Reflections on Nigeria's Public Health Administration: A tribute to Dr Oluwatoyin Salawu Public health is, at its heart, about protecting communities before illness becomes a crisis. It is about preventing disease, detecting outbreaks early, strengthening health systems and ensuring that the most v…
Reflections on Nigeria's Public Health Administration: A tribute to Dr Oluwatoyin Salawu
Public health is, at its heart, about protecting communities before illness becomes a crisis. It is about preventing disease, detecting outbreaks early, strengthening health systems and ensuring that the most vulnerable are not left behind. In Nigeria, these responsibilities have evolved through successive generations of public health practitioners who have confronted epidemics, built institutions, trained health workers and shaped policies under often difficult circumstances.
The establishment of the Nigeria Centre for Disease Control and Prevention (NCDC) in 2011 represented an important milestone in that evolution. The agency emerged from existing structures within the Federal Ministry of Health, including the Epidemiology Division, the Avian Influenza Project and its laboratories, and the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP). The NCDC Act strengthened its legal framework when it was signed into law in November 2018.
The NCDC's mandate includes disease surveillance, outbreak preparedness and response, laboratory development, public health research and support to states in managing outbreaks and public health emergencies. These functions reflect decades of experience with infectious diseases and other health emergencies in Nigeria. From cholera, cerebrospinal meningitis, yellow fever, measles and smallpox to Lassa fever, HIV/AIDS, Ebola, mpox and COVID-19, Nigeria has repeatedly had to mobilise scarce resources and limited human capacity to confront threats to public health.
Many of these challenges are compounded by poor access to safe water and sanitation, flooding and heavy seasonal rainfall, insecurity and displacement, and inadequate health-sector financing. Nigeria has also depended substantially on international partners and development agencies for support with vaccines, disease surveillance, institutional strengthening, research and capacity building. That dependence has become an increasingly important policy question.
Recent reductions and disruptions in international health assistance have exposed the vulnerability of health programmes that rely heavily on external financing. The World Health Organisation (WHO) reported in 2025 that sudden reductions in external health assistance were already disrupting health services, disease surveillance, emergency preparedness and the health workforce in many low- and middle-income countries. The WHO has consequently urged countries to accelerate the transition towards sustainable domestic financing and greater self-reliance.
For Nigeria, the lesson is clear: international partnerships remain valuable, but they cannot indefinitely substitute for strong domestic institutions, political commitment, and sustainable public financing.
The 2001 Abuja Declaration set a target of allocating at least 15 per cent of annual national budgets to health. More than two decades later, many African countries still find the target difficult to achieve. Against this broader history of Nigeria's public health struggles and achievements, we should remember the men and women who helped build the foundations of the system we have today.
During the colonial era, several Nigerian medical practitioners made pioneering contributions to public health, particularly in Lagos and southern Nigeria. Dr Orisadipe Obasa (1863–1940) played an important role in public health campaigns in Lagos and the interior of southern Nigeria after returning from medical training in Britain. Dr Oguntola Odunbaku Sapara (1861–1935), a Yoruba physician of Sierra Leonean descent, became particularly well known for his campaign against smallpox. His work reflected the difficult intersection between modern medicine, traditional beliefs and public health in colonial Nigeria.
Dr Isaac Ladipo Oluwole (1892–1953) was appointed in 1925 as the first African Assistant Medical Officer of Health in Lagos and later became Medical Officer of Health for Lagos Colony. He established the School of Hygiene at Yaba, where sanitary inspectors were trained, and helped improve sanitation, vaccination, and disease control in Lagos.
The history of smallpox control also illustrates the complexity of public health in colonial Nigeria. Among the Yoruba, smallpox outbreaks had traditionally been associated with Ṣọ̀pọ̀na, the deity linked to the disease. The British colonial administration eventually prohibited the public worship of Ṣọ̀pọ̀na in Lagos in 1907. Contemporary accounts also alleged that some priests were deliberately spreading smallpox scabs to preserve their influence.
Whatever one's interpretation of those historical events, they demonstrate how public health interventions have often had to navigate medicine, culture, belief and authority simultaneously.
In post-independence Nigeria, another generation of public health leaders continued this work. Prof. Adetokunbo Oluwole Lucas (1931–2020) became an internationally recognised authority on tropical diseases. His work in public health, research and international health helped advance the development and delivery of interventions against diseases including malaria, leprosy and river blindness.
Prof. Umaru Shehu (1930–2023), a distinguished public health physician and academic, held senior positions at several Nigerian universities and contributed significantly to immunisation and polio eradication efforts. His career also included extensive engagement with the World Health Organisation and other national and international health institutions.
Prof. Olikoye Ransome-Kuti (1927–2003), Nigeria's Health Minister from 1985 to 1992, was internationally respected for his contribution to primary healthcare and immunisation.
A renowned paediatrician and teacher, he brought a strong public-health perspective to national health administration and policy. Prof. Oyewale Tomori, a former President of the Nigerian Academy of Science, has made major contributions to virology, disease prevention and control. His work with the World Health Organisation, particularly in polio eradication and laboratory systems, has had a lasting impact on public health in Nigeria and across Africa. Prof. Muhammad Ali Pate, Nigeria's current Coordinating Minister of Health and Social Welfare, is another Nigerian public health physician whose career has combined clinical medicine, health policy, global health leadership and health-system reform. His international experience includes work with the World Bank and Harvard University. Dr Gabisiu Ayodele Williams (1937–2018) held several important public health positions, including Medical Officer of Health, Lagos Chief Health Officer and Director of Disease Control and International Health at the Federal Ministry of Health. He also represented Nigeria at international meetings and served in various capacities with the WHO and United Nations Children's Fund (UNICEF). Dr Akanni Olufemi Sorungbe, who died in 2019, was a prominent public health physician and pioneer Executive Director/Chairman of the Governing Board of the National Primary Health Care Development Agency (NPHCDA), where he championed reforms in primary healthcare. The contribution of the late Chief (Dr) Emmanuel Ademola Smith, Chief Medical Epidemiologist of the Federal Ministry of Health, also deserves recognition. His work during the smallpox and measles vaccination campaigns of the 1960s and 1970s contributed to controlling and eventually eradicating smallpox in Nigeria and reducing measles mortality. These individuals, among many others, helped build the institutional and professional foundations of Nigeria's modern public health system.
Reflections on Nigeria's Public Health Administration: A tribute to Dr Oluwatoyin Salawu
She remained a proud member of the Queen's College Old Girls' Association, Class of 1968, and maintained friendships forged during those formative years throughout her life. She subsequently attended the Federal School of Science, Onikan, Lagos. In 1971, she won a Federal Government scholarship to study medicine at Ahmadu Bello University, Zaria. Her maternal uncle, the late Dr John Adebayo Oshikanlu (1928–1971), a community medicine physician who served communities in the riverine areas of Lagos State, encouraged her to study medicine. Toyin graduated in 1977 with the MBBS degree, reportedly with a distinction in paediatrics. This early achievement foreshadowed the compassion and commitment with which she would later serve women and children, particularly the most vulnerable.
In 1979, she joined the Federal Ministry of Health as a Registrar in the Epidemiology Division. Her early work involved investigating outbreaks of cholera, cerebrospinal meningitis and yellow fever. Over the next three decades, she rose through the ranks and assumed increasingly senior responsibilities. She served as National Programme Manager for the Control of Diarrhoeal Diseases and Acute Respiratory Infections, National Coordinator of the Integrated Management of Childhood Illness programme, and Chief Consultant in Epidemiology.
In the latter role, she contributed to Nigeria's polio eradication surveillance efforts in collaboration with the World Health Organisation. Between 2004 and 2007, as Director of HIV/AIDS and Sexually Transmitted Infections Control, she led the National AIDS, Viral Hepatitis and STIs Control Programme (NASCP) team in developing Nigeria's first Health Sector HIV Strategic Plan and national HIV treatment and monitoring tools. Her work was subsequently referenced in a 2022 Joint United Nations Programme on HIV/AIDS (UNAIDS) publication on Nigeria's HIV response, and she coordinated Nigeria's Round 5 Global Fund grant.
She later served as Acting Director of Family Health and Director of National Nutrition, contributing to maternal and child health policy at the highest levels of government. Altogether, she spent about 15 years in senior leadership positions within the Federal Ministry of Health. Her expertise also took her beyond Nigeria. She trained and consulted in Belgium, Kenya, Thailand, Ethiopia, Tanzania and Zimbabwe and obtained postgraduate qualifications and professional fellowships, including a Diploma in Public Health from the Royal Institute of Public Health and Hygiene, London; a master's-equivalent qualification in Applied Epidemiology from the Free University of Brussels; and a Fellowship in Community Health from the West African College of Physicians.
She worked with organisations including the World Health Organisation, UNICEF, Save the Children Fund, the Department for International Development (DFID), and USAID on disease surveillance, epidemic control, HIV/AIDS, nutrition, and child survival.
Reflections on Nigeria's Public Health Administration: A tribute to Dr Oluwatoyin Salawu
From 2012 to 2013, she took her experience into the classroom as a visiting specialist teaching physician at Njala University in Sierra Leone, helping to shape another generation of health professionals. Yet the positions she held and the programmes she helped develop tell only part of her story. Those who worked with Dr Salawu knew her as a stickler for transparency, accountability and due process. She earned the confidence of donors, partners and colleagues because she herself could be trusted. She understood that public health was not simply about programmes, statistics and policies; it was ultimately about people. Even after her official retirement, Dr Salawu never truly retired. She continued to consult, mentor, train frontline health workers and support the establishment of nutrition treatment centres for severely malnourished children across Nigeria. Her commitment to service was not tied to a government position or official title. For her, caring for people was a vocation. Behind the statistics, policies and programmes she helped shape was a deep concern for women, children and marginalised communities. She believed, quietly but firmly, that Africa's development had to begin with its most vulnerable people.
The story of the Nigerian public health system is ultimately a story of people: doctors, nurses, epidemiologists, laboratory scientists, community health workers, administrators, teachers and volunteers who have spent their lives confronting disease and strengthening institutions. Dr Oluwatoyin Salawu belonged firmly to that tradition. She did not seek the limelight. Her contribution was instead characterised by professional competence, quiet determination, integrity and an enduring willingness to serve. From the epidemiology corridors of the Federal Ministry of Health to national HIV and nutrition programmes; from disease surveillance and epidemic response to the training of health professionals; and from senior government responsibilities to post-retirement service among vulnerable communities, she demonstrated that public health is ultimately an act of service. Nigeria's public health system still faces formidable challenges. Epidemics will continue to test our preparedness.
Health financing will remain a major concern. External partnerships will remain important, even as the country seeks greater domestic sustainability. And the need for competent, ethical and compassionate public servants will never disappear. The best way to honour people such as Dr Salawu is therefore not merely to remember their names. It is to preserve the values that guided their work: professionalism, integrity, accountability, compassion and service to the most vulnerable. Dr Toyin Salawu passed away peacefully in Lagos on Saturday, 25 July 2026, at the age of 74. (25 April 1952 – 25 July 2026). She leaves behind a legacy of distinguished public service, professional integrity and an abiding commitment to improving the lives of vulnerable communities and children. May her soul rest in perfect peace.
