Why the global health community should support the EndSARS movement in Nigeria

In the past year, more Nigerians have been killed by state-sanctioned security forces than by COVID-19, according to data on the Nigeria Security Tracker and Worldometers.¹ Formed in 1992, the Special Anti-Robbery Squad (SARS) has become the public threat the squad was created to prevent. Killings of young adults by the SARS has spurred peaceful demonstrations across Nigeria calling for disbandment of the SARS.² On Oct 20, 2020, peaceful protesters were murdered by state-sanctioned forces at the Lekki Toll Gate in Lagos, Nigeria's most populous city. Such state-sanctioned acts of violence by the military against its own citizens further worsen the livelihoods of Nigerians who are already facing the devastation of a fragile economy in the wake of the COVID-19 pandemic, rising unemployment, sparse resources, and an average life expectancy of 54 years.³

In the past year, 2542 people in Nigeria have been killed by state-sanctioned forces; 11 000 people have been killed since 2011. The global health community cannot stand idly by during this crisis and must stand in solidarity with the EndSARS movement given the link between police brutality and public health.⁴ The global health community has invested in low-income and middle-income countries (LMICs). In 2019, the US Agency for International Development contributed US$672 million to Nigeria for humanitarian efforts and health.⁵ From 2014 to 2020, the EU contributed €562 million. These efforts and others have led to notable progress in combating the HIV epidemic and continued efforts to combat communicable and non-communicable diseases. If police brutality is not confronted and people's lives cannot be protected, gains that the global health community have witnessed are at risk of being lost.

We have several concrete recommendations. There is an urgent need for a policy report focused on the health effects of police brutality in LMICs. The effect of police brutality on quality of life in LMICs is unknown. Health systems in LMICs should be equipped to provide high-quality care.⁶ Outcomes on quality of care in LMICs should be examined with a new lens accounting for the social, legal, and ethical context of care delivery. For example, gunshot wounds that are otherwise not life-threatening cause fatalities because of poor access to health care and impaired emergency response services,⁷ as was the case in the Lekki massacre. The psychological suffering inflicted by police brutality requires mental health services, which are often scarce in LMICs. Funding agencies should focus funding and research on police brutality. Young adults—who are often the targets of police brutality—are crucial to the future economic development of LMICs (eg, the median age in Nigeria is only 18 years). For every person killed in the SARS crisis, many are injured or permanently disabled, and families experience psychological damage. Collecting data on police brutality in LMICs is key to understanding root causes and crafting evidence-based strategies for mitigation. Collaboration between health-care providers, researchers, and networks on violence prevention can facilitate the development of community-driven action plans.

The global health community should stand in solidarity with Nigeria during its darkest hour and partner with its youth to make an impact. As the great leader, Nelson Mandela said, “What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead”.⁸