By Chioma Obinna

The Pharmaceutical Society of Nigeria, PSN, at the weekend issued a formal appeal to President Bola Ahmed Tinubu, urging for a more balanced and circumspect approach to political appointments in the nation’s health sector.

In a letter addressed to the President, and jointly signed by the PSN President, Pharm. Ayuba Ibrahim Tanko, and the National Secretary, Pharm. Gafar Madehin, the PSN expressed concerns about the overwhelming dominance of physicians in key health-related appointments, noting the negative implications the trend has on the multidisciplinary nature of healthcare in Nigeria.

“We wish to convey our compliments of the season and our sincere prayers for Your Excellency’s health and wisdom as you continue to steer the ship of the Nigerian State.”

The letter tagged: “An Appeal For More Circumspection in Appointments in The Health Sector” addressed the mounting concern regarding appointments within the Ministry of Health and other related agencies since June 2023.

Noting that the health sector is multidisciplinary, the PSN highlighted what they see as an alarming trend as nearly all key positions within the Ministry of Health and its agencies are being occupied by physicians.
“Almost all the appointments in the Health Sector… have gone to only one profession (Medicine), to the extreme detriment of all other healthcare professions,” the letter reads.

The PSN noted that this has created a significant imbalance, particularly given the mandate of the Honourable Coordinating Minister of Health and Social Welfare, Professor Ali Mohammed Pate, to build and harmonise and sustainable healthcare workforce.

The PSN pointed to numerous examples to underline their concerns. These included the appointment of two physicians as ministers in charge of the Federal Ministry of Health, four other physician ministers in other federal ministries, and the appointment of a physician as the National Coordinator of the Presidential Initiative for Unlocking the Healthcare Value Chain (PVAC).

The PSN was especially critical of appointments in agencies that directly affect the practice of other health professionals.
“The Chairman of NAFDAC, NHIA, and more than 90 per cent of MDAs that have been constituted are all physicians,” they noted.
The letter further pointed out that all Vice-Chancellors of Nigeria’s universities of health sciences are physicians, further illustrating the profession’s overwhelming presence in key decision-making positions within the healthcare sector.

Calling for balance and fair representation, the PSN in the letter acknowledged the President’s constitutional prerogative to make political appointments, stressing the need for greater circumspection in these decisions.

“We solicit that a lot more circumspection is brought to bear in making these appointments. It is worrisome that even areas that should not be considered as preserves of physicians are ceded to them,” they stated.

The PSN specifically criticised the appointment of physicians to leadership roles in agencies such as the National Agency for Food and Drug Administration and Control, NAFDAC, which is primarily concerned with pharmacy practice and drug management.

“NAFDAC, an agency that specialises in pharmacy practice and drug and food management, should not be headed by a physician,” PSN argued.

Further raising alarms, the PSN pointed to the appointment of Dr. Ibrahim Oloriegbe as the Chairman of the National Health Insurance Authority (NHIA), a position that the PSN believes is unsuitable for someone with such a controversial history.

They argued that Oloriegbe, a former senator, was involved in a failed bill that sought to restrict the use of the title “doctor” within Nigerian hospitals to only physicians.

The PSN argued that such appointments, combined with others under the leadership of physicians, have led to a failure in managing Nigeria’s social health insurance system.

“As of now, Nigeria’s health insurance coverage rate has plummeted from about 20 per cent in 2010 to a dismal 1.72 per cent in 2017. This underperformance cannot be divorced from the leadership styles of previous physician-led administrations.

“How will Nigeria ever attain Universal Health Coverage, UHC, if Social Health Insurance which is a major condition precedent globally acclaimed is managed by people who have never appreciated consensus building in health management,” the letter asserted. On the threat of the NHFRA Bill, the PSN said it has raised issues over the proposed National Health Facility Regulatory Agency (NHFRA) bill.”

They said the bill, which was orchestrated by former Minister of State for Health Dr. Tunji Alausa and current Minister of State for Health Dr. Iziaq Salako, has raised concerns about professional domination in the health sector.

The PSN claimed that the bill was designed by a team of 15 physicians and only three non-physicians, and that its goal was to restore privileges that physicians had been unable to secure through the National Health Act of 2014.

The PSN warned that the NHFRA bill would undermine the leadership and regulatory power of other healthcare professionals and could lead to further professional marginalization.

“That draconian and vengeful bill which was conceived by the representative templates of Physicians was oiled by the unholy professional domination of the leadership of the FMOH by Physician-Ministers, Special Advisers and a Director of Hospital Services who is more of an employee of umbrella-template of physicians in output.

“Your Excellency, the NHFRA draft bill which was concocted by a team of 15 physicians and 3 non-physicians is designed to restore all the undeserved privileges physicians could not get through the National Health Act -2014 and it actively seeks in spirit to get the enabling Acts of the other 12 professional regulatory Councils apart from the Medical and Dental Council of Nigeria to be repealed when the content is appraised albeit critically.
This bill was finalised for submission to the Dr Iziaq Salako on Friday, March 28, 2025,” they claimed.

The PSN appealed to the President for a more equitable approach to appointments, akin to the structure seen in other sectors like Building and Works, where professionals such as architects, engineers, and surveyors work in tandem, with each discipline’s privileges respected.

“The health sector, like any other sector, is multidisciplinary. We must respect the diversity and contributions of all professionals in the sector, from pharmacy to nursing, to ensure a more inclusive and efficient healthcare system.”

Affirming PSN’s commitment to help to stabilise Nigeria’s health system, which they argued has been underperforming due to unbalanced leadership, they said: “We assure Your Excellency that the PSN will continue to provide building blocks for the stability of the health system.”