Fellow Nurses Africa | Lagos, Nigeria | 22 January, 2026
By FNA Admin – 22/01/226
Nigeria’s federal teaching hospitals have been shut for more than fifty-five days, leaving patients and families stranded and desperate. Health workers are exhausted, demoralized, and angry. For many Nigerians, this feels like yet another chapter in a long story of failure, another strike, another negotiation, another promise that will soon be broken.
But this crisis is not accidental, and it is not limited to the health sector. What we are witnessing is the predictable outcome of an economic system that has quietly undermined Nigeria’s ability to care for its own people.
To understand why hospitals keep collapsing and why strike action is becoming a normal labour language, we must talk honestly about debt, dependency, and who really controls national priorities. When strikes happen, the public debate usually stops at salaries:
• “Why can’t government pay?”
• “Why are workers always striking?”
• “Why is the health sector always unstable?”
These are understandable and needed questions. But they miss the deeper issue. Even if salaries are adjusted today, even if agreements are signed tomorrow, the crisis will return because the structure that produces it remains unchanged.
Nigeria’s healthcare problem is not just about money. It is about who decides how Nigeria’s money can be used. This is where the fundamental issue comes in, DEBT!
What Really Happens When Nigeria Borrows from the IMF and World Bank?
When Nigeria borrows from the International Monetary Fund (IMF) or the World Bank, it does not simply receive funds to solve problems. Nigeria enters into binding agreements known as conditionalities. These conditions shape national policy in very specific ways:
• Government spending must be restricted
• Public-sector expansion must be limited
• Subsidies must be removed
• Debt repayment must be prioritized
Crucially, health and education are always among the first sectors to be constrained. This is not a coincidence. From the lender’s perspective, hospitals and schools are “cost centres,” not revenue generators. Debt repayment, on the other hand, is non-negotiable.
The result is a system where: • Hospitals are chronically underfunded
• Equipment is outdated or unavailable
• Staff shortages worsen
• Salaries lose value to inflation
Even when national revenue rises, the first claim on that revenue is debt servicing, not public welfare, not hospital funding or education funds. Debt Servicing vs. Human Lives You must have heard government talk about debt servicing.
Nigeria now spends a staggering portion of its revenue servicing debt. This means that before government considers hospitals, schools, agriculture, or wages, it must first satisfy creditors. In practical terms, this means:
• Budgets are written to please lenders, not citizens
• Health allocations are cut or frozen
• Capital investment in hospitals is postponed indefinitely
So when health workers strike, for instance, ongoing JOHESU strike, they are not just negotiating with the Nigeria government, they are indirectly confronting an international financial architecture that has already decided how much their lives and labour are worth.
The Dollar Problem: Why Hospitals Depend on Foreign Currency
Nigeria imports almost everything its healthcare system needs, for example Diagnostic machines, Surgical equipment, Drugs and consumables, Power systems and spare parts etc. All of these are paid for in foreign currency, largely in US dollars.
This creates another layer of vulnerability and when dollars are scarce due to government misspending and corrupt practices:
• Hospitals cannot procure equipment
• Drug shortages worsen
• Maintenance stops
• Services shut down
And when the naira falls due to devaluation as one of the conditionalities that comes with borrowing dollars to fund ‘development’:
• Salaries lose real value
• Import costs explode
• Inflation erodes livelihoods
So even when hospitals are “open,” they are often not fully functional.
This is not inefficiency. It is what happens when a country imports its healthcare system instead of building it.
The Way Out
The way out of Nigeria’s healthcare collapse is not perpetual borrowing, emergency negotiations, or temporary concessions, instead, it is production. No country has ever built a strong, resilient health system by importing everything it needs and financing the gap with debt.
Functional healthcare systems are anchored in real economic foundations: local pharmaceutical production, domestic manufacturing of medical equipment, reliable power, and stable industrial employment that sustains public revenue. For Nigeria, this means refining its oil at home, producing its own medicines, building its own machines, and deliberately protecting strategic local industries until they can stand. Only a nation that produces can generate stable revenue, fund public services consistently, pay its workers without recurring crisis, and finally break free from debt dependence.
This is why the current struggle cannot be left to health workers alone. Doctors and nurses are on the front line, but the same forces shutting hospitals are crushing schools, abandoning students, idling engineers, and impoverishing workers across every sector. This is not a health-sector problem; it is a national economic failure. What Nigeria needs now is not another foreign loan, another round of negotiations, or another short-term fix that postpones collapse. It needs a collective decision to stop importing its survival and start building the systems that sustain life, dignity, and work within its own borders.
The hard truth is unavoidable, a nation governed by debt will always sacrifice hospitals and schools to satisfy creditors, no matter how loud the protests or how long the strikes. A nation that produces, on the other hand, gains the power to care for its people. The present crisis is painful, but it is also clarifying.
Nigeria stands at a fork in the road, one path leads deeper into dependency and decay, the other toward rebuilding from the ground up. There is no middle path, and there is no third option.
