The Registrar of the National Postgraduate Medical College of Nigeria, Professor Temitope Esan, has issued a stark warning about the future of Nigeria’s healthcare system, revealing that more than 5,000 resident doctors have abandoned their training exams in pursuit of employment opportunities abroad.
Speaking during a stakeholders’ forum, Esan expressed serious concern over the mass exodus of medical professionals, describing it as a crisis with far-reaching implications.
“What will really interest you is that we currently have over 8,000 doctors on our register,” he stated. “That’s based on our official database, and it doesn’t even account for those working in state hospitals or private facilities we may not be tracking. Yet, of these, only about 2,500 to 3,000 are sitting for our exams. That figure alone tells a grim story.”
According to him, doctors are now leaving within the first or second year of their residency programmes, long before completing training, underscoring a systemic failure that is pushing early-career professionals out of the country.
The comment comes at a time when Nigerians are still reacting to the revelation that former President Muhammadu Buhari, who reportedly died in a London hospital, had received extensive medical attention abroad. His former spokesperson, Femi Adesina, stirred public outrage by asserting that Buhari “would have long died” had he relied on Nigeria’s public healthcare system.
In a separate disclosure, former Head of State Abdulsalami Abubakar confirmed that he had also been treated at the same London facility.
These developments further underline what many Nigerians already know: that their leaders do not trust the healthcare system they are charged with overseeing.
When a country’s president routinely travels overseas for a basic medical check-up, it conveys a message louder than any official white paper, Nigeria’s health system is broken, and those in power have no confidence in its institutions. This issue transcends symbolism. It reflects decades of neglect, underfunding, and systemic failure that have made healthcare inaccessible to the majority of the population.
Despite Nigeria’s wealth in natural and human resources, its health indices remain among the worst globally. Life expectancy hovers around 55 years. One in every ten children dies before reaching the age of five.
In rural areas, health centres often operate without doctors, electricity, clean water, or even basic drugs. Even in urban hospitals, the situation is scarcely better, equipment is outdated, personnel are overstretched, and care is often unavailable.
Meanwhile, top government officials, including presidents, governors, ministers, and legislators, routinely seek medical attention in the United Kingdom, Germany, the United Arab Emirates, and other foreign destinations, often using public funds. These trips are not limited to complex surgeries; many involve routine procedures such as dental care or cataract removal.
Perhaps the most glaring example is President Buhari, who between 2015 and 2023 made at least ten documented trips to the UK for undisclosed medical reasons, spending over 200 days abroad. In 2017, the situation at the State House Clinic, Nigeria’s premier government-run medical facility, was so dire that the First Lady, Aisha Buhari, publicly criticised the hospital for lacking basic supplies.
This trend is nothing new. Late President Umaru Musa Yar’Adua was flown to Saudi Arabia in 2009 during a health crisis that culminated in his death and a constitutional standoff. Military leaders such as Generals Sani Abacha and Ibrahim Babangida also reportedly relied on foreign hospitals throughout and after their tenures. The same applies to state governors. In 2022, Governor Rotimi Akeredolu of Ondo State spent months in Germany receiving cancer treatment. Governor Bello Matawalle of Zamfara was absent from the state for a prolonged period in 2021 on undisclosed medical grounds.
In 2018, then Minister of Health, Professor Isaac Adewole, was accused of seeking private medical care abroad while Nigeria’s public health workers were on strike.
In 2023, investigations uncovered that dozens of National Assembly members received state funding for foreign medical trips, some for procedures as routine as eye treatment or physiotherapy. These expenses are often buried under vague budget headings such as “welfare” or “overheads” and remain shielded from public accountability.
According to the Nigerian Medical Association, the country loses an estimated $1.2 billion annually to medical tourism. This includes spending by private individuals, corporations, and the government. A sizable portion is incurred by public officials drawing from the national purse.
This practice comes at a great cost. The money spent on elite healthcare abroad could easily fund the upgrade of hundreds of primary health centres with solar power, water supply, modern diagnostic equipment, and skilled personnel.
Currently, only about 20 percent of primary health centres in Nigeria are considered functional, according to the National Primary Health Care Development Agency. Maternal mortality is among the highest globally, with over 80,000 women dying every year from preventable pregnancy-related complications. Access to specialist care remains nearly impossible for rural dwellers, who often travel long distances for basic medical attention. Nigeria’s poor response to disease outbreaks, ranging from Lassa fever to cholera, further underscores the fragility of its health system.
The sector is also haemorrhaging talent. It is estimated that over 40,000 Nigerian doctors are practising overseas, mostly in the United States, United Kingdom, Canada, and Saudi Arabia. Poor remuneration, inadequate facilities, insecurity, and poor working conditions are driving this exodus. Nigeria’s current doctor-to-patient ratio stands at an alarming 1:5,000, far from the World Health Organisation’s recommendation of 1:600.
Despite signing the Abuja Declaration in 2001, which committed African governments to allocate 15 percent of their national budgets to health, Nigeria continues to underfund the sector, spending barely 5 percent annually.
Former President Buhari once promised to end medical tourism but failed to act. His successor, President Bola Ahmed Tinubu, initially gave the impression he would prioritise domestic care. However, reports surfaced in early 2024 that he quietly travelled to France for a private medical check-up. Though the government denied these claims, it offered no proof to counter them.
Until Nigeria’s political class demonstrates confidence in the country’s own healthcare institutions by using them, any talk of reform will ring hollow. Restoring public trust begins with leadership by example.
Medical brain drain, elite health tourism undermine Nigeria’s healthcare future.
