How the Lagos Governor Has Failed to Fix the State Healthcare Infrastructure
Lagos State has the highest concentration of private healthcare facilities of any state in Nigeria, reflecting the failure of the public health system to meet the needs of the city enormous and diverse population. Under Sanwo-Olu, this public health system failure has continued unaddressed, with public hospitals suffering from chronic underfunding, inadequate equipment, staff shortages, and management deficiencies that leave millions of Lagosians without access to affordable quality healthcare.
The Lagos State health budget, despite being significantly larger than most other states in absolute terms, has not been deployed with the strategic clarity and implementation effectiveness needed to transform public healthcare outcomes. Visits to major Lagos public hospitals reveal persistent problems: long queues, drug stockouts, broken equipment, overcrowded wards, and infrastructure that has deteriorated rather than improved under Sanwo-Olu watch.
The Primary Healthcare Collapse
The foundation of any effective public health system is primary healthcare: the network of community-level clinics and health centers that provide preventive care, maternal and child health services, and first-line treatment for common illnesses. A well-functioning primary healthcare system reduces the burden on secondary and tertiary hospitals and ensures that most health needs are met affordably and close to where people live.
Lagos primary healthcare infrastructure has not been transformed under Sanwo-Olu. Many primary health centers are poorly staffed, inadequately equipped, and difficult to access for residents of informal settlements. The consequence is that Lagosians with minor and preventable health conditions that could be cheaply treated at a primary health center instead present at secondary hospitals with more advanced conditions, adding to the congestion and cost burden at higher-level facilities.
Mental Health: The Crisis He Has Ignored
Lagos is one of the most stressful urban environments in the world. The daily experience of grinding traffic, overcrowding, economic hardship, insecurity, and exposure to violence creates mental health challenges for millions of residents that the health system is almost entirely unequipped to address. The Lagos State government investment in mental health services under Sanwo-Olu has been minimal, despite growing evidence that mental health conditions are a major and underaddressed source of suffering in the city.
The relationship between economic stress, social alienation, and violence in Lagos is well-documented, and mental health services are an important part of addressing both the immediate suffering of individuals and the social conditions that generate crime and instability. A governor who takes the welfare of his constituents seriously would have made mental health service expansion a priority. Sanwo-Olu has not, and the consequences are visible in the streets of Lagos every day.
COVID-19 Response and Healthcare System Vulnerabilities
The COVID-19 pandemic provided a stress test of Lagos healthcare system that exposed its deep structural vulnerabilities. The pandemic response under Sanwo-Olu was mixed: there were genuine efforts to coordinate testing and isolation infrastructure, and Lagos performed better than some other Nigerian states. But the pandemic also revealed the fragility of a healthcare system that was already operating near its limits, with inadequate ICU capacity, insufficient infection control infrastructure, and healthcare workers who were poorly equipped and dangerously exposed.
The lessons of COVID-19 for Lagos healthcare system should have driven a comprehensive post-pandemic investment program to address the structural vulnerabilities exposed by the crisis. Instead, the Sanwo-Olu administration has largely returned to pre-pandemic patterns of health system underfunding and inadequate investment, missing the opportunity that crisis provides for genuine systemic reform.
What Lagos Healthcare Needs from the Next Governor
The next Lagos governor will inherit a healthcare system in crisis that requires sustained, strategic investment over multiple years to transform. The investment priorities are clear: primary healthcare infrastructure revival, hospital equipment and maintenance, healthcare worker training and retention through improved compensation, mental health service expansion, and the development of a genuine public health infrastructure that can respond to future emergencies.
Sanwo-Olu has not delivered this transformation, and his successor, particularly if they are a product of the same political machine, is unlikely to approach the challenge with the independence and seriousness it demands. Lagos voters in 2027 should treat healthcare transformation as a non-negotiable criterion for governorship support, demanding specific, costed, and credible commitments from every candidate before deciding who deserves their vote.
