Breaking Barriers: Advancing Medical Science, Leadership, and Gender Equality in Nigeria

Nigeria’s progress in advancing medical science, leadership, and gender equality is hindered by systemic challenges. The healthcare sector remains underfunded, with limited resources and a growing brain drain, while academia faces obstacles such as inconsistent funding and inadequate support for research. Women aspiring to leadership roles in these fields often encounter cultural and structural barriers, making their journeys particularly arduous. Professor Folasade Ogunsola, Vice Chancellor, University of Lagos, recently had an exclusive podcast conversation with Private Sector Health Alliance of Nigeria (PSHAN) to discuss how increased investment in healthcare and research, strategic public-private partnerships, and women empowerment can drive transformative change. As a trailblazer in academia and medicine, her insights provide a roadmap for addressing these pressing issues. Here are excerpts from Private Sector Health Alliance of Nigeria (PSHAN) Podcast “Leadership Series” hosted by Dr. Anne Adah-Ogoh, Director of Policy, PSHAN, with Professor Folasade Ogunsola as guest

What inspired your career choice? Could you take us down memory lane?

I have two inflection points in my career. The first was deciding to become a doctor. To be honest, I’m not sure I fully understood why at the time. I just know I always wanted to nurture, and I remember playing “hospital” as a child—it was something I always wanted to do.

The second was choosing medical microbiology, which was different. As a young medical student, it wasn’t my focus—actually, it was one of my worst subjects, and I was ready to drop it. But in private practice, I struggled with interpreting lab results that didn’t align with my patients. I spent time in the lab, talking to scientists.

What really drew me in were three key events: my brother-in-law in clinical microbiology, who made it come alive for me; the onset of HIV in the 1980s, which sparked my interest in microbiologists’ work; and a young woman in my care who died from pseudomembranous colitis caused by antibiotics. These experiences pushed me to switch from pediatrics to clinical microbiology.

It was a series of events, or perhaps, man proposes, and God disposes. Since then, I’ve never looked back. It’s allowed me to do clinical work, public health, policy, and research—all while fitting my restless, non-routine-loving character.

Thank you for taking us down memory lane. It seems like you’ve navigated many male-dominated spaces, from private practice during the early HIV epidemic to microbiology and leadership. How have you managed these challenges, especially as a female leader in fields with few women, like vice-chancellors in Nigerian tertiary institutions?

It’s about knowing your worth and staying true to who you are. I learned not to take things personally and to be intentional—no apologies for being a woman. I also had to learn to speak up, addressing issues respectfully without anger, especially when inappropriate comments were made. Women are often trained to avoid upsetting others, even at their own expense, but I refused to let things slide.

As a female leader, I faced expectations to act as a mother figure, making emotional exceptions. However, I realized that rules exist to ensure fairness. Making exceptions based on emotions leads to favoritism and poor outcomes, so I stayed firm. Over time, this approach worked.

My advice: be confident, embrace empathy, and know your work. When I entered clinical microbiology, I aimed to be the go-to second opinion, ensuring my expertise was undeniable. Women often have to prove themselves more, but once you excel, gender fades, and you’re recognized for your competence and leadership.

Thank you for those insights. Could you share key lessons from chairing the WHO Guidelines Committee for Ebola and leading the Infection Control Africa Network? What should we focus on as we prepare for another pandemic, and what resources should we have in place?

Thank you. Chairing the WHO Guidelines Committee was valuable. Key takeaways include the importance of teamwork—guidelines require collaboration, not just individual expertise. Research must be based on strong evidence, with a graded quality from high-level to observational studies.

We need to develop our own evidence, as much of the research comes from high-income countries and doesn’t reflect our needs. Research here is expensive, and while we are starting to understand the investment required, we still lack some resources. Research must be solution-based and tailored to our environment.

Beyond creating guidelines, we must have systems in place. Many countries focus on clinical care but fail to plan for epidemics. Pandemic preparedness involves strengthening systems, training the right people, and ensuring healthcare professionals are always prepared. We’ve made progress since Ebola, with a national program and curriculum for infection prevention, but there’s still much work to do. The Infection Control Africa Network has contextualized global guidelines to fit Africa’s needs, spanning five regions, and strengthening collaboration, though more remains to be done.

You mentioned the importance of having a team on the ground and asking the right questions. How can we address the increase in the number of young health professionals leaving the country? How can we motivate individuals to continue supporting infection prevention and control efforts in Africa, especially Nigeria, and encourage those still in the sector to stay committed?

It’s a difficult one to answer. When people have high expectations of what they can achieve abroad, it’s hard to meet those expectations, especially when the reality on the ground here is challenging. First, there’s inadequate funding. Second, the work environment doesn’t always allow people to reach their full potential. The world has moved on, but we haven’t quite caught up yet. Third, there’s a lot of criticism aimed at healthcare workers in Nigeria. Many work in extremely difficult conditions and are met with constant negativity, which can lead them to feel unappreciated and demotivated. 

Improving the work environment, increasing salaries, and offering opportunities for self-actualisation could help, but these changes will take time. It’s not something we can achieve overnight. It will be tough, but if we improve conditions of service, perhaps we can allow people to travel, work abroad, and return home without feeling left behind. This could help them feel that they are staying in touch with global standards while still contributing locally.

Given the challenges you’ve highlighted, what opportunities do you see for the private sector to support in addressing these issues?

The private sector must get involved. Historically, it has focused on high-end hospitals serving a small portion of the population, leaving the majority of Nigerians who rely on public healthcare underserved. Public healthcare has immense talent that can be leveraged, but it requires collaboration and investment from the private sector to strengthen the system.

We’ve seen promising partnerships in areas like cancer care, where private sector support has enhanced public hospital capabilities. Additionally, most Nigerians pay for healthcare out of pocket, which is unsustainable. We need equitable health financing, including accessible health insurance, to ensure people receive quality care without the financial burden. Health is expensive, and even public facilities are underfunded. The private sector has a critical role to play in bridging these gaps.

Lagos State has recently made health insurance mandatory under the NHIA Act. Have you seen any improvements in access to affordable and quality healthcare in Lagos, and how can we extend this to neighboring states as we move toward universal health coverage?

I haven’t seen a significant increase in uptake yet. While the laws and policies are in place, the real work now is raising awareness. Many people are unaware of the benefits or skeptical about the government’s ability to deliver. It’s going to take time, and there may need to be additional laws, incentives, and penalties to encourage participation. We’ve made the right start, but there’s much more to be done.

Thank you, Professor. Regarding the challenges in controlling infectious diseases in Nigeria, how can we improve? We discussed a case of pseudomembranous colitis, raising concerns about the appropriate use of antibiotics and following protocols. How can we improve diagnosis, prescription, lab investigations, and medication compliance at t individual, community, and national levels?

The first step in fighting infections is prevention—safe water, housing, and sanitation. Nigeria is the open defecation capital, which contributes to the contamination of the environment with harmful microorganisms. Urban migration has created slums in places like Lagos, where these conditions breed infections. Before we discuss diagnosis, we must address these basic needs. The U.S. began beating infections with clean water, sanitation, and food. Once these infrastructure issues are tackled, we’ll have done 70% of the work.

We also need better diagnostic facilities, standardized care, and proper antibiotic use. Care in Nigeria often varies by doctor, and hospitals internationally use checklists to ensure quality. We must improve training, teamwork, and involve professionals from other sectors like veterinary and water engineers. Health must be a holistic approach, focusing on prevention and wellness, not just disease treatment.

What role can collaboration between academia, medical institutions, and the private sector play in improving health indices through better infection control in Nigeria?

Academia plays a crucial role in research, providing evidence, and training professionals. The private sector brings pragmatism, efficiency, and funding. The challenge is trust between the sectors. If collaboration improves, we can achieve great outcomes. For example, during Ebola and COVID-19, private sector support sped up responses. The public sector has manpower but lacks resources and training. If the private sector supports with better training and equipment, the impact would be greater. Collaboration is also needed in areas like water supply and sanitation to reduce infections. The private sector should see the public sector as a partner to improve systems and ensure a healthier Nigeria.