Prof Uwakwe Abugu
By Professor Uwakwe Abugu, Director General Institute of Medical and Health Law, President – Lifeline Centre for Medical and Health Rights Advocacy and Dean, Faculty of Law, University of Abuja.
As the global community advances toward the implementation of the amended International Health Regulations (IHR 2024), nations stand at a critical legal and institutional crossroads. For Nigeria, a country with a federal structure and a complex intergovernmental public health system, the challenge is particularly significant. The adoption of the amended IHR by the 77th World Health Assembly on 1 June 2024 and their imminent entry into force in September 2025 present both a formidable obligation and an unprecedented opportunity. These amendments place renewed emphasis on multisectoral governance, national coordination, and legal harmonisation, especially through the introduction of a new institutional entity: the National IHR Authority.
The establishment of this body is not optional. It is a binding requirement for all State Parties under Article 4(1 bis) of the amended IHR. This development calls for urgent introspection into Nigeria’s existing legal and institutional architecture. While the Nigeria Centre for Disease Control and Prevention (NCDC) is appropriately designated under its establishing statute as the National IHR Focal Point, there is no existing law that establishes or designates a National IHR Authority as required by the 2024 amendments. Without such a legally grounded and permanent body, Nigeria risks falling out of alignment with its international obligations, and this not only undermines its credibility on the global stage but also its capacity to mount coordinated, timely, and effective responses to public health threats at home.
The public health legal community calls on the Federal Government of Nigeria, the National Assembly, the Federal Ministry of Health, and the NCDC to work collaboratively, and without delay, to enact or amend national legislation to formally designate a permanent National IHR Authority. This authority must be politically visible, legally empowered, and strategically placed to coordinate IHR implementation across all sectors and levels of government in the country.
Understanding the Legal Evolution: From Focal Point to Coordinating Authority
The 2005 International Health Regulations, which came into force in 2007, mandated that each State Party designate a National IHR Focal Point. This was conceived as a central hub for communication with the World Health Organisation (WHO) and for disseminating information to and from domestic institutions responsible for surveillance, preparedness, and response. Nigeria complied with this mandate through the NCDC Act of 2018, which designates the NCDC as the IHR Focal Point. This statutory recognition has enabled Nigeria to build a strong operational bridge to the WHO and ensure consistent outbreak reporting, surveillance coordination, and timely risk communication.
However, the global COVID-19 pandemic exposed limitations in this model, especially the lack of high-level, multisectoral coordination capacity at the national level. Communication with the WHO—while necessary—is not sufficient to ensure domestic readiness or coordinated response. The amended IHR 2024 acknowledge this deficiency and introduce a separate, more robust institution: the National IHR Authority, tasked with coordinating the implementation of the IHR domestically, beyond the narrower role of the Focal Point.
Specifically, Article 1 of the amended IHR defines the National IHR Authority as “the entity designated or established by the State Party at the national level to coordinate the implementation of these Regulations within the jurisdiction of the State Party.” This entity is expected to:
Oversee multisectoral implementation across human, animal, and environmental health sectors (in line with the One Health approach);
Coordinate across sectors and government levels, including states and local governments;
Ensure effective resource allocation and policy integration related to IHR implementation;
Provide national political leadership and legitimacy to health security governance;
Engage with ministries beyond health—including agriculture, environment, transportation, defence, internal security, and civil aviation.
In other words, while the National IHR Focal Point manages communications with the WHO, the Authority ensures that Nigeria speaks with one voice internally and coordinates action across all branches and levels of government. These two bodies—Focal Point and Authority—may be housed within the same institution (an integrated model) or separately (a dual model), but their roles are now clearly distinguished under international law.
Nigeria’s Current Framework: Progress and Gaps
There are commendable institutional developments in Nigeria’s public health governance since the Ebola Crisis of 2014. The NCDC has established itself as a respected public health institution in Africa and beyond. It leads surveillance, outbreak response, and capacity development, and it functions effectively as the National IHR Focal Point.
Further, the pending Public Health Emergency Bill 2024, currently before the National Assembly, seeks to strengthen Nigeria’s epidemic preparedness and response capabilities. Section 5 of the bill creates a Presidential Task Force on Public Health Emergencies, chaired by the Secretary to the Government of the Federation (SGF). This multisectoral body has the legal mandate to coordinate national response measures, guide inter-ministerial efforts, and direct emergency interventions. Its structure reflects a strong potential alignment with the functions envisaged for the National IHR Authority.
Yet a closer reading reveals a critical shortcoming: the Task Force is not a standing structure. It is activated only upon the declaration of a public health emergency and ceases to function outside of those exceptional periods. The amended IHR, by contrast, requires that the National IHR Authority be a permanent body that is operational year-round and ensures continuous oversight, coordination, and implementation of IHR obligations.
This lacuna poses both a legal and institutional risk. It also limits Nigeria’s readiness and responsiveness in the critical “inter-epidemic” periods when systems must be maintained, simulations conducted, lessons learned, and reforms implemented. Emergencies do not arise in vacuums—they expose the strength or weakness of existing structures. A temporary or reactive institution cannot fulfil the obligations of a permanent, proactive National IHR Authority.
Comparative Models: Lessons from Other African Nations
Several African countries have begun to restructure their IHR coordination architecture to reflect the amended regulations. Ethiopia offers one of the clearest examples of an integrated model. Under its new legal framework, the Ethiopian Public Health Institute (EPHI) serves simultaneously as the National IHR Authority and Focal Point. The EPHI coordinates One Health activities, manages the national incident management system, and engages multisectoral actors. This model benefits from administrative coherence and efficient information flow but may lack political leverage at the highest level.
By contrast, Senegal and Côte d’Ivoire have adopted dual models. They place the National IHR Authority within the Office of the Prime Minister, where it chairs a national multisectoral health security council. The Focal Point remains within a specialised technical agency. These models elevate IHR coordination to the highest levels of political leadership while retaining technical expertise within sector-specific institutions. They provide clarity of roles, support long-term planning, and enable sustained government-wide engagement.
The Democratic Republic of the Congo (DRC), a country with a decentralised system like Nigeria’s, is establishing national and subnational coordination councils to manage epidemic and emergency risks. These councils are designed to integrate local realities into national planning and reporting—a crucial lesson for federated countries.
The comparative lesson is clear: while structural models may differ, effective IHR governance demands legal clarity, high-level political support, multisectoral coordination, and integration across government tiers. Nigeria must adapt these principles to its unique context.
Federal Considerations and the Need for Subnational Integration
The Nigerian Constitution allocates public health responsibilities across all three tiers of government. States have significant autonomy in health matters, and state-level Ministries of Health play critical roles in surveillance, immunisation, outbreak response, and emergency preparedness. Any effective National IHR Authority must therefore be able to coordinate not only across sectors at the federal level but also vertically across federal, state, and local governments.
Presently, the NCDC Act allows the agency to support states, and the proposed Presidential Task Force includes Governors. However, states have no binding legal obligation to establish or participate in IHR implementation platforms, nor is there a formal mechanism to integrate state-level IHR efforts with national coordination.
The amended IHR require that IHR implementation be institutionalised across all levels. This calls for the establishment of subnational IHR coordination mechanisms, legally linked to the National IHR Authority and capable of reporting, coordinating, and responding to health security threats at the state and local government levels.
The absence of these structures places Nigeria at a disadvantage and could lead to fragmented responses during future emergencies. The federal government must act swiftly to clarify the country’s health security legal framework, build capacity at the state level, and establish a national framework for subnational IHR coordination.
A National Call to Action: Legal and Institutional Recommendations
In light of Nigeria’s legal obligations under the amended International Health Regulations (IHR 2024), its federal structure, and the necessity of aligning with global best practices, there is an urgent need for legal and institutional reform. First, the Federal Government should prioritise the legal designation of a permanent National IHR Authority. This can be achieved either by revising the pending Public Health Emergency Bill to include explicit provisions establishing such an authority or by amending the Nigeria Centre for Disease Control and Prevention (NCDC) Act to incorporate a permanent coordination body. Alternatively, the National Assembly may consider enacting a standalone legislation that formally establishes the National IHR Authority and situates it within the appropriate structure of government to ensure political visibility and influence.
In tandem with legal designation, the government must define clear mandates and operational frameworks for the National IHR Authority. These frameworks should set out the authority’s roles, responsibilities, and legal powers, particularly in relation to the NCDC, which remains the designated IHR Focal Point. A comprehensive delineation of duties will avoid institutional overlap and promote synergy. Furthermore, there must be codified protocols for multisectoral collaboration, joint decision-making processes, and mechanisms for ensuring transparency and public accountability in the Authority’s operations.
A critical element of IHR compliance is the institutionalisation of year-round multisectoral coordination. This requires the creation or formal strengthening of existing coordination platforms that include representatives from the health, agriculture, environment, internal security, transport, and other relevant sectors. These platforms must not only exist on paper but be active throughout the year, engaging in regular coordination meetings, national simulation exercises, and strategic preparedness planning. Such mechanisms are essential to sustain intersectoral engagement beyond periods of crisis.
To ensure that IHR implementation is consistent across Nigeria’s federated governance structure, there is a pressing need to integrate subnational coordination mechanisms into the national framework. This will require amending relevant federal laws to mandate the establishment of IHR coordination platforms in each state, linked directly to the National IHR Authority. These subnational bodies should be supported by legal instruments that mandate harmonised epidemic preparedness planning, routine data sharing, and joint risk communication. Without this vertical integration, Nigeria risks fragmented implementation and uneven public health responses across its thirty-six states and the Federal Capital Territory.
At the same time, Nigeria must continue to strengthen the capacity and role of the NCDC as the National IHR Focal Point. As the central communication hub with the WHO, the NCDC must be adequately funded to maintain its operational autonomy, invest in technological infrastructure, and retain a highly skilled public health workforce. Effective communication between the NCDC, the WHO, and national stakeholders depends on the continuity, credibility, and technical strength of the Focal Point. It is essential that the institution be empowered to discharge its obligations under Articles 4 and 6–12 of the IHR without political interference or bureaucratic constraints.
Finally, no reform can succeed without the requisite political will and fiscal commitment. The integration of IHR governance should be embedded within Nigeria’s broader national development strategy and health sector financing plans. The Federal Government must ensure dedicated and predictable budgetary allocations for the National IHR Authority and other health security-related agencies in Nigeria. Long-term sustainability depends on treating health security not merely as a technical or public health issue but as a central pillar of national security and economic resilience.
Conclusion: The Cost of Inaction
The September 2025 deadline for IHR compliance is not merely a date on the calendar—it is a test of Nigeria’s institutional maturity and legal foresight. The establishment of a permanent, high-level, legally grounded National IHR Authority is both a strategic necessity and an international obligation. It is also a matter of national security.
Failure to act decisively will result in continued fragmentation, diminished credibility, and vulnerability to public health threats. The time to act is not tomorrow but today. The Federal Government, led by President Bola Ahmed Tinubu, must rise to this occasion with urgency and resolve.
This is a constitutional, legal, and moral imperative.
Source: BarristerNG
