Revelation by the Nigerian Association of Resident Doctors (NARD) that there are only 55,000 medical doctors to serve the hundreds of millions of Nigerians is alarming. It is a sobering situation in the health sector, confirmed by the President of the Nigerian Medical Association, Prof. Omoti Ernest, who reportedly said that whereas the Medical and Dental Council of Nigeria (MDCN) has 130,000 names on its register, only about 55,000 are practising in the country.

The situation has multidimensional implications that need to be addressed with all seriousness, given that ‘health is wealth’; only a healthy population can be productive for the country. In the extant constitution, after ‘security’, good health is at the apex of the welfare consideration. Furthermore, both ‘the sanctity of the human person’ and ‘human dignity’ espoused in S.17 (2)(b) are predicated upon ‘adequate medical and health facilities for all persons.’

The World Health Organisation (WHO) recommends a doctor-to-citizen ratio of 1:600 or, according to some other sources, 1:1,000. It is estimated that Nigeria needs about 363,000 doctors to meet the WHO standard. Omoti said that figures available point to only one doctor to attend to between 3,600 and 4,000 Nigerians. Some other African countries fare better. Cape Verde, Algeria, Seychelles, and even embattled Libya, reportedly meet the WHO standard.

The 2026 Federal Government health budget is N2.48 trillion or 4.3 per cent of the total budget,  a breach of Article 26 of the 2001 Abuja Declaration pledged by the Heads of State and Government of the then Organisation of African Unity “to set a target of allocating at least 15 per cent of our annual budget to the improvement of the health sector.” This was as far back as April 2001. If successive governments lived up to this lofty commitment –and judiciously applied the funds provided -, health care would be better in the country.

Armed with N8.7 trillion of the 2026 federal budget, for the health sector, medical personnel could be better paid as and when due, medical facilities would be expanded and equipped with up-to-date tools, more and better medical schools would be opened, foreign funding and partnerships, and foreign experts would consider it worthwhile to come to Nigeria to work, research, and share knowledge and experience with local health workers. Nigerians would, without doubt, be in better condition of health and more productive than they generally are now.

Notably, the resident doctors had reiterated an earlier statement by the Minister of Health and Social Welfare, Prof. Muhammad Pate that up to 16,000 doctors left this country in the last five to seven years, arguably for better work environments.

Further depressing statistics by the Nigeria Health Statistics Report released by the Federal Ministry of Health and Social Welfare indicate that 4,193 doctors and dentists left Nigeria for other climes in 2024, and 43,221 doctors, nurses, pharmacists and medical laboratory scientists migrated out of the country between 2023 and 2024.

The ‘Japa’ syndrome that causes the loss of expensively- trained doctors and other professionals to other climes has both ‘push and pull factors. Omoti explained the push factor: ‘‘The reasons behind this migration include poor remuneration, inadequate working conditions, insecurity, limited opportunities for career advancement, and insufficient investment in healthcare infrastructure, among others.”  At the 27th Annual Faculty Lecture of the National Postgraduate
Medical College of Nigeria, recently, Dr Haroon Ajibode, former Chief Medical Director of Olabisi Onabanjo UniversityTeaching Hospital, Sagamu, spoke in similar terms. He noted that most Nigerian medical graduates were being ‘pushed’ out of the country due to poor remuneration, bad governance, insecurity, and unfavourable working conditions.

In respect of the pull factor, Prof. Omoti said that “many professionals are attracted by better pay, improved facilities, and more stable environments in countries such as the United Kingdom, Canada, and the United States.” Ajibode said many doctors were seeking residency training abroad.

The dire consequences of this are reflected by NARD: “Nigerian resident doctors work an average of 106.5 hours per week, with surgical residents enduring over 122.7 hours weekly. This translates to an average of four to five days of 24-hour call duty per week.”  Furthermore, “This … deeply troubling [situation] inevitably leads to increased medical errors due to burnout, endangering patients’ safety, with a severe toll on the mental, physical, and psychological well-being of doctors. Too often, resident doctors sacrifice their health and sometimes their lives in service to their patients. The consequences are tragically evident with early career doctors paying the ultimate price”.

Undoubtedly, every level of government has the primary responsibility to ensure the health of the people. This is the reason that Section 17(3)(d) says “The State shall direct its policy towards ensuring that… there are adequate medical and health facilities for all persons”. This is a constitutional injunction to be carried out by every government of the day; it is neither an advice nor a suggestion.

It has been reasonably suggested that, for effective official attention to the health sector, a law should be enacted prohibiting high government officials from seeking medical attention outside the country. That way, successive governments will have no choice but to put the healthcare delivery system in the best condition.
However, it will take a political leadership of the utmost patriotism to bring this to pass.

In his ‘Renewed Hope 2023’ Manifesto to the electorate, President Bola Tinubu had acknowledged, rightly, that healthcare is ‘a matter of right and urgency [because] the productivity and welfare of a nation depends on the vitality of its people”. He promised, if elected, to ‘frontally address our nation’s healthcare challenges, including inadequate healthcare infrastructure, fragmentation, an overburdened workforce…” among other elaborate measures.

Three years on, most of these promises remain unfulfilled. But it’s not too late to do the needful. A man’s word should, nay must, be his bond, especially at the highest level of national leadership. 55,000 doctors for over 200 million Nigerians is not acceptable at all.