The Nigerian Medical Association (NMA) has issued a 21-day ultimatum to the Federal Government to address longstanding issues affecting the country’s healthcare sector or face a possible nationwide strike.

Speaking in an interview, NMA President Bala Audu said the association’s demands are not new but are based on already approved agreements that remain unimplemented, especially concerning doctors’ remuneration, arrears, and the health workforce crisis.

Audu explained that the core of the NMA’s advocacy has been focused on retaining Nigeria’s health workforce, which has been severely depleted due to the mass exodus of professionals a phenomenon commonly referred to as the japa syndrome. “Healthcare delivery is manpower intensive and physician-driven. The workforce must be motivated to deliver quality care,” he stressed.

Among the NMA’s demands are:

• Withdrawal of a recent circular issued by the National Salaries, Incomes and Wages Commission (NSIWC), which allegedly reduced allowances for senior consultants without due consultation or input from the Ministry of Health or stakeholders.
• Immediate settlement of 18 months’ salary arrears that have already been approved by President Bola Tinubu but remain unpaid.
• Reactivation of a long-overdue collective bargaining agreement (CBA) process, with the last review dating back over a decade.
• Implementation of presidential waivers allowing health institutions to recruit critical clinical staff, which Audu says are being stalled by administrative bottlenecks.
• Full rollout of policies such as the retirement age extension to 70 for healthcare workers involved in direct patient care.

Audu criticised the NSIWC for issuing a new circular “unilaterally,” ignoring NMA’s objections and concerns. He accused the commission of failing to involve the Ministry of Health or allow a negotiation process that could have addressed the discrepancies.

“Beyond taxes, the circular reduced allowances for senior consultants who are already leaving this country. That’s unacceptable,” he said, warning that continued neglect could lead to the collapse of the country’s healthcare system.

Although there have been discussions with the Minister of State for Health, Audu noted that no formal engagement has taken place with the Federal Ministry of Health directly. However, he expressed hope that progress would be made before the expiration of the ultimatum.

“We don’t want the system shut down. But if we are pushed to the wall, we will act. Our demands are straightforward and already approved we are only asking for implementation,” Audu stated.

The NMA president lamented that despite a presidential waiver on hiring, health institutions have not received clearance to recruit more doctors. Meanwhile, the lack of specialist training opportunities is pushing more young medical graduates to seek education and jobs abroad, compounding the workforce crisis.

The NMA has warned that it does not wish to shut down healthcare services but urged the government to act swiftly to avoid industrial action. “The policies are there, the approvals are there what’s missing is commitment and implementation,” Audu concluded.

The ultimatum, issued on July 2, expires in late July. If no resolution is reached by then, Nigeria could face a major health sector shutdown at a time of already strained services and mass medical brain drain.