Nigeria Watched Its Doctors Leave and Is Now Paying the Price

When the Nigerian Labour Minister, Chris Ngige, appeared on a popular television show in 2019 and declared that the country had a surplus of doctors, he was not speaking in error or off the cuff. He meant every word. On Channels TV’s Sunrise Daily, he stated that Nigeria had an “excess” of doctors and that […]

When the Nigerian Labour Minister, Chris Ngige, appeared on a popular television show in 2019 and declared that the country had a surplus of doctors, he was not speaking in error or off the cuff. He meant every word. On Channels TV’s Sunrise Daily, he stated that Nigeria had an “excess” of doctors and that those who went abroad sent money home, making them a source of foreign exchange rather than a sign of crisis. The audience did not find this reassuring.

That statement captured something important about how successive Nigerian governments chose to frame one of the most serious public health disasters unfolding in real time. Not as a crisis. Not even as a problem. They chose to frame it as a feature.

However, the numbers told a different story—one that now points to a national emergency. The Nigerian Medical Association has repeatedly noted that the practising ratio in the country has degraded closer to 1 doctor to 9,000 or 10,000 people. Meanwhile, the World Health Organization recommends a ratio of 1 to 600. Alarmingly, roughly half of all Nigerian-trained doctors are now practising abroad. These are not abstract figures; they mean overloaded wards, women dying in childbirth for lack of a skilled attendant, and patients forced to rely on doctors too exhausted to function properly.

Now, the exodus has been building for decades, but the last ten years represent an acceleration that should have triggered urgent policy action long before any minister went on television to call it a surplus situation. The United Kingdom immigration report for 2022 showed that 13,609 Nigerian healthcare professionals were granted working visas in the UK in 2021 alone. Between December 2021 and May 2022, a further 727 Nigerian-trained doctors relocated to the UK, roughly four moving to the same country every day. As of 2023, the UK remained the leading destination with over 12,000 Nigerian doctors, while the United States, Canada, and Germany followed closely.

Sadly, a more recent report found that 43,221 doctors, nurses, pharmacists, and medical laboratory scientists left the country between 2023 and 2024 alone. That is a 200% surge across all professional cadres. In two years, Nigeria lost more health workers than many African nations have ever trained.

The reasons for leaving are well-documented. Poor working conditions, low salaries, and political instability are the key push factors, while better pay and career prospects draw health workers to richer countries. Entry-level doctors in state hospitals have for years earned as little as 150,000 naira a month, a figure that shrank further after the naira collapsed following currency reforms in 2023. Beyond pay, there is the daily indignity of erratic power, expired consumables, equipment that has not been serviced in years, and, for many, genuine personal safety concerns. The decision to leave is not impulsive. It is the conclusion of years of accumulated disappointment.

Around 2018, then Health Minister Isaac Adewole suggested in a video that went viral that doctors who could not find work should consider alternative careers. “Some will be farmers, some will be politicians. It might sound selfish, but we can’t all be specialists,” he said. President Muhammadu Buhari reportedly told departing professionals that they could move to another country if they felt they had one. That Buhari himself regularly sought medical treatment abroad was not lost on Nigerians.

The truth is that these were not isolated gaffes. They reflected a coherent, if unspoken, position: that the departure of health workers was either inconsequential or beneficial, that remittances compensated for lost expertise, and that training more doctors urgently would fill the gap. As recently as August 2022, health minister Osagie Ehanire told a press conference in Abuja that there were “actually enough doctors in the system”, that the number leaving was less than 1,000 a year, and that the government intended to replace each departing doctor on a one-for-one basis. By November that year, he was describing the exodus as a global phenomenon and pointing out that European doctors were also moving to where salaries were better.

What this position ignored was the cost. A 2018 Mo Ibrahim Foundation analysis estimated that training a Nigerian medical doctor costs between $21,000 and $51,000. Nigeria was among nine countries that, combined, lost over $2 billion between 2010 and 2017 training doctors who then emigrated. The government was, in effect, subsidising the health systems of wealthier nations.

Then came the U-turn. The Ministry of Health disclosed that 16,000 doctors had emigrated in five years, leaving only 55,000 licensed doctors for a population of 220 million. In August 2024, the government launched a National Policy on Health Workforce Migration. The president of the Nigerian Association of Resident Doctors, Innocent Orji, acknowledged the shift but noted that the government had previously been “feigning ignorance” and “saying that we have surplus doctors”. A policy document is not the same as reform.

Lagos State Health Commissioner Akin Abayomi noted that for three consecutive years, the state was unable to fill advertised medical positions because no one applied. Six years before then, the same posts had applicants competing for limited slots. That collapse reflects a generational loss of faith in the system’s ability to provide a decent professional life. A 2024 study found that nurses are more likely than doctors to intend to emigrate, partly because global demand makes it easier for them to qualify and find work abroad. The pipeline is draining at both ends.

Now, the government must show a genuine commitment to improving conditions for health workers, not just produce policy documents. That means sustained investment in infrastructure, honest salary negotiations, and security. However, while that work unfolds, what can ordinary Nigerians do to help themselves?

The most practical step is to enrol in the National Health Insurance Authority scheme. Out-of-pocket payments represent about 70% of total health spending, and health expenses push over one million Nigerians into poverty every year. The NHIA created a Vulnerable Group Fund for children under five, pregnant women, elderly people, people with disabilities, and those earning 70,000 naira or less per month. More than 180 million Nigerians remain outside formal health insurance. Enrolling, even in a basic plan, would spread the financial risk.

Telemedicine is increasingly viable for non-emergency care. Platforms such as HealthConnect247 offer round-the-clock access to doctors and clinical psychologists, and for follow-up appointments on conditions like hypertension or diabetes, a video call is often sufficient. The caveat is connectivity: only about 20% of Nigeria’s rural population has reliable internet access, so this remains largely an urban option.

Prevention reduces the pressure on an already strained system. Attending immunisation sessions, using bed nets, seeking antenatal care early, and managing chronic conditions consistently all reduce the likelihood of needing emergency hospital care. Nigeria has approximately 30,000 primary healthcare facilities, but only 20% are fully functional. Using them early, for minor symptoms, rather than waiting for a crisis, is essential. Community health extension workers, trained in increasing numbers and often the closest health contact for rural Nigerians, are a resource that too many people overlook.

Beyond individual action, citizens can put pressure that policy alone cannot. Reporting poor care, engaging local representatives on health spending, and supporting accountability organisations are viable options to be embraced. However, the brain drain is a policy failure, and reversing it requires political will. That will have to come from somewhere. It rarely comes from the top without pressure from below.

Ojenagbon, a health communication expert and certified management trainer, lives in Lagos.