Liberia

The Constitution does not provide a right to health. However, it includes a chapter on general principles of national policy serving as guidelines in the formulation of legislative, executive and administrative directives, policy-making and their execution (art. 4). Under this chapter, article 8 refers to the obligation of the Republic to direct its policy towards ensuring for all citizens, without discrimination, opportunities for employment and livelihood under just and humane conditions, and towards promoting safety, health and welfare facilities in employment.

The Constitution does not include any specific provisions regarding competent authorities for health.

The main goal of the "National Health Policy 2022-2031: Republic of Liberia" is to improve the health and wellbeing of all people in Liberia by transforming the health sector into an effective, efficient, and equitable system for the delivery of quality health services towards the attainment of Universal Health Coverage (UHC) (page 25).

There are several policy objectives outlined, including strengthening governance, leadership, and management at all levels of the health care delivery system, ensuring the availability and retention of a highly-skilled and well-motivated health workforce, improving access to and utilization of quality essential health services, and guaranteeing health security through national frameworks aligned with International Health Regulations 2005 (page 25).

The context and situational analysis sections provide the main legal provisions governing health including: the executive law establishing the ministry of health (1972 and amended in 2015), the 1976 Public Health Law and the 2010 Liberia Medicines and Health Products Regulatory Authority (LMHRA) Act (pages 2; 16; 18). The Policy also highlights challenges regarding the existing legislation. This includes limitations of the Public health Act in addressing adequately key issues such as emergency treatment, discrimination, mental health, nutrition, regulation of marketing of products for infants and young children, zoonotic diseases, non-communicable diseases, antimicrobial resistance, clinical trials, and complementary and alternative medicine (page 16). This also includes the lack of implementing regulations to accompany the LMHRA Act (page 18).

As specific legislative and regulatory actions, the Policy stresses the need to revise the LMHRA Act to align with the African Union Model Law on Medical Products Regulation (page 36), to enhance the implementation of the decentralization arrangements provided under the 2018 Local Government Act (page 38). It also refers to the need to pass the Liberia Health Equity Fund into law, to strengthen regulation and integration of the private sector (page 21), to regulate transfers of health workers (page 33).

The main goal of the "National Health Sector Strategic Plan: a roadmap to Universal Health Coverage 2022-2026" is to improve the health and wellbeing of all in Liberia (page 30)).

The strategic plan identifies four strategic objectives including: strengthening governance, leadership, and management at all levels of the health care delivery system ; ensuring the availability and retention of a highly-skilled and well-motivated health workforce ; improving access to and utilization of quality essential health services ; and guaranteeing health security through national frameworks aligned with International Health Regulations 2005 (page 30). It further highlights nine strategic priority areas and interventions: leadership and governance; highly skilled and well motivated health workforce; quality and equitable health care services; health infrastructure and technology; Essential medicines, medical supplies and diagnostics; health information system, research and communication; sustainable community health and engagement; Sustainable health financing; and Public Health Emergency Preparedness and Response

In the "Background" and "Situational Analysis" sections, the document references several legislative and regulatory frameworks that shape the health sector in Liberia. This includes the Executive Law of 1972 led to the establishment of the Ministry of Health and Social Welfare, which was revised and amended in 2015 to establish the Ministry of Health (page 7). This also includes the Public Health Law of 1976 which insufficiently addresses a number of issues such as emergency treatment, mental health, non communicable diseases (non exhaustive list) (page 16)

The plan outlines specific actions to enhance the legal and regulatory framework of the health sector. These are diverse and include capacity strengthening for the ministry of health and other regulatory authorities to regulate or enforce existing texts; development of new regulations and legal revisions; and enhanced implementation of exiting legislation. For example, the plan emphasizes the need to strengthen regulatory bodies to promote the monitoring and reinforcement of the Public health law; to institute mechanisms to ensure that the workforce complies with existing legislation, regulations and procedures; to revise the Public Health law to ensure that the mandates, roles, and responsibilities of various bodies dealing with regulation, standards, and maintenance of ethical conduct are clearly defined and regularly communicated to all stakeholders; and to strengthen regulation of health professions educations (page 33). The Plan also calls for strengthening the Ministry of Health and regulatory authorities’ capacity to implement and enforce legislative and regulatory frameworks for the health sector including the Public Health Law, health regulations and protocols (page 35). Furthermore, the Plan outlines the need for regulatory interventions to reduce the modifiable risk factors for non-communicable diseases (unhealthy diets, physical inactivity, tobacco use and harmful use of alcohol and other substances) (page 45) and violence and injury prevention and control (page 47). It also calls for an enhanced implementation of the 2017 Mental Health legislation (page 49) and pharmaceutical regulations (page 61) and for strengthening regulatory structures for traditional medicine services (page 56) and to strengthen regulatory bodies oversight to ensure mandatory reporting by private providers (page 62). Lastly reference is made to the development and implementation of national regulations for biosafety and biosecurity (page 70).