Medical Tourism Signals a Deepening Trust Crisis in Nigeria’s Health System, Experts Warn

Health sector stakeholders have issued a stark warning: Nigeria’s massive annual expenditure on medical tourism—estimated at $1.3 billion—is not merely a financial drain but a profound symptom of a collapsing public trust in the nation’s healthcare system. This crisis of confidence, they argue, poses a more fundamental threat than funding gaps or infrastructure deficits alone.

In interviews with the News Agency of Nigeria (NAN), experts explained that the continued exodus of both patients and healthcare professionals represents an erosion of faith in the system’s very foundations. This has severe long-term implications for service delivery, workforce morale, and national health security.

Dr. Richard Ajayi, Executive Vice Chairman of the Bridge Clinic Fertility Centre, framed the issue clearly: “The trend signals that many Nigerians no longer believe the domestic health system can adequately protect, diagnose, or treat them when serious medical needs arise.” He highlighted a particularly damaging cycle: when government officials and elites publicly seek treatment abroad, it reinforces the public perception that local hospitals, regulatory bodies, and oversight structures are fundamentally unreliable. This creates a vicious cycle where lack of trust leads to under-utilisation of local facilities, which in turn starves them of resources and further degrades quality.

The core issue, according to Dr. Ajayi, extends beyond brain drain or underfunding. “It centres on a gradual erosion of belief in hospitals, health professionals, institutions, and leadership stewardship across the national system,” he said. Trust is built, he contends, when leadership demonstrates accountability, regulation functions effectively, financing is transparent, and health workers are respected as partners in policy and planning.

Recent data from the Central Bank of Nigeria (CBN) presents a complex picture. Balance of Payments figures show a dramatic 96.2% decline in outward medical tourism spending in the first half of 2025 compared to the same period in 2024, falling from $2.38 million to just $0.09 million. While this appears positive, analysts urge caution. They attribute the sharp drop largely to tighter foreign exchange conditions, economic pressures restricting travel, and delayed decisions—not to a sudden resurgence of faith in local healthcare.

“Falling expenditure does not necessarily signal restored confidence,” warned one analyst. “Suppressed demand can mask persistent, deep-seated trust deficits. The underlying reasons people sought care abroad—perceived superior quality, advanced technology, and reliability—remain unaddressed.”

Dr. Muyiwa Tegbe, Managing Partner at Park Harmon Advisory, emphasized that the loss of trust manifests in more ways than just international travel. “It appears in local health-seeking behaviours,” he noted. “Many Nigerians now avoid formal care altogether, opting for risky alternatives like home births, self-medication, or informal treatments.” This avoidance leads to dangerous delays in accessing life-saving care, exacerbating complications and mortality rates, especially for vulnerable groups like mothers and infants.

Dr. Tegbe expressed a critical concern: that some health investments are framed primarily as a strategy to curb capital flight, rather than as essential investments to build a reliable, patient-centred system. “Health sector development must be viewed primarily as an investment in regaining citizen and workforce trust,” he argued, “not merely as a fiscal containment strategy.”

Dr. Benjamin Obire, Founder of Health-Hub Africa, quantified the opportunity cost of the trust crisis. “The $1.3 billion annual outflow could fund approximately 50 modern tertiary hospitals,” he stated, noting that a 120-bed specialist facility can be built for roughly $25 million. Beyond infrastructure, the human capital loss is staggering: more than half of Nigeria’s registered doctors now practise abroad, representing an estimated $2 billion in lost training investments since 2010.

Dr. Obire pointed to the broken promise of the 2001 Abuja Declaration, where African nations pledged to allocate 15% of their annual budgets to health. Nigeria’s health budget has consistently remained below 5%, systematically undermining system resilience, capacity, and the ability to retain skilled professionals.

Rebuilding trust, the experts concluded, requires a multi-faceted, long-term commitment. It hinges on consistent policy implementation, ethical governance, and demonstrable accountability from leaders. It requires respecting healthcare professionals and involving them in system design. Ultimately, trust will return only when Nigerian hospitals can reliably deliver dignified, effective care, supported by transparent funding and rigorous oversight. Until then, the signal sent by medical tourism will continue to flash red, indicating a system in critical condition from a deficit far deeper than money: a deficit of faith.