…From Aso Rock to foreign wards: The medical exodus of Nigeria’s rulers
On a quiet afternoon in London, the former Nigerian President Muhammadu Buhari reportedly breathed his last. The news, though unsurprising, carries with it a somber symbolism: yet another Nigerian leader, who presided over the affairs of more than 200 million people, died not on the soil he governed, but in a foreign land — in this case, the United Kingdom, a nation whose healthcare system he neither funded nor served.
Reports also suggest that General Abdulsalami Abubakar, another former head of state, was critically ill in the same hospital, before being discharged. This isn’t just a pattern; it’s a national tragedy, repeated over decades, wrapped in hypocrisy, and bathed in irony.
London has become the preferred hospice for Nigeria’s powerful, while Nigeria remains the graveyard for its voiceless poor.
The Personal Is Political
When Nigerian leaders fall ill, they don’t check into Lagos University Teaching Hospital (LUTH) or the National Hospital in Abuja. They flee — sometimes in secret, often in chartered jets — to London, Germany, or Saudi Arabia. Their first instinct is flight, not faith in the health institutions they oversaw. It is a damning commentary on a political class that, for over six decades, failed to build a healthcare system they themselves could trust.
Former President Umaru Musa Yar’Adua died in office in 2010 after a long illness that saw him shuttling between Nigeria and Saudi Arabia. His prolonged absence and the mystery surrounding his health crisis created a constitutional vacuum and national anxiety. Buhari himself spent over 200 days cumulatively on medical leave in London during his presidency. In 2017 alone, he was absent from Nigeria for 104 days straight due to illness. During this time, no comprehensive disclosure was made to the Nigerian people about the nature of his condition.
From Babangida to Obasanjo, from Yar’Adua to Jonathan and Buhari, and, now Tinubu; the elite circle of Nigeria’s ruling class has displayed a common contempt for the nation’s public hospitals — institutions they budgeted for, staffed, and regulated.
A Healthcare System in Ruins
Nigeria’s healthcare statistics paint a bleak picture:
The World Health Organisation (WHO) ranks Nigeria 187th out of 191 countries in overall health system performance.
The doctor-to-patient ratio in Nigeria is approximately 1:5,000, far below the WHO’s recommended 1:600.
Over 4,000 Nigerian doctors emigrate annually, most to the UK, US, and Canada. As of 2024, there were over 12,000 Nigerian doctors practicing in the UK, while many government hospitals back home face crippling shortages.
Public hospitals suffer chronic underfunding, equipment failure, frequent strikes, and poor working conditions.
The total health allocation in Nigeria’s 2024 budget was ₦1.33 trillion, representing only about 5% of the national budget — still far short of the 15% benchmark agreed upon in the Abuja Declaration of 2001, where African leaders (including Nigeria’s) pledged to improve healthcare investment.
Medical Tourism: A Crisis of Confidence
According to a 2023 report by PricewaterhouseCoopers (PwC), Nigeria loses an estimated $1.2 billion annually to medical tourism. The top destinations? India, the UK, the UAE, Germany, and the US. Most of this expenditure is borne by the wealthy and politically connected — often funded by public resources or undeclared assets.
Medical tourism isn’t inherently wrong. But when leaders who control the nation’s purse strings choose foreign hospitals over local ones, it becomes a symptom of failed governance. They are, in essence, voting against the system they built.
This systemic hypocrisy was eloquently captured by Professor PLO Lumumba, a Kenyan legal scholar, who once said: “African politicians go to Europe to die, but never to govern.”
What If…?
Imagine if each Nigerian leader had prioritised healthcare during their tenure. Imagine if, instead of billion-naira convoys and private jets, they invested in world-class teaching hospitals in every geopolitical zone. Imagine a National Cancer Centre fully equipped in Abuja, or a Cardiovascular Institute in Kano, or a Renal Research Centre in Enugu.
What if Buhari, during his eight years in office, had committed just half of the funds spent on Aso Rock clinic renovations to building a specialized medical facility for advanced diagnostics and care?
In 2017, the State House Clinic received a budget of ₦3.2 billion, yet the First Lady, Aisha Buhari, lamented publicly that the clinic lacked basic drugs and equipment. “I wanted to do an X-ray, they said the machine was not working,” she said in a speech that shocked the nation.
So where did the money go?
A Nation as Cemetery, London as Sanctuary
For the average Nigerian, hospitals are often a place of despair, not healing. Newborns die in incubators when power fails. Accident victims bleed out on potholed roads with no ambulances in sight. Women in labour are turned away due to lack of oxygen or personnel. In many rural areas, the nearest doctor is hours away — if one exists at all.
Meanwhile, our leaders die comfortably, surrounded by machines, trained caregivers, and sanitised rooms — not in the institutions they governed, but in those built by other nations who value life as a public good, not a private luxury.
Leadership by Absence
Governance in Nigeria has long been marked by absenteeism — physical, moral, and institutional. It is a pattern of escape rather than engagement. Our leaders rule by proxy, heal in foreign wards, and return home in caskets.
This is not leadership. It is betrayal.
It is a betrayal of trust, of mandate, of nationhood.
A Call for Accountability
The time has come to demand more than cosmetic reforms. Medical exile must become politically and socially unacceptable. No minister, no president, no governor should be allowed to seek foreign treatment at public expense unless it is proven beyond doubt that no such care is available in Nigeria — and even then, it should raise questions, not praises.
We need:
Mandatory public healthcare usage policies for elected officials and their families.
Whistleblower protection laws for uncovering corruption in healthcare budgets.
Sustained investment in medical education, technology, and research.
A National Healthcare Sovereignty Act, limiting foreign medical expenditure by public officials.
Conclusion: Reclaiming Dignity in Death — and Life
A nation is judged not by how its leaders die, but by how its people live. Until we reverse this disgraceful tradition of elite medical exile, Nigeria will remain a place where the poor die in silence, and the powerful die in comfort, far from the consequences of their rule.
The final breath of our leaders should not be drawn on foreign soil. If they cannot trust the hospitals they built, then they have built nothing at all.
It is time to choose dignity over decadence, investment over escape, and leadership that lives and dies with the people — not apart from them.
Sources & References:
World Health Organization (WHO), Global Health Observatory
PwC Nigeria, “Medical Tourism: The Private Sector’s Role” (2023)
Premium Times Nigeria, “Nigeria’s Healthcare Budget Still Below 15% Abuja Declaration” (2024)
Vanguard, “Over 12,000 Nigerian Doctors Practicing in UK” (2024)
BBC Africa, “President Buhari’s Long Medical Leaves Spark Debate” (2017)
Benjamin Omoike is a writer/researcher/analyst focused on truth, equality, justice, fairness, governance, development, African affairs and humanity.
