Opinion: Somalia Needs an Independent Health Regulator That Belongs to No One

“Independence does not put the NHPC above the law. The Council remains answerable to the law, to financial and institutional oversight, and to the courts.” Dr. Yahya Shoole

When Somalia’s central government collapsed in 1991, healthcare did not stop. Private hospitals, small clinics, new universities and professional associations stepped into the space the state had left behind. Much of what works in the health system today exists because of them.

But that growth took place with almost no national oversight. For years, clinics opened, training programmes graduated students and doctors practised without a central body checking standards. Many of us have seen the results: graduates whose training cannot be verified, facilities that should never have passed inspection, and families with nowhere to turn after a clinical error.

Law No. 31 was intended to address this. It established the National Health Professionals Council (NHPC) as an independent statutory body, with responsibility for registering and licensing health professionals, overseeing professional conduct, licensing facilities, supervising training institutions and protecting the public from malpractice.

Its 15 members are drawn from government ministries, including Health, Education and Justice, as well as professional associations, the private health sector and civil society.

Why independence matters#

If the same ministry that sets health policy and runs services also decides who receives a licence, who is disciplined, which hospital passes inspection and which programme is approved, each decision can invite suspicion. Even a fair decision may appear political.

The Ministry and the regulator have different responsibilities. The Ministry leads policy and the health system. The regulator applies professional standards and must be able to do so without pressure from politicians, businesses or the professions themselves.

Independence does not put the NHPC above the law. The Council remains subject to legal, financial and institutional oversight, as well as review by the courts. It means that decisions are governed by rules, not by whoever holds power at the time.

Expertise, not interests#

No regulator can understand Somali healthcare from a government office alone. Professional associations understand clinical practice and ethics. Universities know what it takes to train a competent doctor, nurse or midwife. Private hospitals employ much of the health workforce. Excluding them would weaken regulation.

But a member nominated by an association, university or hospital should contribute expertise, not defend the organisation that nominated them. Once appointed, members’ duty is to the law and the public. This matters because the NHPC regulates the same sectors represented on the Council.

The safeguards are straightforward:

●      Members declare their interests when they take office.

●      A member linked to a university takes no part in decisions on that university’s accreditation.

●      A hospital representative steps aside from any licensing, inspection or disciplinary matter involving their hospital.

●      In each case, the member discloses the interest, leaves the discussion, abstains from the vote and has the recusal recorded in the minutes.