Nigeria was a prime medical tourism destination in the 1960s. It is hard to believe, but true. Wealthy patients from all over, and even royalty, headed for the University Teaching Hospital, Ibadan. But so much has changed since then.
Every year, countless Nigerians and other African elites now travel to Europe, India, Saudi Arabia and other countries for medical care, spending billions of dollars in the process. Nigeria alone is estimated to have lost about $2.39bn (R42bn) on outbound medical tourism in 2024, a significant financial outflow that highlights the pressing need for Africa to address and manage the issue.
Medical tourism and the attendant capital outflow not only drain resources; they stunt capacity building and skills transfer, stymie efficient health-care service delivery and ultimately exacerbate the health-care gap on the continent. There is also the brain drain and the widening infrastructure gap as African medical practitioners migrate to the West due to poor health infrastructure and poor remuneration, thus aggravating an already bad situation.
Access to affordable health care and world-class medical facilities remains a challenge in much of Africa; the Africa Health Agenda International Conference notes that more than half the continent’s 1.3-billion people lack access to basic health-care services.
Both urban and rural dwellers are affected, with the latter bearing much of the brunt.
There has also emerged a two-tier health system. This means that those on the lower rung of the economic ladder end up dying from what should be nonfatal conditions.
The result is a resort to private medical care locally or abroad for those who can afford it. The World Bank estimates that 50% of health-care spend in Africa goes to private medical providers.
If health is indeed wealth, then Africa’s offshore medical tourism junkets are squandering resources that could be channelled into enhancing health-care infrastructure, health-care delivery, capacity building and skills transfer.
Recent health emergencies such as ebola, Covid and mpox, seasonal outbreaks of cholera, lassa fever and other diseases, as well as a rise in noncommunicable diseases such as cancer and cardiovascular problems, highlight not just the fact that Africa bears a disproportionate share of the global disease burden but also focus attention on the yawning gap in Africa’s health-care systems.
So-called scarcity nationalism and vaccine diplomacy, the Covid pandemic phenomena whereby rich countries stockpiled and hoarded essential medical supplies and vaccines, is a sobering reminder of why we must strive for our own centres of health-care excellence.
Many African governments continue to invest relatively modestly in health care, allocating an average of just 7.4% of their national budgets
This focuses renewed attention on calls for a decolonisation of the global health system and infrastructure, which continue to privilege the West while marginalising the Global South. Africa must be independent politically, economically and healthwise because entrusting our health-care needs to others presents both security and economic risks.
To put this in context, global health spending reached $9.8-trillion in 2022 — but low- and lower-middle-income countries received less than 3.2% of that amount. This disparity reflects a broader challenge: many African governments continue to invest relatively modestly in health care, allocating an average of just 7.4% of their national budgets.
This falls short of the 15% commitment made under the 2001 Abuja Declaration, when AU member states pledged to prioritise health spending. While there has been some progress over the past two decades, the gap remains significant.
Looking ahead, growing pressures — including shifting geopolitical priorities, declining official development assistance, shrinking foreign reserves and rising debt — are likely to compound these challenges and make access to health care even more difficult.
There is an urgent need, now more than ever, to reinforce investments in resilient, local health systems that can withstand global shocks and meet the needs of African populations.
Collaborative synergies between governments, private entities and other stakeholders should be encouraged even as African nations are urged to honour the 2001 Abuja Declaration.
An example of a broad public-private partnership is the African Medical Centre of Excellence (AMCE) Abuja, a tertiary-level multispecialty medical institution developed by African Export-Import Bank (Afreximbank) in collaboration with King’s College Hospital, London, with the support of the federal government of Nigeria.
The centre, which commenced operations on June 5, is expected to create about 3,000 jobs and serve more than 350,000 patients from Nigeria and other African nations in its first five years.
The vision for the AMCE is not just to provide top-notch health care, but to serve as a catalyst for the transformation of the African health sector. It is making a bold statement to the world that Africa is finally taking its destiny in its hands in terms of health-care sovereignty and setting global standards.
The AMCE is more than just one crucial component of Afreximbank’s network of health-care facilities, which aim to address brain drain, reduce outward medical tourism, foster job creation and facilitate capacity building and skills transfer.
It is a space for developing and supporting health-care professionals as a hub of innovative research, development and education, delivering comprehensive services in oncology, haematology, cardiovascular care and general medical and surgical services. Its African Life Sciences Foundation is expected to drive research into intractable “African diseases” such as sickle cell and malaria and produce cures in five to seven years.
The success of AMCE Abuja will validate Afreximbank’s proof of concept and hopefully open a new era signposting Nigeria — and indeed Africa — as a prime inward medical tourism hub, building a health-care ecosystem that will outlive us all.
• Shettima Mustapha is vice-president of Nigeria
• Oramah is president and chair of Afreximbank
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