By Barau Simon (Dantani Jr)
When he took office as the Minister of Health and Social Welfare Prof. Muhammad Ali Pate made a bold promise: to “Save Lives, Produce Health, and do it for all Nigerians.
But as bold as his promises are and were, the decline of the Nigerian health sector, as well as the dwindling of it, has shown that the Minister’s assertion while taking office was just mere words and rhetoric and has not at any point translated into realities and achievements of any sort.
A cursory look at the just-verbalized four-pillar agenda he dished out to revamp the health system shows that, rather than delivering, the health system has been in a comatose state.
What he promised and what the reality is at the moment:
He promised the health governance and synergy, pledging to coordinate the three tiers of government, the health sector has continued to battle a historical lack of synergy between federal, state, and local governments, fragmentation has been the word that is existing in this sector, as it is this has brutally hampered primary healthcare (PHC) delivery, resulting in overloaded tertiary hospitals, poor funding, and inadequate supply of medical staff and supplies across rural communities.
On the ground, realities prove that the “lack of synergy” remains an ongoing hurdle, which is a slap on the minister’s promise of health governance synergy. Under him, stakeholders have often pointed out that needs assessments of the community are hardly or not even synchronised, an act that has led to duplications in some areas and complete neglect of medical facilities in others.
Again, he promised Primary Healthcare (PHC) and Maternal Health, the minister’s assertion to focus on expanding and revitalizing grassroots primary care to ensure basic services—such as routine vaccines and maternal health facilities—are available to everyone has remained a mirage; nothing has been achieved further than what was achieved in the previous governments.
As of today, the primary healthcare (PHC) system in Nigeria is relentlessly constrained, with only about 20% of the over 30,000 PHC facilities deemed fully functional. There is little or no funding, and the continuous massive brain drain of medical professionals, dilapidated infrastructure, and severe shortages of essential drugs and medical equipment remain unchanged.
The case of six in ten Nigerians lacking access to quality primary health care service remains as it is, there has not been any improvement under the current minister and with the basic primary facilities lacking delivery tools, emergency interventions, and skilled midwives, treatable pregnancy complications regularly turn fatal, particularly for women and newborns in rural communities, and so far so long, maternal and child mortality has remained even high more than the way it is before he took saddle on the position as the minister.
Suffice to say that the Nigerian health sector, under the Coordinating Minister of Health and Social Welfare Prof. Muhammad Ali Pate, instead of soaring high like what he promised when he took office, is rather plummeting, and this is shown in terms of severe infrastructural decay, paralyzing labor strikes, and systemic vulnerabilities that have continued.
Key areas that show failure in the health sector under Ali Pate
Decay of Facilities
Little or no funding has left tertiary health institutions brutally derelict, as seen in the dilapidation of diagnostic and laboratory facilities within them, which has shifted the weight of apt medical investigations to costly private hands.
Labour Strike and Crisis of Human Resources
There have been a series of strikes embarked by health workers and medical personnel under Ali Pate as Minister of Health. More so, there have been obnoxious policies that have exacerbated the human resource crisis and sped the “brain drain” of medical professionals leaving the country in droves.
They are as follows;
Non-payment of Entitlements: The health sector has been plagued by incessant and interminable strikes by medical workers, including the Nigerian Association of Resident Doctors (NARD), the Joint Health Sector Unions (JOHESU), demanding the implementation of the Consolidated Health Salary Structure (CONHESS).
The Minister’s “No Work, No Pay” Policy: Under the Minister’s leadership, his ministry enforced an abhorrent rule of a “no work, no pay” for striking health professionals, a posture health sector critics argued has worsened the human resource crisis and sped the “brain drain” of medical professionals leaving the country in their numbers.
Professor Muhammad Ali Pate’s enforcement of the “no work, no pay” rule for striking health workers—particularly during the prolonged 2025–2026 Joint Health Sector Unions (JOHESU) industrial action over the Consolidated Health Salary Structure (CONHESS)—severely disrupted public healthcare delivery.
Service Disruption: The policy failed to deter unions like JOHESU, which represents roughly 85% of the healthcare workforce. Workers continued their strike, forcing public hospitals to close or operate at heavily reduced capacities, leading to delayed treatments, postponed surgeries, and compromised patient care.
Worsening Brain Drain: Financial pressures, combined with a lack of hazard allowances and delayed wage negotiations, are accelerating the exodus of vital health workers. This “japa” wave leaves the remaining public hospitals critically understaffed.
Deteriorating Sector Morale: The enforcement of this rule—which was applied to some unions but selectively missed for others—has bred feelings of marginalization and institutional disrespect. Experts warn that these execution gaps and disputes undermine trust in the government’s ability to manage health system reforms.
Increased Out-Of-Pocket Costs: With public hospitals paralyzed by these labor disputes, vulnerable Nigerians have been forced to bear the high, out-of-pocket costs of seeking care at private clinics.
The hidden cost of these prolonged labor disputes ultimately cripples the population’s access to care, with citizens bearing the brunt of the instability.
How Health Policies Are Fragmentally Executed As Gaps Exist In Policy Implementation
Feeble and Weak Execution: for instance, health sector Groups like Corporate Accountability and Public Participation Africa (CAPPA) have mentioned failures to execute health funding policies as a reason for frequent expenses and overdue care for patients.
Struggles within the State Level: Despite policies being made, the Nigerian Health sector critics are of the view that even with reforms and policies, little or nothing has been implemented successfully in the states.
Continuous Brain Drain Syndrome Under The Minister
In February 2025, the Minister of Health for the State, Professor Iziaq Salako, reechoed what his boss, Professor Ali Pate, has consistently said of stopping the brain drain syndrome, popularly known as japa syndrome.
But the reforms under the Minister of Health Professor Ali Pate have failed to arrest or stop the japa syndrome, even with targets to increase local medical manpower and retain professionals. Persistent inflation, poor remuneration, and challenging working conditions have continued to drive record numbers of Nigerian health workers to migrate.
Critics and unions argue these measures do not address the root causes of the japa wave, they said poor foundational salaries and systemic lack of infrastructure continue as the primary drivers of the brain drain.
Non-payment of entitlements, policy somersault has continued to cause industrial actions by health and medical personnel.
Timeline of strikes under the current Minister of Health
Under the tenure of the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, the Nigerian Association of Resident Doctors (NARD) engaged in a prolonged strike in late 2025 and issued several ultimatums in 2026 over unfulfilled welfare and allowance agreements.
The timeline of major NARD industrial actions and agreements under his administration includes:
•July 2023: NARD embarked on a nationwide, indefinite strike over unfulfilled salary and allowance demands. The action lasted until mid-August.
In November 2023, President Bola Tinubu approved the waiver of the “No Work, No Pay” order against the doctors.
•September 2025: NARD issued a 30-day ultimatum to the Federal Government regarding lingering welfare issues, specifically the non-disbursement of the 2023 Medical Residency Training Fund and unpaid arrears.
•November 1, 2025: Following the expiration of ultimatums, NARD began a “total, comprehensive and indefinite” nationwide strike over overwhelming workloads, unpaid salary arrears, and poor hospital infrastructure.
•November 29–30, 2025: NARD signed a 19-item Memorandum of Understanding (MoU) with the Federal Government. The union’s National Executive Council voted to suspend the 29-day strike to allow government ministries to fulfill commitments.
•January 12, 2026: NARD resumed its indefinite strike, citing the Ministry of Health’s failure to implement provisions from the November MoU (such as correcting professional allowance errors and reinstating dismissed union leaders in Lokoja) and the enforcement of a “no work, no pay” policy.
•February 2026: The broader health sector experienced significant friction, as JOHESU embarked on a strike.
•April 7, 2026: NARD initiated another nationwide indefinite strike due to protracted pay disputes and the government’s attempts to halt the newly revised Professional Allowance Table (PAT).
•April 8, 2026: Following high-level interventions by Vice President Kashim Shettima and Minister Pate, NARD suspended its indefinite strike after the government committed to restoring the revised allowance table.
Under Professor Ali Pate as Health Minister, the Joint Health Sector Unions (JOHESU) embarked on two major industrial disputes and other ones all these are primarily driven by demands for the implementation of the adjusted Consolidated Health Salary Structure (CONHESS) and other welfare packages.
A timeline of these actions:
•June 2023: Health workers embarked on a 12-day nationwide strike. The action was suspended after a direct intervention by President Tinubu, who requested a 21-day timeline to resolve the unions’ demands. [1]
•November 2025 – February 2026: Following prolonged stalemates regarding the full implementation of the adjusted CONHESS, JOHESU declared an indefinite nationwide strike on November 15, 2025. The strike paralyzed public tertiary and secondary health institutions nationwide.
•January 2026: The Federal Government invoked the “No Work, No Pay” policy in an attempt to force striking health workers back to their duties, a move the union strongly resisted.
•February 2026: Following successful conciliation meetings in Abuja with the Federal Ministry of Health and Social Welfare, JOHESU officially suspended their 84-day nationwide strike on February 6, 2026.
Also under him, the National Association of Nigerian Nurses and Midwives (NANNM) has embarked different strikes action over disputes that centers on salary structure adjustments, inadequate staffing, and unpaid allowances.
A detailed timeline of these actions is as follows:
July–August 2025: Nationwide Warning Strike
•July 14, 2025: Nurses issued a 15-day ultimatum to the federal government citing poor remuneration, staff shortages, and unresolved welfare issues. [1, 2]
•July 30, 2025: Following the expiration of the ultimatum, nurses commenced a 7-day nationwide warning strike that temporarily paralyzed health services at 74 federal hospitals, state facilities, and primary health centers. [1, 2]
•August 3, 2025: NANNM suspended the warning strike after the federal government signed a Memorandum of Understanding (MoU) with agreed-upon timelines for addressing key demands, including the gazetting of a new scheme of service and finalizing the upward review of allowances.
Mid-2026: Continued Unrest and Negotiations
•May–June 2026: Lingering distress over delayed allowances, coupled with Nursing and Midwifery Council of Nigeria (NMCN) certificate delays, continued to generate unrest in the sector. Negotiations over the new allowance structures and demands to implement full agreements remain ongoing, with unions frequently warning of further industrial action to press home their demands.
Grants Received
As the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, Nigeria has received and facilitated over $4.6 billion in foreign health grants and investments. Key international funding received under his tenure includes:
• Global Fund: An allocated $933 million grant for the implementation period spanning across 2024 to 2026 to combat HIV/AIDS, tuberculosis, and malaria.
• United States Government: A nearly $2 billion grant commitment to support Nigeria’s health priorities, specifically focusing on antiretroviral therapies, malaria, and maternal/child health.
• International Investment & Localization: Over $5.5 billion in foreign investments have been secured to build local pharmaceutical and healthcare manufacturing capacity, including financing from the European Investment Bank and Afreximbank.
Despite grants received, cases such as Malaria, Tuberculosis has remained high. Nigeria remains vulnerable to recurring disease outbreaks, exposing the weakness of its healthcare system.
Nigeria’s health sector remains fragile despite the Minister’s so much talk of bold promises and what he has achieved under the sector that are nowhere to be seen.
Even with his policy and reforms the persistence of challenges still rearing their ugly heads health sector raises questions about his capacity to improve healthcare in Nigeria as he has claimed he will do.
For instance at the 2025 Strategic Health Summit, health advocates assessed the sector’s progress and acknowledged that significant gaps persist.
Ali Pate’s approach to healthcare sector where he superintend as the Minister has become a mix of broken promises and penny-pinching. The consequence is simple and brutal. For Nigerians, visiting a public hospital has become a gamble. Will you see a doctor? Will the lab be open? Will the nurse be available? Will the strike still be on?
And even if you are lucky, you are likely to meet exhausted professionals carrying the weight of a system that refuses to support them.
This is the state of our public healthcare under the current Minister.
