Nigerians spent over $3.6bn annually on foreign healthcare under Buhari

During the eight years of former President Muhammadu Buhari's rule, Nigerians spent at least $29.29 billion on overseas medical bills. During the evaluation period, this corresponds to an annual expenditure of almost $3.6 billion.

This is based on a thorough examination of information from the quarterly statistical bulletins published by the Central Bank of Nigeria. The amount, which falls under the "Health-Related and Social Services" category, represents total foreign exchange outflows from June 2015 to May 2023, which is exactly how long Buhari spent in office throughout his two terms, from May 29, 2015, to May 28, 2023.

With the CBN's record demonstrating a year-over-year transfer of funds overseas for medical purposes amid economic downturns or dollar shortages at home, the data our correspondent studied demonstrates the extent of Nigeria's reliance on international healthcare services.

It also draws attention to the irony that, in spite of the administration's repeated claims to improve the health sector and curb capital flight, foreign exchange outflows related to health continued to be substantial and even sharply increased in the latter years of Buhari's presidency.

The first year of Buhari's administration saw the largest amount spent on medical tourism, according to a detailed analysis of the expenditure trend. Nigeria paid a total of $7.81 billion on foreign health services between June 2015 and May 2016.

Under his leadership, this amount alone was responsible for more than 25% of all medical tourism spending. Notably, September 2015 was a month of extraordinary outflow, disbursing $3.20 billion, the most for any one month over the eight-year span.

That spike occurred during Buhari’s first few months in office and was followed by elevated monthly figures in October, November, and December of 2015, which further raised questions about whether the expenditure reflected a backlog of deferred medical bills or a broader trend among elites seeking healthcare abroad immediately after the administration took office.

In the subsequent year, between June 2016 and May 2017, the figure dipped to $2.76bn, although substantial sums were still recorded in months such as March 2016 ($0.96bn) and April 2016 ($0.67bn).

Spending continued to decline in Buhari’s third year in office, falling to $1.72bn between June 2017 and May 2018. By the fourth year of the first term, which ran from June 2018 to May 2019, Nigeria’s medical tourism bill had dropped sharply to just $0.44bn — the lowest across all eight years.

However, a closer examination of the second term reveals a different picture. After a relatively low fifth year, when Nigeria spent $0.92bn on medical services abroad between June 2019 and May 2020, there was a slight increase in the sixth year, with foreign exchange outflows reaching $1.57bn.

This modest recovery coincided with the COVID-19 pandemic, which imposed global travel restrictions and temporarily subdued international medical travel. The data during the lockdown period between April 2020 and June 2021 reflected lower figures, but it also hinted at pent-up demand that would soon be unleashed.

Indeed, from June 2021, medical tourism experienced a surge once again. The seventh year of Buhari’s administration — between June 2021 and May 2022 — recorded $6.96bn in health-related foreign exchange disbursements.

June 2021 alone accounted for $3.02bn, almost matching the record set back in 2015. April 2022 saw another massive jump with $1.28bn spent, suggesting that Nigerians, particularly the affluent class and public officials, resumed international travel en masse to seek healthcare that remained inaccessible or underdeveloped at home.

Spending $7.12 billion between June 2022 and May 2023 was the second-highest annual spending during the administration's eighth and final year. With $2.30 billion in medical outflows, January 2023 was an especially expensive month and the third-highest monthly total under Buhari's administration.

The second term of Buhari's government, which at first seemed more conservative in terms of health-related foreign exchange usage, ended up surpassing the first term due to this late spike in medical tourism spending.

In contrast to the $12.73 billion spent in the first term, $16.56 billion was spent in the second term. This change implies that, in spite of previous restrictions, the fundamental causes of medical tourism—such as inadequate local healthcare facilities, mistrust of domestic healthcare providers, and the elite's inclination for overseas care—were not addressed and may have gotten worse.

Buhari received a lot of flak for traveling overseas for medical treatment during his administration. He visited the UK several times for unannounced medical procedures, occasionally remaining for long stretches of time.

Buhari visited at least 40 nations since 2015 and spent at least 225 days abroad on medical visits during his eight-year rule. The former president had his first medical travel to London, UK, on February 5, 2016, eight months after taking office, and stayed for six days.

Four months later, on June 6, 2016, he made his second medical journey, spending ten days treating an unidentified ear infection. Buhari left for London on January 19, 2017, on his second-longest medical journey, which lasted 50 days.

Meanwhile, the Nigerian Medical Association, the Medical and Dental Consultants’ Association of Nigeria, and the Nigerian Association of Resident Doctors earlier criticised political leaders for consistently seeking medical care abroad while neglecting the country’s healthcare system.

The President of the Nigerian Association of Resident Doctors, Dr Tope Osundara, described the trend as not only disheartening but an indictment of Nigerian leaders’ investments in the sector they are expected to strengthen.

Osundara expressed disappointment that Nigerian leaders continue to patronise foreign hospitals despite annual budget allocations to domestic medical facilities like the State House Clinic.

“It’s more like building a company, investing resources in it, then refusing to use the product and telling others to trust it. It tells you that something is fundamentally wrong with the system, with the people entrusted with managing it.

“There was a time when the former president, Muhammad Buhari, made some utterances that they should abolish this medical tourism. But unfortunately, before he died, he was even at the forefront of going abroad for treatment. Even a former Head of State, General Abdulsalami Abubakar, disclosed that he and Buhari were admitted to the same hospital in London shortly before Buhari passed away. This tells you that Nigeria’s healthcare system is in bad shape.”

On his part, the President of the Nigerian Medical Association, Prof Bala Audu, noted that while individuals are free to seek care wherever they choose, the consistent reliance of public office holders on foreign hospitals despite Nigeria’s budgetary allocations to domestic healthcare speaks volumes about misplaced priorities.