Public Health Laws

Public health: “Fulfilling society’s interest in assuring condition in which people can be healthy”

• Assessment
• Policy development
• Assurance

• Prevent epidemics and spread of disease
• Protect against environmental hazards
• Prevent injuries
• Promote and encourage healthy behaviours
• Respond to disasters and assist communities in recovery
• Assure the quality and accessibility of services

1. Monitor health status to identify and solve community health problems
2. Diagnose and investigate health problems and health hazards in the community
3. Inform, educate, and empower people about health issues
4. Mobilize community partnerships to identify and solve health problems
5. Develop policies and plans that support individual and community health efforts
6. Enforce laws and regulations that protect health and ensure safety
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable
8. Assure a competent public and personal health care workforce
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services
10. Research for new insights and innovative solutions to health problems

The Public Health Wheel shows the three core functions (assessment, policy development, and assurance) in black around the “wheel” of essential services. In essence, the essential services can be grouped under the three core functions.

Essential services 1 and 2 fit under the core function of assessment.

Essential services 3, 4, and 5 fit under policy development while essential services 6, 7, 8, and 9 fit under assurance.

Research (essential service 10) and system management form the centre of the wheel since these activities are included within all three core functions.

Health law refers to a statute (decree, act, bill, order, and ruling edits), ordinance or code that prescribes sanitary standards and regulations for the purpose of promoting and preserving the community's health. (Black's Law Dictionary, 8th ed. 2004)

PHL is concerned with the legal powers and duties of the government to assure the conditions for people to be healthy (e.g., to identify, prevent, and ameliorate risks to health in the population) and the limitations on the power of the government to constrain the autonomy, confidentiality, privacy, or other legally protected interests of individuals for the protection or promotion of community health. (Gostin, L: Public Health Law: Power, Duty, Restraint, 1st ed. 2000)

1. Government – PHL is a special responsibility of government, in collaboration with partners in the community, business, the media and academia.
2. Populations –focuses on the health of populations rather than individual patients.
3. Relationships –addresses the relationship between the government and the population (or between the government and individuals who place themselves or the community at risk).
4. Services –Deals with the provision of population-based services grounded on the scientific methodologies of public health (e.g., biostatistics and epidemiology).
5. Power – Public health authorities possess the power to regulate individuals and businesses for the protection of the community, rather than relying on the ethic of voluntarism.

• (PHL) is a collection of rules, remedies and sanctions as may be related to health.
• PHL is a collection of do's and don'ts or norms for healthy living. Thus PHL is normative
• PHL like other laws is usually made by the legislature that is, (NASS or SASS, LGA), or by a delegated authority, agency or by some other authority, according to the system of government or legal system that is in place in a given country.
• PHL is territorial and has territorial limit. Law of federation of Nigeria, public health Laws of each State in Nigeria, bye laws etc. Thus, PH laws only operates or takes effect in the geographical territory in which the health law applies, such as a corporation, institution, agencies, local government, state, country or international community, as the case may be.

1. Constitution
2. Statues Legislation
3. Case Law or Judiciary Precedents
4. Revised English Law
5. Custom and
6. Shariah Law

Nigeria has operated fully or in part six federal constitutions since October 1st 1960.

1. The Independence Constitution 1960
2. The Republican Constitution 1963
3. The 1979 Constitution
4. The 1989 Constitution, never fully operational.
5. The 1999 Constitution
6. The 2011 Amended Constitution

At Independence Nigeria was a Federation of 3 regions in 1960. Then to 4 regions in 1963, 12 states in 1967, 19 states in 1976, 21 states in 1987 and 30 states in 1991 and 36 states in 1999, 36 state in 2011 constitution.

Nigeria Constitution is a the source of all legal authority for the government at all levels

Health in the Constitution of FRN

• The 1979 Constitution spelt out health as a universal human right and prescribed the roles of the three tiers of government in the provision and maintenance of health services.
• However, under the current 1999 as amended 2011 Constitution, only vague reference is made to LGA responsibility for health.
• In Section 45, the Constitution makes provision for the overriding of individual rights, if it is in the interest of, among other things, public health.

• Nigeria legislative frame work and mandate in Section 4, 1999 Constitutional provided that Federal – National Assembly (NASS) shall be 2 Chambers (Senate and House of Representative). Nigeria legislative frame work and mandate in Section 4, 1999 Constitutional provided that Federal – National Assembly (NASS) shall be 2 Chambers (Senate and House of Representative).
• NASS Can Legislate on Exclusive LEGISLATIVE LIST (Part 1 of 2nd Schedule 1999 constitution) and Concurrent Legislative list (1st Column of Part 2 of 2nd Schedule See Sect. 4 (1, 2, 3, 4 & 5) of 1999 Constitution).NASS Can Legislate on Exclusive LEGISLATIVE LIST (Part 1 of 2nd Schedule 1999 constitution) and Concurrent Legislative list (1st Column of Part 2 of 2nd Schedule See Sect. 4 (1, 2, 3, 4 & 5) of 1999 Constitution).

The constitution of the federal Republic of Nigeria (“the Constitution”) is the supreme law of the land 6 and by section 1 (3) its provisions prevail in the event of any inconsistency with any other law.

States

• States House of Assembly
• Can legislate on matters not included in Exclusive Legislative list and
• Matters included in Concurrent Legislative list
• States laws must not contradict National laws on matters of concurrent list

Local Government Council

• Can make Bye laws on maters contained in 4th schedule of 1999
• Constitution to the extent that it does not contradicts with states laws

• In Nigeria PHL is contained in special volumes of the laws of Federation of Nigeria for each State in the country
• It also spells out the power of PH officer and defines the general duty of a medical officer of health
• PHL is made up of many parts

1. Investigate of the causes, origin, and mode of transmission and distribution of infectious diseases
2. To advice his council/government on all matters affecting public health in his area of jurisdiction
3. Upon the outbreak of diseases, the MOH visit and inquire into the causes and circumstances of the outbreak and take appropriate measure to prevent the spread of the diseases.
4. Direction of the work of the public health inspectors
5. Take appropriate action to prevent food contamination and deal with unsound food
6. Take necessary steps to deal with offensive food traders
7. Compile weekly record of notifiable disease and forward it to the appropriate authority
8. Compilation of annual report on all aspect of activities under his control and forward it to appropriate authority.
9. Deal with nuisance (abatement law)
10. Serve an abatement (nuisance) notice by filling form E.H.4 contained in the schedule to PHL on any person by whose act or default is caused or continues or on the owner or occupier of any premises on which the nuisance exists, requiring him to abate the nuisance within a specified time, and to prevent a recurrence of the nuisance.
11. Fill monthly form E.H. 8 or animal form E.H.9 contained in the schedule of PHL for submission to the Honorable Minister of Health or Commissioner for Health or delegated authority

This act provides a framework for

• Regulation
• Development
• Management

It set standards for rendering health services in the Federation Sec. 2 (2) 1999 as amended 2011 constitution and other matters connected there with.

In NHB there are 65 sections divided into seven parts.

1. PART I – Responsibilities for Health & Eligibility For Health Services and Estab. of National Health System
2. PART II – Health Establishments and Technologies
3. PART III –Rights and Obligations of Users and HealthCare Personnel
4. PART IV- National Health Research and Info. System
5. PART V – Human Resource for Health
6. PART VI – Control of Use of Blood, Blood Products, Tissues and Gametes in Humans
7. PART VII – Regulations and Miscellaneous Provisions

• Everyone is permitted to have the privilege of knowing this
• By Section 1 of the Compulsory Treatment and Care for Victims of Gunshot Act 2017, all hospitals in Nigeria shall accept and treat without a police clearance any person with a gunshot wound. Section 2 further mandates all security agencies to render the necessary assistance to gunshot victims and ensure that they are taken promptly to a hospital for treatment.
• Furthermore, in the said Section, the law provides that all victims with gunshot wounds shall be treated without a request for initial monetary deposits and such persons shall not be victims of any inhuman or degrading treatment.
• A hospital that receives any person with a gunshot wound is also enjoined to make a report to the nearest police station within 2 hours of treatment, failure to do this attracts a fine of N100,000 and every doctor concerned with the treatment, is liable on conviction to a fine of N100,000 or 6 months imprisonment or both.
• Any person, police officer or security agent who stands by and fails to give the necessary help to a victim of gunshot wound, which leads to the unnecessary death of the Victim, commits an offence and is liable on conviction to a fine of N500,000 or 5 years imprisonment or both.
• Also any person who commits an offence which causes substantial damage of whatever form to the victim, is liable on conviction to 15 years imprisonment without the option of fine.
• In addition to all these penalties, the court can also order that a person or corporate body in default, pays to the victim, an amount equivalent to the loss sustained by the victim. This is known as restitution.
• Please share across all platforms so security agents and medical practitioners are informed of this law, in order to ensure the preservation of the lives of victims with gunshot wounds.