Mortality of any African leader outside Africa due to health issues would be a loss for the outside country.

Nigeria's ex-President Muhammadu Buhari passed away in a British hospital last Saturday. It underscores a large problem in Africa: political leaders frequently seek costly medical attention overseas. It ends up costing the government a great deal of money, yet the medical systems back home are not supported much and aren't very good.

Numerous African leaders and significant personalities have perished in hospitals outside of Africa. It indicates a significant betrayal of the people and a great error in realizing what is most significant in life.

It would be ironic to juxtapose the funds transferred to large hospitals in these nations against the health of the population. For instance, the State House Clinic in the Nigerian capital, Abuja, was established for the medical requirements of the President, the Vice President, their families, as well as government ministers. Between 2015, when Muhammadu Buhari first assumed the Nigerian Presidency, and March 2023, ₦15.24251 billion was deducted from the national fund for the sake of the State House Clinic. Converted to the current exchange rate, it was roughly $9.95 million, funds that would go a very long way in helping the various government health centers.

The budgets of the clinic every year are extremely large: ₦3.94 billion, ₦3.87 billion, ₦3.2 billion, ₦1.03 billion, ₦798.86 million, ₦598.6 million, ₦641.1 million, ₦708.75 million, and ₦455.2 million. Though much money is raised, the clinic is frequently reported to be in a state of disrepair, stating it does not even possess basic drugs and medical equipment. Former First Lady Aisha Buhari attacked the clinic, asking how the money was used and how there were no elementary medical supplies such as syringes. The gap between the money raised and the state of the clinic reveals serious issues of neglect and mismanagement that damage the nation’s health care.

Nigeria's health system has not improved since Buhari assumed office as the country's leader. Funds for health in the national budget have always been extremely low, ranging from 4.1% to 6.4%. It rose to 6.2% in 2015, decreased to 4.1% in 2016, and increased marginally to 6.4% in 2023. These figures are significantly less than the Abuja Declaration's recommendation to allocate 15% of national budgets to health, presenting no strong indication of support for the health of the people.

Even more alarming is the precipitous decline in the ratio of doctors to patients. In 2015, the ratio was approximately 1:4,000, already strained. By 2022, the rate had worsened to around 1:6,000, and by 2023, it had plummeted to an astonishing 1:9,000. This critical shortage of medical professionals is exacerbated by a continuous “brain drain,” with Nigerian doctors migrating abroad in search of better working conditions and remuneration, further crippling the already fragile system.

This dismal state of affairs squarely points to the failures of the health ministers under Buhari’s administration. Critics frequently lambasted them for their perceived inability to translate policy into tangible improvements, halt the exodus of medical professionals, or effectively utilise the limited funds allocated to public health. Rather than championing robust local healthcare infrastructure, their tenure was largely marked by maintaining the status quo, which resulted in public hospitals being dilapidated and under-equipped.

Muhammadu Buhari’s frequent and prolonged medical sojourns in London throughout his presidency became a significant point of contention. While his health was a private matter, his reliance on foreign hospitals, paid for by the Nigerian taxpayer, starkly contrasted with the dilapidated conditions ordinary citizens face. This dichotomy drew sharp criticism from the Nigerian Medical Association and various civil society groups, who argued that such actions eroded public confidence in the nation’s healthcare system and set a poor precedent.

In defending the former President’s actions, his spokesman, Femi Adesina, offered a statement that, for many, epitomised the problematic mindset of the political elite. In an interview with Channels TV, Adesina asserted that Buhari chose foreign hospitals “because staying alive came first.” He further contended that Nigeria lacked the necessary medical expertise to treat the former president, suggesting that relying on Nigerian hospitals could have led to his demise sooner.

This justification, while attempting to rationalise a personal decision, inadvertently serves as a damning indictment of the very system the government was meant to improve. It begs the question: if the nation’s leader, with dedicated State House Clinic funds and the resources of the state at his disposal, could not trust domestic medical facilities, what hope did the average Nigerian have? The argument that a leader must first stay alive to effect change falls flat when seeking foreign care undermines the potential for that change to occur within the country’s medical landscape. It highlights a system where public officials, rather than strengthening local institutions, opt for the convenience and perceived superiority of foreign services, perpetuating a cycle of neglect and underdevelopment at home.

The death of African leaders abroad is not merely a personal tragedy but a poignant symbol of a wider systemic failure. It reflects a leadership class that, despite presiding over immense national wealth and allocating significant budgets to healthcare, frequently fails to invest adequately in, and perhaps more crucially, trust, its public services. Until African leaders demonstrate a genuine commitment to developing and utilising robust domestic healthcare systems, the irony of their final moments spent in foreign hospitals will continue to be a painful and enduring symbol of unfulfilled promises.

By Stephen Wise