Killing the Health Bill….slowly

Leadership. What is leadership? Not a question we will explore in detail in this blog, but suffice it to say that the barest minimum expected of a leader is to take decisions. Sometimes it is as simple as yes or no, sometimes it is more complex but leaders are there to make decisions. That is the primary reason every society is organised into leadership structures – to organise the decision making process. 

In the 2009 and 2010 we followed with great interest the intriguing battles of the American President – Barack Obama in getting his Healthcare reform bill passed. In 2011, we watched an even more interesting battle in the UK – from who we inherited our fractured health system. After a series of reforms again – the coalition government got their own health bill through despite vociferous objections from across the health community in the UK (as in the bill board below). Like it or not – the party was elected to make decisions and they decided that the NHS needed reform! 

Sadly in our country, Nigeria….the health bill, having taken an unprecedented 8 years to get through our extortionately paid legislature to the presidents desk…..Mr President has let the bill elapse. In an interview that drew little attention recently, our Minister quietly told us that the president had failed to make a decision in the time permitted. True to character – he neither said – yes…or no. He just did nothing….now we are in limbo. The Ministers words as quoted by Leadership newspapers to the question;

Leadership: What is the state of the National Health Bill?

Prof Chukwu: The state of the National Health Bill is that it was passed by the sixth National Assembly and transmitted to Mr. President. Unfortunately, within the time permitted for it to be signed into law by Mr. President, it was not signed. ….Now, the presidency is looking at how to work with the National Assembly to bring it (health bill)  back on stream. So, it is something that will be decided by the presidency. The President has let us know that he would soon call a meeting.

I mean really! How bad can it get – Our president neither says, yes….or no! He just does not decide. Does not lead. This is the tragedy of leadership in Nigeria. 

Nobody suggests that your decision will be easy Mr President. Next time you are at the UN ask your colleagues Obama and Cameron, how they made these decisions. They put substantial political capital on the line for action they believed in. Mr President – why can’t you make a decision on the health of Nigerians? As I reflect on this issue – I reflect on the words of Franz Fanon when he said: Every spectator is either a coward or a traitor….hhhhmmmm go figure.

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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