How to keep Nigeria’s health billions at home

Nigerians are spending huge scarce foreign exchange on medical bills abroad. From politicians to business moguls, Nigeria’s bourgeoisie spend at least $1 billion to $1.6 billion annually on medical tourism, mostly to India, the United States, and the United Kingdom, according to the federal government records.

Olayemi Cardoso, the Central Bank of Nigeria (CBN) governor, said in early 2024 that Nigerians spent $40 billion on medical and educational tourism between 2004 and 2014.

This was happening when the poor struggled to foot medical bills and died due to lack of critical equipment or healthcare specialists in local hospitals.

Health systems development experts are concerned that Nigeria has failed to invest sufficiently to capitalise on medical tourism despite a significant demand for healthcare services at home.

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Khama Rogo, former lead, World Bank Health in Africa Initiative, said the foreign healthcare needs of Nigeria and other West African nations drive about 25 percent of two major African businesses: Kenya Airways and Ethiopia Airlines.

This indicates that a lot of money is being pushed out of a system that needs the same funding to thrive.

“Overnight at the airport in Addis Ababa or in Nairobi, you will see West Africans who are in wheelchairs. And when we say West Africans, that means Nigerians. They are going for care and coming back here. It is 25 percent of the airline business for those two airlines. That is real money,” Rogo said, speaking at the 2025 annual conference of the Health Federation of Nigeria held in Lagos weekend.

“So, when they tell me Nigeria cannot meet the Abuja budget, then I asked myself, how come that money is only available when individuals travel but is never available when you want to treat the masses?”

To improve Nigeria’s attraction as a medical tourist destination, Rogo suggested a strong partnership between the private and public health sector in governance, financing and human resource production and utilisation.

In financing, Rogo believes there needs to be an improved outlook of the business of healthcare by banks, noting that there is “less default when you lend to the health sector.”

For patients in many African countries, medical tourism provides access to treatments that are both more affordable and of superior quality compared to what is available domestically.

South Africa, Tunisia, and Morocco are attracting global attention by implementing robust national strategies, including public-private partnerships, tax-investment incentives and targeted marketing campaigns.

A US Chamber of Commerce report on African medical tourism highlights that successful strategies commonly include: comprehensive packages featuring assistance with medical visas, airport meet-and-greets, private nurses, pre- and post-surgery hospital accommodations, and even luxury safaris after treatment.

These market features are also complemented by good climate, exotic tourist locations, and highly certified medical practitioners and facilities.

The chamber said that South Africa, Morocco, and Tunisia have committed to necessary infrastructure development and secured private capital to finance projects aimed to propel their countries as top medical tourist destinations.

Keeping Nigeria’s billions at home

Analysts say that reducing Nigeria’s medical tourism requires a strong will by the government. Emeka Ezennia, a medical doctor, recalled that Muhammadu Buhari started his administration in 2015 by announcing a ban on medical tourism for all civil servants.

However, the former president soon became a regular visitor to the United Kingdom for medical care.

“Buhari had spent over 200 days in the UK by 2021, mostly for treatment,” Ezennia said in an interview.

Experts say that something needs to be done to reduce the nation’s medical tourism.

“Adequate funding of the system, improved health care facilities, better remuneration and motivation for health workers, and government intervention on the battle for supremacy among health workers are key,” a paper presented by Mohammed Abubakar, Salawu Basiru, Joseph Oluyemi and three others noted.

“Immediate ban of government sponsored medical trips abroad, adequate training, enforcement of legal action against medical negligence, improved medical research and encouraging foreign investment are alo important.”

Abdu Mukthar, national coordinator, Presidential Unlocking Healthcare Value Chain Initiative, said at the annual conference of the Health Federation of Nigeria that the government plans to execute more programmes this year to plug the gaps in the health sector.

He said there are clear goals for healthcare financing in the national budget signed last week by the president, providing access, quality and ensuring sustainable pathways to funding.

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Mukthar noted that outcomes are targeted at achieving improvement in mortality and morbidity rates, drop in out-of-pocket expenditure by patients and reduction in difference in health outcomes between different income quartiles.

Through the initiative, financing was drawn from the European Investment Bank (1 billion Euro), Afreximbank ($1bn) and development finance institutions such as Bank of Industry (BOI) and Ministry of Finance Incorporated (MoFI), with advanced discussion for dedicated financing platforms.

According to Ezennia, earlier quoted, there is a need for Nigeria to invest in quality hospital equipment while keeping healthcare workers from the prying eyes of the United Kingdom, the United States or the Middle-East.

“We need to take care of our healthcare workers to encourage them to stay here. We need to have the equipment needed to take care of patients. Right now, our medical or health sector is not attractive enough.”

Akin Abayomi, Lagos State Health commissioner representing the governor, emphasised the crucial role of healthcare financing, stating that increased government or corporate health spending directly correlates with improved disease outcomes, longer life expectancy, higher standards of living, and expanded gross domestic product (GDP).

“It is logical. Governments, entities and individuals need to spend money to get healthy. It has to come from intentional policies of government and private sector partners to provide the necessary components for healthy community outcomes,” Abayomi said.

Pamela Ajayi, Health Federation of Nigeria (HFN) president, said Nigeria must prioritise building its own robust healthcare industry and actively purchase and promote locally-made drugs, consumables, and medical equipment.

She noted that the group has spent 10 years advocating for health development and has influenced policies to ease the operating environment for players.

“Over the past few years, several centres of excellence have been established, offering world-class medical services in specialties such as cardiology, oncology, orthopedics, and fertility treatments. We are now witnessing a remarkable shift-patients from other African countries and even beyond coming to Nigeria for specialised surgeries and treatments. This is a testament to the growing confidence in our healthcare system. We must continue to promote and invest in our healthcare institutions, ensuring that Nigeria becomes the preferred destination for high-quality medical care in Africa,” Ajayi said.