As Nigeria grapples with crumbling hospitals, the exodus of healthcare professionals, and soaring out-of-pocket costs, its leaders have made foreign hospitals their second homes.

As you read this article, it is no longer news that millions of Nigerians perish from treatable diseases due to a collapsed healthcare system, while the nation?s top political leaders continue to spend billions of naira seeking medical attention in foreign hospitals.

The Irony is haunting; they flee the very system they were elected to fix but refused to do so. Former President Muhammadu Buhari of blessed memory, between 2015 and 2023, became the symbol of Nigeria?s elite medical tourism culture. He was reported to have spent over 200 days abroad for treatment, mainly in London, during his time in office.

While the exact nature of his ailment was kept under wraps, his frequent and prolonged absence raised serious concerns about leadership accountability and trust in local healthcare. Also, recently, a former Head of State, General Abdulsalami Abubakar (rtd), publicly disclosed that he had been admitted to the same London hospital as Buhari.

His remark exposed the reality that Nigeria?s most powerful men do not rely on the same healthcare system they supervise. That reality is bitter for many ordinary Nigerians who cannot afford even basic drugs, let alone air ticket to London.

Even today, President Bola Ahmed Tinubu is not different. Since assuming office in 2023, he has reportedly embarked on multiple medical trips to Paris, though his aides have remained evasive about the purpose. The trips have sparked widespread criticism, with many Nigerians questioning why the nation?s number one citizen would bypass local hospitals, including the heavily funded Aso Rock Clinic, for foreign care. Worse still is the issue of health budgets.

For many years after the Abuja Declaration of 15 per cent allocation to the health sector, successive governments have failed to allocate any figure close to 10 per cent to the sector, a situation, experts say is a major factor that has kept the health sector backwards.

Budget

For instance, under the administration of the late Buhari, Nigeria?s health budget increased significantly from ? 237 billion in 2015 to ? 1.17 trillion in 2023.

In raw figures, this was 324 percent rise. However, the increase was misleading. The allocation never exceeded 5.75 percent of the national budget, falling short of the 15 percent Abuja Declaration target set by African Union countries in 2001.

While capital expenditure also grew from ? 22.7 billion to ? 404 billion, over 70 percent of the total health budget went into recurrent spending, mostly for salaries and administrative overhead.

This left little for infrastructure, diagnostic equipment or life-saving medical supplies.

Tinubu?s 2024 health allocation stood at ? 1.23 trillion, accounting for 5.46 percent of the total budget.

In 2025, he proposed ? 2.48 trillion, just 5.18 percent with ? 300 billion intervention fund added by the National Assembly to plug urgent gaps.

Despite the large figures, the percentage of the budget going to health remains low, especially in the light of inflation, the ongoing doctor brain drain, and poor service delivery across public hospitals.

Meanwhile, questions have been asked concerning the billions earmarked for the Aso Rock Clinic.

Black hole for billions?

One of the most ironic examples of Nigeria?s healthcare failures is the State House Clinic, built to serve the President, Vice President, and other top government officials. Between 2015 and 2020 alone, the clinic received nearly ? 14 billion in public funding.

In 2015, ? 3.94 billion was allocated to it, followed by ? 3.87 billion in 2016, and ? 3.20 billion in 2017. Subsequent years saw smaller allocations, with ? 1 billion in 2018, ? 823 million in 2019, and ? 723 million in 2020.

Despite these huge sums, the clinic remained notoriously under-equipped.

Reports alleged the facility lacking essential drugs, medical equipment, and even power supply.

Critical health watchers argue that if even the Aso Rock Clinic is unfit to serve the nation?s leaders, it is no surprise that the average Nigerian has little hope of accessing quality care in general hospitals in Kano, Ebonyi, or Cross River among others.

This stark reality, where the elite bypass the very system they ostensibly control, casts a long shadow over the lives of ordinary citizens.

Human Cost of Medical Abandonment

While the country?s leaders book first-class tickets to London and Paris for medical care, Nigerians across rural and urban communities continue to die from conditions that are preventable and treatable.

In most communities across Nigeria, outbreaks of cholera and typhoid have killed dozens due to lack of access to clean water and basic antibiotics.

In parts of the states, women die in labour because hospitals lack obstetricians or electricity for emergency surgeries.

Even in Abuja, the FCT, families sell belongings or take loans just to afford common drugs or diagnostic tests. Essential medications for chronic illnesses like hypertension and diabetes have become unaffordable for the poor and middle class, with price increases of over 300 percent reported since 2023.

Experts? take

The death of Buhari in a London hospital, and the claim by his former media aide, Mr. Femi Adesina, that he ?would have passed on before now?, if treated in Nigeria, have sparked outrage.

Health professionals vehemently disagree, insisting that Nigeria possesses highly trained practitioners, but leaders have failed the system.

They argue that medical tourism by public officials deepens inequality and is not just a policy failure but a moral one. ?It sends a message that the rest of us are expendable,? one of them asserts, describing the trend as ?shameful and unsustainable.? They highlight the lack of accountability, inflated budgets, diverted funds, and empty facilities while leaders ?jump on jets when they have headaches.?

Prominent human rights lawyer Femi Falana (SAN) has been a vocal proponent of legislative action, repeatedly calling for a law that mandates all public officials to receive treatment within Nigeria.

He pointedly asks, ?Why should we vote for leaders who cannot be treated in the hospitals they built??

According to the Chairman, Society of Family Physician of Nigeria (SOFPON), Lagos Chapter, Dr. Ozuomba Sixtus, a situation where leaders continued to embark on medical tourism even for the simplest illness was a betrayal of public trust.

He states, ?If our leaders invested just a fraction of their medical tourism budget into the health system, Nigeria would be a medical hub in West Africa.?

For these Nigerians, the health crisis is not a lack of funds but a fundamental failure of priorities and accountability.

This is a reflection of a healthcare system in crisis ?Dr. Ifeanyi Casmier, AMLSN National President

To the National President of the Association of Medical Laboratory Scientists of Nigeria, AMLSN, Dr. Ifeanyi Casmier, the persistent trend of medical tourism among Nigeria?s political elite is not just a national embarrassment but also a reflection of a healthcare system in crisis.

Casmier, who is also a prominent advocate for health sector reform, described medical tourism by public officials as a deliberate act of neglect that has persisted from the days of the First Republic to the present administration.

According to him, Nigeria?s health system has become one of the weakest in the world, regularly ranking near the bottom on global health indices.

?Our health system has become very weak and is consistently ranked among the worst globally. It is abysmal. It is disgraceful?, he said.

The AMLSN National President pointed to international rankings such as Bloomberg?s, where Nigeria often places just above countries like the Republic of Congo and Myanmar, hovering around 189 or 190 out of 192 nations.

Casmier lamented the decline, especially when considering Nigeria?s past.

?People like the Prince of Saudi Arabia used to come to University College Hospital, Ibadan, for treatment. We were once among the top five in the Commonwealth for healthcare. Now, our leaders go to London for checkups?, he recalled.

Illustrating the scale of the problem, he described a recent scenario in which two former Nigerian presidents were admitted to the same small hospital in London.

?One was later discharged, only to learn the other had died?, the AMLSN National President said.

?That is how ludicrous and painfully ironic it has become. Even the State House Medical Centre is not trusted by the President who oversaw it for eight years.?

Casmier pointed to Buhari as a prime example of failed healthcare leadership.

He noted that while the former Nigerian leader once received care in Nigeria at the Ahmadu Bello University Teaching Hospital, before taking office, he later resorted exclusively to London for treatment throughout his presidency.

?For eight years, Buhari could not restructure the health system or even make the State House Clinic reliable,? the AMLSN National President said.

The trend, Casmier added, extends across the political class, including governors, ministers, senators, and even former speakers.

He cited one former governor, currently facing trial, who sought court permission to travel abroad for hypertension treatment ? despite claiming to have built a world-class hospital in his village.

?Who?s treating the over 40 per cent of Nigerians living with hypertension here?? the AMLSN National President asked. ?Why won?t he go to his own hospital??

Casmier argued that Nigeria is not suffering from a lack of talent or resources but from a failure of governance.

?We train some of the best doctors, nurses, and medical laboratory scientists in the world ? and other countries poach them. That means our training is world-class. So what?s the excuse??

He traced the root of the leadership crisis back to 1985, when Decree 10 reshaped the administrative structure of the health sector, placing it in the hands of political appointees instead of professionals.

?In countries our leaders go to for care, you won?t find healthcare professionals leading ministries. They are managed by professionals trained in administration, allowing doctors to focus on care,? Casmier said. ?That?s not the situation in Nigeria.?

The AMLSN National President called on Tinubu to urgently confront the leadership failures in the health sector.

In his view, one of the first steps must be to end the use of public funds for overseas medical treatment by government officials, including the President, a measure often linked to the call for a legal mandate.

Casmier argued that, at worst, foreign medical experts could be flown into Nigeria to treat top officials, which would create opportunities for skills and technology transfer to local healthcare workers.

?That expertise will rub off on the indigenous staff. ?That?s how capacity is built,? Casmier said.

He also called for a more transparent and accountable budgeting system for public hospitals, one that requires annual performance and financial reports before new funds are allocated.

?Not where we buy an ambulance for you this year, and next year, we buy the same ambulance again,? the AMLSN National President noted.

?We must see clear improvement in care.?

He expressed disappointment with the lack of progress made by the Coordinating Minister of Health, Prof. Ali Pate, who took office with a promising four-point agenda, including reforms to governance systems.

?We had high expectations. He?s a wonderful person, but two years down the line, we don?t see those reforms,? he said.

Casmier also expressed concern about the state of Nigeria?s diagnostic infrastructure.

The AMLSN National President argued that weak laboratory services are the most fragile link in the chain, undermining the entire health system.

?If we don?t know what we?re treating because of poor diagnostics, the entire system collapses,? he said.

?Every chain is only as strong as its weakest link.?

Casmier urged the Federal Government to fully implement the Maputo Protocol of 2008, which calls for strengthening national health systems through improved laboratory services. Without accurate diagnostics, he said, patients are often misdiagnosed, mistreated, or not treated at all ? exacerbating public distrust in the system.

The AMLSN National President further advocated for the development of at least one center of medical excellence in each of Nigeria?s six geopolitical zones, hospitals that could compete not just regionally but across the African continent and the Commonwealth.

?Why can?t we return to the era when UCH Ibadan was a medical tourism hub?? he asked.

?We have the resources, the talent, and the history. What we lack is the political will.?

Casmier concluded with a stern warning, blaming not only the politicians but also a passive public.

?It is the docility of the Nigerian people that has allowed this to fester,? he said. ?Our leaders are unpatriotic in their disposition. They and their families fly abroad when sick, while the rest of us are left to perish using our common patrimony to fund their escapes.?

The AMLSN National President called for urgent, courageous action, warning that without it, Nigeria?s health system will remain in critical condition abandoned by those elected to protect it.

It Is a national embarrassment ? Dr Saheed Babajide, Lagos NMA Chairman

According to the Chairman of the Nigeria Medical Association, NMA, Lagos State chapter, Dr. Babajide Saheed, the persistent medical tourism by Nigeria?s political leaders is an ?em?arrassing display of hypocrisy and failure.?

Babajide warned that no meaningful health reform will take place until elected and appointed officials are legally barred from seeking treatment abroad on public funds.

He recalled that medical tourism did not begin recently, but has worsened since 1999 due to systemic neglect and a lack of political will to prioritise healthcare.

?It is not just unfortunate, it is a national disgrace that our leaders abandon the country?s health system, which they are meant to develop, and rush abroad for care?, the NMA chief said.

?What message are we sending to the world when our presidents and governors become regular patients in foreign hospitals??

He cited poor budgetary allocation, lack of infrastructure, inadequate human resources, and widespread corruption as core reasons for the health sector?s collapse.

?The federal, state, and local governments have always treated health and education as non-lucrative sectors, so they ignore them?, Babajide stated.

?You can?t expect miracles when health budgets are low, infrastructure is poor, and doctors are overworked and underpaid all while the population keeps growing.?

The NMA Chairman criticised top officials within the sector, including past ministers, Chief Medical Directors (CMDs), and Permanent Secretaries.

?Even those of us in the system have failed,? he said bluntly.

?Money has been given to CMDs and hospital administrators, but what has changed? There?s no transparency, no accountability. ?Until we address corruption and hold people to account, we will keep losing lives and money.? (Sunday Vanguard)

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