IHR Implementation In Nigerian Law - Mapping Of Legal Authorities And Analysis Of Legislation At Federal Level

Foreword

The Nigeria Centre for Disease Control is the National Public Health Institute (NPHI) for Nigeria. Our role includes the coordination of public health functions and programs to prevent, detect, and respond to public health threats, including infectious diseases and other health events. NPHIs like NCDC contribute to compliance with International Health Regulations (IHR, 2005).Our agency is mandated by law to serve as the IHR National Focal Point for Nigeria.

As part of our IHR focal point function, NCDC works to strengthen the collaboration among Ministries, Departments and Agencies with a specific role in health security for Nigeria. We also support national accountability for IHR and contribute to strengthening the overall health system.

In 2017, the Joint External Evaluation (JEE) of our IHR capacities revealed a gap in the legislative frame­work for IHR implementation in Nigeria. However, an objective assessment of existing laws and policies had not been carried out.

In 2019, Resolve to Save Lives (RTSL) supported NCDC in reviewing Nigeria's legal framework for IHR. This included an analysis of existing laws for disease surveillance, detection and response; port health; quarantine services; food safety and others.

This document describes findings from this assessment including strengths in existing laws, gaps where they exist and recommendations to strengthen the legal framework for IHR implementation in Nigeria. It provides detailed findings, which can also serve as guidance document for countries that want to cre­ate more robust and effective national public health capacities. The success of health security activities in any country, requires a well-structured legal framework to support implementation as well as other resources.

We are grateful to all the colleagues and partners that have worked hard in the implementation of this project and delivered this excellent report.

The Nigeria Centre for Disease Control remains committed to working with other Ministries, Depart­ments and Agencies as well as our partners to ensure that Nigeria has the strong legal framework to effectively strengthen health security.

Acknowledgements

This Report focuses on a mapping and analysis of federal law and aims to makes a unique contribution to Nigeria's implementation of the International Health Regulations (2005).This Report is the result of significant support and efforts by several institutions and individuals dedicated to strengthening the implementation of the International Health Regulations (2005) Nigeria. The author of the Report would like to thank the Nigeria Centre for Disease Control and Prevention (NCDC), whose support for this project was critical to its success. Much appreciation to Dr Chikwe Ihekweazu, the Director General of NCDC, for recognizing the importance of this project and providing room to work on it, for bringing stakeholders together to support the project, and for providing the author with relevant information. The support of Safiya Musa, the Legal Adviser at NCDC, is also acknowledged. I am grateful to other team members at the NCDC: Oyeronke Oyebanji for providing information, feedback and support throughout the process, and to Chizoma Ihebuzor, for his research assistance.

I would like to highlight several interested stakeholders who participated in a meeting at the start of this project and provided insights from their work, and asked questions that helped to shape this report, including representatives from the Federal Ministry of Health, Federal Ministry of Justice, Federal Minis­try of Finance, Federal Ministry of Agriculture Research and Development (FMARD), Nigeria Agricultural Quarantine Service (NAQS), World Health Organization, the United States Centers for Disease Control and Prevention (CDC), African Field Epidemiology Network (AFENET), Pro-Health International, and Pub­lic Health England.

Much appreciation goes to the Resolve to Save Lives team for funding this research. Much gratitude also goes to the legal team. I am grateful to Aaron Schwid, legal director, for shepherding the process of putting this Report together and for his thoughtful feedback on previous drafts. Many thanks to Cedric Aperce, legal advisor, for his technical support throughout the process of working on this Report, his incisive and insightful feedback and comments on previous drafts, and his research support. Many thanks also to Christopher Lee for insightful comments on and contributions to the Report. I thank Jere­miah Omirigbe of the Nigerian Agricultural Quarantine Service for providing me with a copy of the law.

Finally, I thank Atinuke Akinsuroju, Associate at Health Ethics and Law Consulting, for research assis­tance on this Report.

Abbreviations

AG - Attorney General

CAP - Chapter

FMARD - Federal Ministry of Agriculture Research and Development

ICCPR - International Convention on Civil and Political Rights

ICESCR - International Convention Economic and Social Rights

IHR - International Health Regulations

JEE - Joint External Evaluation

LFN - Laws of the Federation of Nigeria

NAFDAC - National Agency for Food and Drug Administration and Control

NAPHS - National Action Plan for Health Security

NAQS - Nigeria Agricultural Quarantine Service

NCAA - Nigeria Civil Aviation Authority

NCDC - Nigeria Centre for Disease Control and Prevention

NDPR - Nigeria Data Protection Regulations

NEMA - Nigeria Emergency Management Agency

NFP - National Focal Point

NITDA - National Information Technology Development Agency

NPHCDA - National Primary Health Care Development Agency

NWLR - Nigerian Weekly Law Reports

PHEIC - Public Health Emergency of International Concern

POE - Point of Entry

SOPs - Standard Operating Procedures

WHO - World Health Organization

SC - Supreme Court

1. Executive Summary

Nigeria is bound by the International Health Regulations (IHR) (2005), which came into force in 2007.An analysis of Nigeria's compliance with the IHR (2005) was undertaken through the Joint External Eval­uation (JEE) in 2017 under the technical area—National Legislation, Policy and Financing. That evalua­tion indicated a poor level of performance. Based on this, certain priority actions were recommended, including a comprehensive assessment of the existing legislative and policy framework to identify gaps hindering compliance with the IHR, and on the basis of this assessment, advocating revision of legal instruments and policies to address existing gaps and challenges.¹ Following from this, the National Action Plan for Health Security (NAPHS) 2018–2022 specifies the need for 'Working towards ensuring that adequate statutory and administrative provisions for the implementation of the IHR are in place by December 2019 ...'²

This Report addresses these priority actions by providing a comprehensive assessment of legislation drawn up at the federal level. It investigates the powers of the federal government to enact laws to ensure compliance with the IHR, and the extent to which it has exercised those powers in enacting legislation.

This Report undertakes both a mapping of the current legislation at the federal level and an evaluation of how the current federal laws align with IHR requirements. In terms of structure, the Report is divided into two parts. The first part is analysis of federal powers to enact legislation relevant to IHR require­ments. Such powers are primarily contained in the Exclusive Legislative List in the Constitution of the Federal Republic of Nigeria, meaning only the national government may legislate on these topics. They are also on the concurrent lists, meaning both national and state governments may legislate within certain parameters. Such IHR-relevant matters as quarantine, shipping and aviation are exclusive legis­lative matters, and the federal government has legislated on these issues.

The second part focuses on the mapping of the relevant law and analyses of these laws, many of which have been enacted by the federal government pursuant to its exclusive legislative powers. The Quar­antine Act, based on the International Sanitary Regulations, has been in place for over 70 years. Thus, many of its provisions do not align with the provisions of the IHR of 2005, as the IHR 2005 replaced the IHR 1969 which had earlier replaced the International Sanitary Regulations. Other laws are more recent and align more closely with the IHR, such as the Nigerian Civil Aviation Regulations made under the Nigerian Civil Aviation Act, which reference the IHR specifically. Reference is also made in this Report to bills that have been before the National Assembly at different points, which though they did not and may not become law, show the necessity for ensuring harmony in all IHR-relevant legislation to promote IHR compliance.³

The evaluation of the identified laws based on the mapping is based primarily on legal assessment guides from the WHO and from Resolve to Save Lives. The guides provide a streamlined but compre­hensive way to assess the compliance of domestic legislation with the IHR, focusing on key aspects of the IHR.

The evaluation identified several gaps that need to be addressed. These include but are not limited to differences in key definitions, due in large part to dated legislation; lack of designation of points of entry in national legislation; and lack of delineation of human rights and freedoms in the context of public health emergencies, isolation and quarantine. Given the more recent enactment of the Act establishing the National Focal Point, the Nigeria Centre for Disease Control and Prevention, earlier legislation does not clearly recognize its role, leaving room (at least within the existing pieces of legislation) for con­flicts in mandate and gaps in coordination. This evaluation also finds that there are no legal provisions dealing with the communication of reports on detection, assessment and notification of public health events between competent authorities at the federal level, state and local communities. Neither are there specific legal provisions for communication between the National IHR Focal Point and WHO.

Recommendations are proffered to address the gaps identified in this Report. Some of these include suggestions on different approaches that may be taken to align Nigeria's legal framework more closely with IHR requirements and to address the gaps identified in the JEE Report, for instance: the need for new regulations especially in the area of procedures of administration of public health measures at the point of entry; the need to revise existing legislation such as the Quarantine (Ships) Regulation; and review of future legislation for closer alignment with IHR requirements. Although recommendations are made about possible approaches that may be utilized to bring Nigerian law into greater alignment with the IHR as suggested in the JEE Report and the National Action Plan on Health Security, this report and its author do not endorse any position on whether any of these pend­ing bills should or should not be passed by the Nigerian Legislature. Any recommendations for improvements to the bill are intended purely to illustrate how such bills could better align with IHR requirements.

Summary of Recommendations

The following table highlights concrete steps that the federal government would need to take to improve on IHR compliance and Nigeria's JEE scores in relation to National Legislation, Policy and Financing tech­nical area in the next assessment.

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Footnotes

1 World Health Organization, Joint External Evaluation of IHR Core Capacities of the Federal Republic of Nigeria, 2017 (Nigeria JEE 2017) https://apps.who.int/iris/bitstream/handle/10665/259382/WHO-WHE-CPI-REP-2017.46-eng.pdf?sequence=1 accessed on 6 November 2019.

2 Federal Republic of Nigeria, National Action Plan for Health Security 2018 -2022 (Nigeria NAPHS 2018-2022) https://ncdc.gov.ng/themes/common/files/establishment/5e88f9e22d2b4e4563b527005c8a0c43.pdf accessed on 6 November 2019.

3 The Public Health Bill 2013 which has elapsed and has not been reintroduced in the Nigerian Senate is one key example.

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