Nigeria’s resident doctors commenced an indefinite nationwide strike at midnight today, a decision they describe as inevitable following repeated federal government failure to honor promises made after several rounds of dialogue. The strike is expected to paralyse activities in government owned hospitals across the country, and it comes at a particularly vulnerable moment for a healthcare system already hemorrhaging medical professionals to better opportunities abroad.
Dr. Muhammad Suleiman, president of the Nigerian Association of Resident Doctors (NARD), announced that the decision was reached after a five hour emergency meeting of the association’s National Executive Council last week. What distinguishes this strike from the routine labor disputes that plague Nigeria’s public sector is the sheer accumulated weight of broken promises. There are allowances pending for over two years, some for 18 months, seven months, four months, and even as far back as 10 years, according to Suleiman, who added that the basic salary of doctors in Nigeria has not been reviewed for 16 years.
That’s not a typographical error. Some doctors are owed allowances that predate the COVID pandemic, the #EndSARS protests, multiple election cycles, and several finance ministers. It speaks to institutional dysfunction that extends far beyond simple budget constraints.
The federal government owes medical personnel an estimated N38 billion in accumulated allowances and arrears, a figure that would be staggering in any context but becomes particularly troubling when considering that unpaid healthcare workers are expected to provide life saving care to citizens while their own financial situations deteriorate. Several hospitals continued to operate under poor conditions due to lack of funding and inadequate staffing, creating a situation where doctors are simultaneously underpaid and overworked, a combination guaranteed to drive talented professionals out of the country.
The association presented 19 demands it describes as minimum expectations, a characterization that suggests these aren’t aspirational requests but basic necessities for functional healthcare delivery. Key demands include immediate payment of the outstanding 25 to 35 percent Consolidated Medical Salary Structure (CONMESS) arrears and the 2024 accoutrement allowance, settlement of all pending financial entitlements owed to doctors and other health workers, and reinstatement of five resident doctors dismissed from the Federal Teaching Hospital in Lokoja with full payment of their outstanding salaries and allowances.
Others include implementation of a humane working hours policy in line with international best practices, greater autonomy for hospital chief executives to hire replacements under the one for one replacement policy, and payment of specialist allowances to all doctors and correction of entry level placements. The association also called for urgent completion of the Collective Bargaining Agreement Committee’s work on the overdue review of CONMESS and related allowances.
The timing of this strike matters. It arrives three years into President Bola Tinubu’s administration, which has faced criticism for economic policies that have dramatically increased inflation and cost of living while wages stagnate. Suleiman emphasised that this is the first total strike declared by the association in three years, suggesting NARD has exercised considerable restraint even as conditions worsened.
The NARD president acknowledged awareness of the pains and inconveniences that accompany any disruption in healthcare services, expressing deep regret about the situation. But that regret hasn’t prevented action, because the alternative, continuing to work without payment or recognition while watching colleagues emigrate to countries that value their skills, has proven unsustainable.
Demands include issues of excessive workload, fair remuneration, payment of arrears, improvement of working conditions, adequate staffing, and provision of essential medical infrastructure, all of which directly impact the quality of healthcare delivered to Nigerians. A nation’s health system can only be as strong as the hands that sustain it, Suleiman noted, adding that if the doctors are broken, under motivated, or forced to seek survival abroad, the patients suffer most.
That’s the core issue driving this strike. Nigeria’s brain drain in the medical sector has reached crisis proportions, with thousands of doctors and nurses relocating to the United Kingdom, United States, Canada, and other countries where their qualifications translate into liveable wages and functional healthcare systems. The dismissal of five resident doctors from the Federal Teaching Hospital in Lokoja, which NARD is demanding be reversed, exemplifies institutional insensitivity to workforce retention during a period when every lost doctor represents irreplaceable clinical capacity.
Among grievances are unpaid arrears from the 25 and 35 percent upward review of CONMESS, which the government promised to settle by August 2025. That deadline passed months ago, another broken promise in a long series. NARD also expressed anger over non payment of promotion arrears and the 2024 accoutrement allowance, despite multiple assurances from the Ministry of Health.
NARD also decried the downgrading of newly employed resident doctors from CONMESS three Step three to CONMESS two Step two, resulting in reduced earnings and unpaid salary arrears in several federal hospitals. This downgrading of entry level positions means young doctors who’ve completed medical school and are beginning their careers earn less than predecessors, making an already difficult profession even less attractive to new entrants.
Resident doctors employed by the Federal Capital Territory Administration have issued notice to join the strike, expanding the action beyond just federal institutions. The FCT doctors stressed that they would continue their indefinite strike action until all demands peculiar to their centre have been satisfactorily met, even if NARD suspends or calls off its national strike. That independent stance suggests frustration has reached levels where local chapters are prepared to act unilaterally if necessary.
Resident doctors form the backbone of clinical care in Nigerian hospitals, handling most ward rounds, emergency room coverage, and surgical procedures under supervision. The strike is expected to cause severe disruption in patient care, especially in emergency, surgical, and maternal health units. Teaching hospitals, federal medical centres, and specialist facilities will be hardest hit, potentially forcing patients who can afford it to seek private healthcare while those who can’t either forgo treatment or risk traveling to facilities still operating.
NARD called on Nigerians, including patients, civil society groups, labour unions, religious and traditional leaders, and every citizen of conscience, to stand with them and add voices to appeals urging the federal government to do the right thing. That appeal for public support recognizes that strikes only succeed when citizens understand the underlying issues and pressure government to act.
Appealing directly to President Bola Tinubu, Suleiman called for urgent intervention to avert a total collapse of healthcare services across Nigeria. Whether that appeal receives serious attention or gets dismissed as another labor dispute remains to be seen, but the pattern of ignored grievances and broken promises suggests optimism would be misplaced.
This isn’t Nigeria’s first rodeo with healthcare worker strikes. The country has experienced multiple physician strikes over the past decade, each following a similar script: doctors issue ultimatums, government promises action, deadlines pass with minimal progress, strikes commence, services collapse, government and doctors negotiate, agreements are reached, doctors return to work, implementation stalls, and the cycle repeats. That pattern has become so predictable it’s almost ritualistic, with both sides playing familiar roles while patients suffer the consequences.
What makes this strike particularly concerning is the erosion of hope that negotiations will lead to sustained change. When allowances remain unpaid for 10 years and basic salaries go unreviewed for 16 years, it signals systemic failure rather than temporary financial constraints. It suggests either unwillingness or inability to prioritize healthcare funding, and neither explanation offers much comfort to patients depending on public hospitals.
The economic context matters here. Nigeria is facing its worst economic crisis in a generation, with inflation above 30 percent, the naira dramatically devalued, and fuel subsidy removal triggering cost increases across all sectors. Government revenue hasn’t kept pace with obligations, creating genuine fiscal constraints. However, those constraints haven’t prevented spending on other priorities, from presidential jets to legislative allowances to security votes that disappear into opaque accounts. The question isn’t whether Nigeria can afford to pay doctors but whether it chooses to prioritize healthcare over other expenditures.
International observers watching Nigeria’s healthcare sector collapse see it as symptomatic of broader governance challenges. A country with roughly 200 million people, significant oil revenues, and economic potential matching its demographic size shouldn’t struggle to maintain functional hospitals and retain medical professionals. That it does speaks to priorities misaligned with public welfare, institutions captured by political interests, and accountability mechanisms too weak to compel performance.
For patients facing medical emergencies during this strike, options are limited and mostly grim. Private hospitals remain operational but charge fees beyond what most Nigerians can afford. Mission hospitals and clinics run by religious organizations may pick up some overflow, but they lack capacity for serious cases requiring specialized care or surgery. Some patients will delay treatment, hoping the strike resolves quickly. Others will suffer complications or die from conditions that would be treatable if hospitals were functioning normally.
The government’s response in coming days will reveal whether leadership genuinely cares about healthcare delivery or views it as just another budget line to be minimized. Quick mobilization of funds to meet at least some demands would signal recognition that healthcare workforce retention matters. Prolonged standoff with hardline statements about discipline and budget constraints would confirm that doctors rank low on the priority list, accelerating emigration and deepening the crisis.
The latest decision marks yet another confrontation between NARD and the federal government, following a series of strikes in recent years over similar issues of unpaid entitlements, poor working tools, and mass brain drain in the sector. Each strike chips away at public confidence in government healthcare while pushing more talented professionals to seek opportunities abroad, creating a downward spiral that becomes harder to reverse with each passing year.
Nigeria’s healthcare system was fragile before this strike. Afterward, assuming it eventually ends through negotiated settlement, it will be even weaker unless genuine structural reforms accompany whatever financial commitments get made. That requires political will that hasn’t been evident in past negotiations, making it difficult to envision a breakthrough that would justify doctors’ sacrifices during this industrial action.
For now, hospital wards are emptying of resident doctors, patients are being turned away or referred elsewhere, and another chapter in Nigeria’s chronic healthcare crisis is unfolding in predictable fashion. The only surprise would be if this time proves different, if government actually follows through on commitments, if allowances get paid and conditions improve enough to slow the exodus of medical talent. History suggests skepticism is warranted, but perhaps desperation will finally force the accountability that routine negotiations have failed to produce.
