Abuja: Dr Ifedayo Adetifa, former Director-General of the Nigeria Centre for Disease Control and Prevention (NCDC), emphasized the crucial role of control over diagnostic tools and disease surveillance systems in achieving Nigeria’s health sovereignty. Adetifa, in an interview with the News Agency of Nigeria (NAN), discussed the insights from his recent publication titled ‘Who Holds the Power, and Who Names It?’
According to News Agency of Nigeria, Adetifa argued that health sovereignty should extend beyond just domestic financing and local manufacturing. He stressed the importance of countries being able to determine their own health challenges, identify what health issues are prioritized, and validate the evidence that shapes health policies. The core of his proposition is that diagnostic capacity significantly influences how nations understand and respond to disease threats.
Adetifa highlighted that diagnostic tests and surveillance case definitions collectively decide what is considered a health problem. He warned that countries relying too heavily on diagnostic tools and disease definitions from abroad might compromise their authority to determine their own disease burden and health priorities. He labeled diagnostic sovereignty as an often overlooked yet crucial component of national health security.
He further explained that discussions around health sovereignty usually center on manufacturing and financing. However, the deeper issue involves determining who has the authority to create and validate knowledge about a country’s health challenges. Adetifa also expressed concern over the increasingly transactional nature of global health, where international cooperation is often tied to strategic interests, funding priorities, and access to data and biological resources.
Adetifa acknowledged the value of international investment in strengthening health systems but cautioned against allowing external influences to dictate a country’s health agenda. He emphasized that strong national leadership is essential to ensure that investments align with domestic priorities. A clear national vision, effective coordination across government institutions, and well-defined priorities for partners are critical for leveraging external resources to support national health objectives.
Drawing from his experience at the NCDC, Adetifa noted the necessity of holding development partners accountable to nationally defined priorities, even if it creates discomfort. He reiterated that global health security is unattainable without strong national health security. He praised the Federal Government’s implementation of the Sector-Wide Approach for Health (SWAp) as a vital mechanism for aligning development partners with a unified national health plan.
The approach, he noted, could address donor fragmentation and the proliferation of vertical programs by aligning financing and activities within a common national framework. However, Adetifa cautioned that the effectiveness of such mechanisms could be limited by inadequate domestic health financing and varying levels of commitment among stakeholders, which might leave the country vulnerable to external priorities.
Adetifa linked health sovereignty to ‘epistemic power,’ the ability to define legitimate knowledge and recognize credible authorities. He pointed out the imbalance in global health research, where African researchers and institutions are often underrepresented in defining and documenting the continent’s health challenges. He urged for greater authority for African researchers in defining research questions, interpreting evidence, and shaping narratives around African health.
He stressed that decisions on funding, policy, and interventions often rely on how health problems are identified and described. Therefore, the ability to diagnose and measure disease is not just technical but also an issue of power. Asserting control over diagnostics equates to asserting the right to define a country’s own disease burden.
Adetifa called for stronger national investment in diagnostic capacity, surveillance systems, research, and health financing to ensure Nigeria can set its health priorities while benefiting from international partnerships. He emphasized the importance of global solidarity, supported by institutions, financing, and accountability, to strengthen national systems and contribute to long-term health security.
He concluded that strengthening Nigeria’s ability to detect, define, and respond to its health challenges would ultimately benefit both national and global health security. He stated, “There is no health for all without diagnosis for all, and no diagnosis for all without the power to define what counts as evidence and to be believed.”