Calls intensify for stronger health regulation after Lagos hospital tragedy

Healthcare professionals, legal experts and policy advocates have renewed calls for far-reaching reforms in Nigeria’s health sector following the death of Nnamdi Nkanu, son of celebrated author Chimamanda Ngozi Adichie, at a hospital in Lagos. The incident has reignited a nationwide debate on patient safety, accountability and the glaring absence of effective regulatory oversight in healthcare delivery across the country. Beyond the individual tragedy, the case has become a rallying point for long-standing concerns about systemic weaknesses that continue to expose Nigerians to preventable harm.

Speaking in Abuja, experts argued that the growing convergence of opinion among clinicians, legal practitioners and health policy specialists reflects the urgent need for a comprehensive overhaul of Nigeria’s healthcare regulatory architecture. They said such reforms are critical to preventing avoidable deaths and restoring public confidence in a health system many Nigerians increasingly view with apprehension.

Dr Richardson Ajayi, founder of Bridge Clinic Fertility Centre, Abuja, said the tragedy underscored the need to strengthen healthcare systems rather than focusing solely on individual practitioners. “While healthcare depends on the dedication of doctors, nurses and other professionals, patient safety ultimately rests on the strength of the systems that support them,” Ajayi said. “To build real trust, we need clear standards, transparent oversight and continuous improvement—without resorting to blame for those on the front line.”

He called for the establishment of a National Health Facilities Regulatory Agency that would be empowered to set and enforce minimum standards, accredit healthcare facilities and ensure consistent quality of care nationwide. Ajayi urged the public to await the outcome of official investigations into the circumstances surrounding Adichie’s son’s death, describing her public account as deeply troubling and reflective of long-standing systemic failures. “Healthcare operates in a life-and-death environment where market forces alone cannot guarantee safe, equitable and affordable care,” he said. “Regulation is essential to define standards, protect patients’ rights, safeguard data and coordinate responses to public health emergencies.”

Legal experts have also weighed in, arguing that Nigeria’s regulatory framework has failed to keep pace with the growing complexity of healthcare delivery. Dr Olisa Agbakoba, a Senior Advocate of Nigeria (SAN), warned that weak oversight and poor enforcement mechanisms were at the heart of recurring tragedies in the sector. He called for the immediate creation of an independent Health Regulatory Authority and the reinstatement of Chief Medical Officers (CMOs) at both federal and state levels. “The fundamental problem underlying these tragedies is the complete failure of the legal and regulatory framework governing Nigeria’s health sector,” Agbakoba said. “Unless oversight mechanisms are urgently restored, preventable deaths will continue.”

Drawing on more than two decades of experience in medical malpractice litigation, Agbakoba recalled that Nigeria once operated a more functional supervisory system anchored by CMOs and Health Inspectors. According to him, that structure has largely collapsed under the current legal framework. “Today, under the National Health Act and various State Health Laws, there are no routine inspections, no systematic reporting, and no effective enforcement of professional standards,” he said.

Agbakoba also criticised the existing arrangement in which Ministers and Commissioners of Health simultaneously oversee policy formulation and regulatory enforcement, describing it as a “fundamental governance failure.” “There must be a clear separation between policy and regulation,” he argued. “You cannot be both the referee and the player.” He disclosed that his law firm is currently handling 25 medical negligence cases across the country, stressing that the Adichie incident represents only a fraction of a much wider and largely under-reported crisis in Nigeria’s healthcare system.

Questions have also been raised about how best to structure health regulation within Nigeria’s federal system. Mr Jide Falaki, Senior Vice-President, Finance and Treasurer at McKesson, United States, noted that healthcare falls under the concurrent legislative list, making states constitutionally responsible for regulating healthcare delivery within their jurisdictions. “This reality must be carefully considered in designing any national regulatory framework,” Falaki said. “Any reform must respect federalism while ensuring minimum national standards that protect patients regardless of where they seek care.” He added that effective regulation would require coordination rather than duplication, with clearly defined roles for federal and state authorities.

Clinicians working within the system say the consequences of weak regulation are evident in daily practice. Dr Ndayi Amdii, a consultant gynaecologist and fertility specialist at Bridge Clinic Fertility Centre, said consistent and timely regulation of healthcare facilities in Nigeria is long overdue. “Although in Adichie’s case there appears to be more than meets the eye, I speak from experience, having also been at the receiving end of Nigeria’s healthcare delivery system,” Amdii said.

He noted that inadequate supervision, poor infrastructure and inconsistent enforcement of standards have become normalised across both public and private facilities, with patients often bearing the cost. “Stronger regulation is not optional; it is fundamental to patient safety,” he said. “Regulation is not a luxury or a bureaucratic exercise—it is as basic as the air we breathe.”

Observers say the renewed debate presents a rare opportunity for policymakers to confront entrenched weaknesses that have long been acknowledged but insufficiently addressed. From poorly monitored private hospitals to overstretched public facilities, Nigeria’s healthcare landscape remains fragmented, with regulation often reactive rather than preventive.

For many Nigerians, the tragedy in Lagos has amplified fears that access to care does not necessarily translate into safety or quality. As public attention intensifies, experts argue that meaningful reform—rooted in transparency, accountability and independent oversight—will be the true measure of whether the health system can honour its most fundamental obligation: to protect life rather than imperil it.

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