At 65, a person is often expected to look back on their life with wisdom, strength, and a sense of fulfillment. At 65, a nation should be stepping confidently into maturity, with the scars of youth turned into lessons for progress. But Nigeria, at 65, tells a different story—especially in the healthcare sector. Ours is a nation that has been in motion without movement: running in circles, talking big but achieving little, and watching our people die of preventable causes while leaders fly abroad for medical tourism.
The Illusion of Progress
Since independence in 1960, successive governments have pledged to prioritize healthcare. Grand blueprints were drawn, policies launched, and summits organized. Yet the reality remains bleak: hospitals with peeling walls, wards without electricity, patients on the floor because of inadequate bedspaces, and doctors improvising with substandard materials, makeshift tools or faulty equipment.
In 2001, Nigeria was one of the African countries that signed the Abuja Declaration, pledging to allocate 15% of its annual budget to healthcare. Today, 24 years later, our health budget still hovers around 4–6%, a clear betrayal of both citizens and the promises made. Compare this to Rwanda, a smaller economy, which allocates 10–12% consistently and has built a healthcare model praised across Africa.
What does this mean? It means that Nigeria has been running on a treadmill—plenty of sweat, but no forward motion.
Startling Statistics
Numbers don’t lie, and Nigeria’s healthcare statistics are damning:
- Doctor-to-patient ratio: Nigeria has 1 doctor per 9,000 citizens, far worse than the WHO recommendation of 1 per 600.
- Maternal mortality: Nigeria accounts for 20% of global maternal deaths. Roughly 82,000 women die annually during childbirth. That’s 225 women every single day.
- Infant mortality: 74 out of every 1,000 Nigerian children die before their 5th birthday. Compare this to South Africa (31) or Egypt (18).
- Life expectancy: At 55 years, Nigeria ranks among the lowest in the world, behind war-torn nations.
- Brain drain: Between 2015 and 2023, over 15,000 Nigerian doctors migrated to the UK, US, Canada, and Saudi Arabia. As of 2024, 1 in 3 Nigerian-trained doctors work abroad.
If healthcare reflects the soul of a nation, Nigeria’s soul is sick.
The Nigerian Paradox
What makes this tragedy even more painful is the paradox: Nigeria is Africa’s largest economy, blessed with oil, gas, and abundant human talent. Yet we spend more money sending politicians abroad for checkups than we do equipping our hospitals. In 2021, some high powered politicians spent over 200 days in London hospitals for treatment, while the State House Clinic in Abuja, meant for top officials, was reported to lack basic drugs and syringes.
Our leaders’ actions scream a bitter truth: they do not trust the very healthcare system they preside over. If they cannot lie on a hospital bed in Abuja or Lagos, why should ordinary Nigerians trust it?
Healthcare Workers: Heroes Abandoned
At the heart of every healthcare system are the workers consisting of doctors, nurses, midwives, pharmacists, and laboratory scientists. Yet Nigeria treats them with neglect. Most
Nigerian doctors earn between ₦160,000–₦400,000 monthly ($120–$300) while their counterparts in the UK or Canada earn $3,000–$6,000 monthly. The salaries, often delayed for months, not only impact negatively on their physical state such as catering for personal and family needs, but psychologically affecting their concentration when attending to patients. Nurses are overworked, sometimes handling 40 patients per shift. Hospitals lack gloves, oxygen, and even water. Many health workers buy equipment with their own money to keep patients alive. We have several health care workers who have died in the line of duty, forgotten in a wink despite being killed by the very country they desired to serve, due to inhospitable working environments and hours that can stretch for more than 72hrs non stop.
Is it surprising then that they leave in droves? When a country trains its best only for them to serve other nations, that country is not moving forward—it is bleeding slowly to death.
The People’s Burden
For the average Nigerian, healthcare is not a right—it is a gamble. Over 70% of healthcare expenses are paid out-of-pocket, meaning that illness often drives families into poverty. A father with a sick child must choose between paying school fees and buying drugs. A pregnant woman in a rural area may deliver at home with an untrained personnel because the nearest clinic is 30 kilometers away and has no ambulance.
Every Nigerian family has a story of loss: a brother who died from appendicitis because there was no surgeon; a cousin who bled to death in childbirth because there was no blood in the bank; a father who succumbed to hypertension because he couldn’t afford regular drugs. These are not rare stories; they are now daily realities.
Why Motion Without Movement?
The tragedy of Nigerian healthcare lies not in a lack of ideas but in the absence of will. Policies have been written, committees set up, and billions allocated. Yet corruption, mismanagement, and lack of accountability cripple progress. Hospitals that should be centers of healing become centers of decay.
We have moved on paper – countless policies, reforms, and visions – but we have not moved in practice. That is why, 65 years after independence, we are still struggling with the same diseases that smaller, poorer countries have largely overcome.
What Needs to Change
If Nigeria is to break this cycle of motion without movement, radical changes are needed:
- Healthcare Financing: Allocate at least 15% of the national budget to health and ensure transparent use. Money must reach hospitals, not disappear into private pockets.
- Infrastructural Development: Modernize hospitals, build functional primary health centers in every ward, and equip them with electricity, water, and basic drugs.
- Human Resource Retention: Pay doctors and nurses competitive wages, provide housing and insurance, and create incentives for them to stay.
- Health Insurance Expansion: Ensure universal health coverage, including coverage for all health care workers, reducing out-of-pocket expenses for Nigerians.
- Accountability and Political Will: Leaders must end medical tourism for public officials. If they are forced to use Nigerian hospitals, change will come faster than any policy paper.
A Call to Reflection
At 65, Nigeria must ask itself hard questions:
- How long will our people continue to die of preventable illnesses?
- How long will doctors and nurses continue to flee?
- How long will we remain a nation rich in resources but poor in care?
It is not enough to celebrate independence with parades and speeches. True independence means building systems that protect life, dignity, and hope. Without healthcare, there is no development; without healthy citizens, there is no nation.
Conclusion
Nigeria at 65 stands as a cautionary tale: a nation in motion without movement, where healthcare has been reduced to statistics, promises, and failures. Yet it doesn’t have to remain this way. The future can be different, but only if leaders choose action over rhetoric, accountability over corruption, and investment over neglect.
History will not forgive a nation that lets its citizens die when solutions are within reach. At 65, Nigeria must decide: will we keep running in circles, or will we finally move forward?
In 21st century healthcare delivery, standing still is the same as moving backward, and Nigerians have already paid too high a price.
Long Live Federal Republic of Nigeria
Dr Benjamin Oluwatosin Olowojebutu
First Vice-President
Nigerian Medical Association
