventions swiftly and effectively.

Surveillance and early detection: The bill emphasise the importance of surveillance systems for early detection and response. It provides guidelines for establishing robust disease surveillance mechanisms, including mandatory reporting of suspected cases and timely information sharing among relevant stakeholders. Risk communication and public awareness: Recognising the significance of clear and accurate communication during emergencies, the bill emphasises the importance of public education and awareness campaigns. It mandates the dissemination of reliable information to the public to promote understanding, compliance with preventive measures, and reduce misinformation.

Coordination and collaboration: The legislation emphasises the need for effective coordination and collaboration among different government agencies, international organisations, civil society, and other stakeholders involved in emergency response efforts. This ensures a cohesive and well-coordinated response to public health emergencies.

The Public Health Emergency Bill brings several benefits and significant impacts to Nigeria’s ability to respond to public health emergencies effectively:

Strengthened emergency preparedness: The legislation enhances Nigeria’s preparedness for potential public health crises by providing a clear roadmap for emergency response, establishing protocols, and facilitating coordinated efforts among various stakeholders.

Rapid response and containment: The bill empower the government and relevant authorities to act swiftly and decisively in the event of an emergency. This allows for the prompt implementation of necessary interventions such as quarantine measures, contact tracing, and the establishment of isolation facilities, thereby aiding in the containment of outbreaks.

Improved surveillance and early detection: By mandating robust surveillance systems and reporting mechanisms, the bill facilitates early detection of infectious diseases and other public health threats. Early detection enables timely response measures, reducing the risk of widespread transmission.

Enhanced public awareness and education: The legislation prioritises effective risk communication and public awareness campaigns. By disseminating accurate information, addressing misconceptions, and promoting preventive measures, the bill empowers citizens to make informed decisions and actively participate in safeguarding their health.

Strengthened international cooperation: The Public Health Emergency Bill aligns Nigeria’s legal framework with international standards and best practices. This facilitates collaboration with global health organisations, enabling access to technical expertise, resources, and support during emergencies.

Nigeria’s Public Health Emergency Bill marks a significant milestone in the country’s efforts to strengthen its legal framework for responding to public health emergencies. By providing a comprehensive set of guidelines and authorities, the bill equips Nigeria with the necessary tools to prevent, detect, and effectively respond to outbreaks and other health crises.

The Public Health Emergency Bill’s emphasis on early detection, risk communication, coordination, and collaboration underscore the importance of a holistic and integrated approach to emergency response. It not only enhances the government’s ability to protect the health and well-being of its citizens but also promotes transparency, accountability, and public trust. Moving forward, the successful implementation of the Public Health Emergency Bill will require adequate resources, capacity building, and ongoing evaluation and adaptation to address emerging challenges.

However, continuous engagement with relevant stakeholders, including health professionals, community leaders, and civil society organisations, will be crucial in ensuring the bill’s effective implementation. Nigeria’s commitment to strengthening its legal framework for public health emergencies sets a positive example for other nations grappling with similar challenges. It demonstrates the government’s dedication to safeguarding the health and safety of its citizens and lays the foundation for a more resilient and responsive public health system.