A stakeholder in Nigeria’s pharmaceutical sector, Dr Kingsley Amibor, has alleged that the 1985 military decree that mandated only physicians to head the country’s health sector contributed to the persistent dysfunction in healthcare delivery.

In a detailed critique titled “Revamping Nigeria’s Health Care Sector: Undeniable Roles of Consultant Pharmacists,” Amibor said the policy change, which elevated physicians to sole leadership positions, marked the beginning of systemic decay in Nigeria’s healthcare infrastructure.

He explained that before 1985 when hospital administrators were at the helm, the country witnessed a more efficient and coordinated healthcare delivery system, but since the introduction of the military decree that made it exclusive for physicians to head the sector, peace and professionalism have eluded the country’s healthcare structure.

“During the time of hospital administrators, the country witnessed sane, proficient and efficient health care delivery. But since the ascendancy of physicians to the leadership of the health sector via the instrumentality of military Decree in 1985, that stipulated that only physicians should head the sector, peace and tranquility have eluded the sector,” he stated.

Amibor said the dominance of doctors has bred an unhealthy culture of superiority, rivalry, and marginalisation of other health professionals rather than prioritise clinical governance, which focuses on patient safety and quality care.

He insisted that all these do not augur well for optimal healthcare delivery, but could worsen already poor health indices, quality of care, and encourage capital flight.

“The current managers are more interested in projecting power, dominance trait, last man standing posturing, and winner-takes-all mentality,” he alleged.

According to him, this dysfunction is one of the driving factors behind the surge in medical tourism. “Elsewhere in the world, health care delivery is anchored on team spirit, with every professional playing his role to achieve desired patient outcomes. Little wonder that medical tourism continues to thrive, as citizens troop outside the country’s shores to access care that ordinarily should have been available in the country,” he said.

Amibor was particularly critical of the Nigerian Medical Association (NMA), accusing it of promoting a narrative that excludes other professionals from leadership and clinical relevance. He alleged that the association, instead of focusing on improving its members’ adherence to clinical governance, spends time running down other professionals while presenting physicians as the sole custodians of healthcare.

He emphasised that clinical governance, a system where healthcare professionals are held accountable for quality, safety, and patient satisfaction, requires cooperation, respect, and continuous professional development for all roles in the sector. “Ironically, here in Nigeria, NMA fumes and is piqued whenever non-medical doctors attempt to improve on their knowledge and skills, usually from their pockets.”

A current flashpoint, according to Amibor, is the NMA’s resistance to the implementation of the Pharmacists Consultant Cadre, a government-approved initiative that recognises advanced clinical training for pharmacists. “Pharmacists are not competing with doctors. We have our unique role. Any health facility without a pharmacist is simply a clinic.”

He explained that consultant pharmacists are trained in medication therapy management and clinical governance, helping patients adhere to treatment, avoid drug errors, and manage chronic conditions like diabetes and hypertension more effectively.

“Globally, consultant pharmacists are playing crucial roles in patient safety, treatment optimisation, and cost reduction. Nigeria must not lag behind, especially when countries like Ghana, South Africa, Egypt, and Sierra Leone have already embraced the model.”

Amibor urged the Federal Government not to yield to territorial objections by the NMA and emphasised the need to restore sanity and professionalism in the health sector by undoing policies that promote exclusion but focus on better patient care.