FEC-approved hospital projects in Nigeria are stalled due to institutional refusal to execute concession agreements, raising serious questions about governance and the nation’s investment climate. This unprecedented situation involves critical healthcare infrastructure projects that received Federal Executive Council (FEC) approval over a year ago, yet remain unimplemented. The delay stems from the host institution’s reluctance to sign concession agreements, despite extensive regulatory approvals and ministerial directives. This stalemate highlights a significant governance challenge impacting Nigeria’s public-private partnership (PPP) framework and its attractiveness to investors. The projects, a nursing students hostel and a mortuary/pathology laboratory, were intended to address urgent infrastructure deficits at a prominent teaching hospital. Their stalled progress after a rigorous four-year approval process underscores a systemic issue that requires immediate attention. The journey of these FEC-approved hospital projects began with a comprehensive four-year process overseen by the Infrastructure Concession Regulatory Commission (ICRC), Nigeria’s dedicated body for PPP project regulation. Official documentation reveals a timeline meticulously adhering to federal regulations. In early 2022, the hospital’s board sanctioned the submission of an Outline Business Case (OBC) to ICRC, which subsequently granted its approval, paving the way for the projects to advance. Following the OBC approval, the process moved to the Full Business Case (FBC) stage. In October 2023, ICRC issued Full Business Case Compliance Certificates for both the nursing hostel and the mortuary/pathology laboratory projects. A detailed six-page letter from the ICRC Director General confirmed that these projects met all stipulated requirements outlined in the National Policy on Public Private Partnership and ICRC regulations. As the original 2023 certificates approached their expiration, ICRC revalidated both FBC Compliance Certificates in May 2024. This crucial step extended their validity for another six months, providing the Ministry of Health the necessary window to present the projects to the Federal Executive Council for final approval. The crucial FEC approval for both critical healthcare infrastructure projects was granted on June 25, 2024, following their presentation by the Federal Ministry of Health and Social Welfare. A subsequent letter dated December 9, 2024, from the Ministry’s Deputy Director officially confirmed this approval, strongly urging the hospital to expedite implementation. By June 2025, the Federal Ministry of Justice had completed its review of the concession agreements, effectively removing the final regulatory hurdle and clearing the path for the projects’ commencement. However, despite this comprehensive approval process, the hospital has persistently refused to execute the concession agreements. What is the primary reason for the stalled FEC-approved hospital projects? The primary reason for the stalled FEC-approved hospital projects is the host institution’s refusal to execute the concession agreements, despite receiving full regulatory approvals and ministerial directives after a four-year PPP process. In an attempt to resolve the impasse, the Federal Ministry of Health convened two meetings in October 2025, one in Abuja and a virtual session. However, meeting summaries indicate that the hospital largely reiterated earlier objections and appeared to seek a complete renegotiation of the entire PPP process, a move seen as unilaterally imposing their own terms. Hospital officials expressed an intention to discontinue the FEC-approved concessions and insisted on physical meetings in Ibadan, a demand rejected by the private sector partner who deemed virtual discussions sufficient. Consequently, no agreement was reached, and the talks collapsed, leaving the projects in limbo. The private sector partner involved described the hospital’s actions as acting “ultra vires”—beyond its lawful authority—by attempting to alter or abandon projects already sanctioned by the FEC. This stance highlights a fundamental challenge to the integrity of the PPP approval process. In February 2025, ICRC intervened by convening a meeting with all parties to address concerns. While a resolution was communicated to the Minister of Health, ICRC’s Director General later expressed serious concern in a letter dated February 19, 2025. He warned the hospital to adhere to the agreed terms due to potential legal consequences and reputational damage to the government. ICRC specifically cautioned that unilateral changes could inflict significant reputational damage on the Federal Ministry of Health and Social Welfare and the current administration. The commission proposed a project review clause for after three years of implementation, offering flexibility within the approved framework rather than justifying outright renegotiation. The nursing students hostel project aims to modernize existing facilities and expand capacity, providing decent and secure accommodation to alleviate transportation costs and enhance the learning environment for students. This upgrade is crucial for supporting the hospital’s educational mission. Similarly, the mortuary and pathology laboratory project seeks to replace worn-out equipment and outdated facilities with state-of-the-art technology. This upgrade is essential for the proper storage of deceased individuals and for supporting critical research and medical services, thereby improving overall service delivery. The Federal Ministry of Health has made numerous attempts to resolve this ongoing dispute. Both the physical meeting in Abuja and the subsequent virtual session were convened to harmonize positions after the Ministry of Justice’s review, but the hospital’s insistence on physical meetings in Ibadan stalled further progress. The private partner formally appealed to the Coordinating Minister of Health in October 2025, emphasizing that the hospital should not unilaterally vary or discontinue FEC-approved projects, thereby acting ultra vires. They requested ministerial intervention to bring the four-year process to a conclusion. This situation raises critical questions about institutional authority, with legal experts asserting that a teaching hospital cannot override FEC decisions. Furthermore, the hospital has not publicly articulated new factors justifying the refusal to execute agreements post-FEC approval, and the cost of these delays remains a significant concern. The precedent set by institutional resistance effectively nullifying a completed PPP process sends a troubling message to potential private sector partners across Nigeria’s infrastructure sectors, undermining confidence in the regulatory framework. The continued inadequacy of healthcare and educational infrastructure means students and patients suffer while bureaucratic gridlock persists. This case has broader implications for Nigeria’s PPP framework, testing its ability to attract and retain private investment amidst infrastructure deficits. If projects cleared by rigorous processes and FEC can be blocked at the implementation stage by institutional resistance, it signals a lack of predictability for investors. The World Bank has consistently identified inadequate infrastructure as a major impediment to Nigeria’s economic growth. The establishment of ICRC was intended to provide a clear regulatory framework and build investor confidence, but cases like this threaten to erode that confidence. Nigeria’s PPP framework, established in 2005, was designed to ensure that properly approved projects are implemented as agreed. This case challenges whether this framework holds weight against institutional resistance, even when it appears to contradict FEC approval, which will be closely watched by potential investors. As of publication, the concession agreements remain unexecuted, with the private partner formally requesting an urgent meeting with the Coordinating Minister to finalize the matter after a four-year engagement. Sources suggest that direct intervention from the highest levels of government may be necessary if the stalemate persists. This case is a critical test of Nigeria’s commitment to the rule of law in public contracting, the sanctity of FEC decisions, and its ability to foster a predictable investment climate for private sector participation. The outcome will determine whether the regulatory framework prevails or if institutional resistance can override federal approvals, setting a significant precedent for Nigeria’s PPP program. Early 2022: ICRC approves Outline Business Case for both projects. March 21, 2022: ICRC issues detailed letter on OBC approval for hostel project. October 30, 2023: ICRC issues Full Business Case Compliance Certificates. May 2, 2024: ICRC revalidates FBC certificates for 6 months. June 25, 2024: Federal Executive Council approves both projects. June 2025: Federal Ministry of Justice completes review of concession agreements. February 19, 2025: ICRC convenes resolution meeting with all parties. October 23, 2025: Federal Ministry of Health convenes meeting in Abuja. October 30, 2025: Virtual meeting held; no resolution reached. November 11, 2025: Private partner requests urgent ministerial intervention. December 2025: Projects remain unimplemented (17 months after FEC approval).
