Nigeria: Kano’s Public Health Security Bill Sets a Model for Nigeria’s Other States

In a landmark step reported on January 19, 2025, the Public Health Security Bill was signed into law by the Kano State Governor, His Excellency Abba Kabir Yusuf. The bill, which serves as a framework for public health surveillance, emergency management, and the protection of healthcare workers, is Nigeria’s first subnational Public Health Security Bill.

Back in 2017, Nigeria was rated as “not ready” to manage significant health security threats, scoring a ReadyScore of just 39% in the first Joint External Evaluation (JEE), a tool used to assess various countries’ health security capacities under the International Health Regulations (IHR) framework.

As of August 2023, Nigeria achieved significant progress by raising its JEE score to 54%. However, considerable legislative gaps remained, especially concerning the institutional legal frameworks that govern public health prevention, detection, and response mechanisms. Additionally, health security laws at the subnational level needed improvement to enhance local epidemic preparedness and align with federal and international standards.

In June 2024, the IHR was subject to amendments to address weaknesses exposed by the COVID-19 pandemic. Countries are now required to update their legal frameworks to reflect these changes, which includes establishing a National Coordinating Authority to manage multisectoral coordination during public health emergencies and primarily strengthening core capacities at the subnational level and ensuring that local governments are prepared to respond effectively to outbreaks.

Global experience has shown that well-designed legal frameworks, especially at the state level, can significantly enhance health security. If national and subnational legal reforms adequately support amendments, countries can make substantial progress in safeguarding public health.

In federated systems like Nigeria, state governments have significant autonomy to legislate and implement health policies suited to their unique needs. Therefore, subnational health security becomes essential for strengthening epidemic preparedness at all levels.

A little bit of background

While the Federal Government has been making strides to increase this score, subnational efforts are equally critical. In June 2021, a significant stride was made in Kano State, which conducted its own JEE using a version of the evaluation tool adapted for state-level assessments. The evaluation reviewed 15 technical areas of infectious disease prevention, detection, and response, achieving a score of 46%, placing it in the “Work to Do” category according to PreventEpidemics.org. This suggests efforts have been fair, but more effort was needed to strengthen epidemic preparedness and response (EPR).

To bolster the state’s effort Resolve to Save Lives, in partnership with the Nigeria Centre for Disease Control and Prevention (NCDC), the Government of Kano State, the Centre for Awareness on Good Governance and Development (CAGGAD), the Foreign, Commonwealth and Development Office (FCDO), Lafiya Nigeria, the Legislative Initiative for Sustainable Development (LISDEL), and the Global Health Advocacy Incubator (GHAI), began to develop legal reforms that align with national and international health security standards.

Federal lawyers from NCDC worked closely with state-level legal teams, providing technical assistance and guidance. A review of the state legal landscape and mapping was conducted, and the outcome indicated major gaps in the legal and regulatory framework necessary to support health security efforts. Kano State’s House of Assembly received the report and showed enthusiasm for remedying the identified gaps.

With all the partners working collaboratively and comprehensively, the state legislators developed a draft State Bill based on the gaps identified. This document provided a basis for further discussions and advocacy by other organisations. The draft aimed to provide a comprehensive, multi-sectoral approach to health security, recognising key government agencies involved in health security and their roles, drawing from key documents such as the Technical Guidelines on the Integrated Disease and Surveillance Response (IDSR), and adopting a One-Health and human rights approach.

After years of collaboration — marked by regional outbreaks, in-depth assessments, and rigorous debate — the Kano State Health Security Bill was finally passed by the Kano State House of Assembly in February 2024 and then became law in 2025.

The International Health Regulations (IHR, 2005) provide an overarching legal framework for countries to prepare for, detect, and respond to public health events that may cross international borders. These regulations, legally binding for 196 countries (including the 194 WHO Member States), emerged as a global response to historical epidemics that ravaged Europe. Under the IHR, countries have obligations, such as reporting public health emergencies and building core capacities for surveillance and response.

In Nigeria, the IHR framework shapes national health policies and preparedness strategies. A key requirement of the IHR is the designation of a National IHR Focal Point to facilitate communication with the WHO. Nigeria fulfils this role through the Nigeria Centre for Disease Control and Prevention (NCDC), which was formally established by the NCDC Act of 2018.

In June 2024, the IHR underwent critical amendments to address weaknesses exposed by the COVID-19 pandemic. Countries are now required to update their legal frameworks to reflect these changes, which include establishing a National Coordinating Authority to manage multisectoral coordination during public health emergencies and primarily strengthening core capacities at the subnational level, ensuring that local governments are prepared to respond effectively to outbreaks.

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Next Steps: Critical actions for implementation

While passing the Bill is a significant achievement, several key actions must be taken immediately to ensure its effectiveness:

1. Establishing effective frameworks for implementation: Practical guidelines and operational frameworks are needed to support the implementation of the new law. This includes identifying clear roles, responsibilities, and reporting structures for various stakeholders.

2. Awareness and sensitisation campaigns for stakeholder buy-in: Building awareness and fostering multisectoral collaboration is essential for the law’s success. Engaging government agencies, health workers, community leaders, and civil society organisations will create ownership and promote compliance.

3. Encouraging other states to replicate Kano’s process: Kano’s success provides a model for other states to follow. Sharing lessons learned through advocacy efforts and technical assistance will encourage similar health security initiatives across Nigeria, contributing to national health security.

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