Health sector stakeholders say Nigeria’s estimated 1.3 billion-dollar annual medical tourism spending reflects a deeper crisis of public confidence in the country’s healthcare system, beyond funding gaps or infrastructure deficits nationwide.

They warned that the continued flight of patients and health professionals represents an erosion of trust rather than a purely economic challenge, with long-term implications for service delivery and workforce morale.

They spoke in interviews on Friday in Abuja, discussing causes, consequences, and possible reforms needed to rebuild confidence in Nigeria’s public healthcare delivery system.

Executive Vice Chairman, Bridge Clinic Fertility Centre, Dr Richard Ajayi, said the trend signalled that many Nigerians no longer believed the health system could adequately protect, diagnose, or treat them when serious medical needs arose domestically.

Mr Ajayi said the situation worsened when government officials sought treatment abroad, arguing that such actions reinforced public perceptions that local hospitals, regulation, and oversight structures were unreliable or untrustworthy to citizens nationwide.

According to him, the core crisis extends beyond worker migration or underfunding, centring on a gradual erosion of belief in hospitals, health professionals, institutions, and leadership stewardship across the national system.

He said trust grew when leadership demonstrated accountability, regulation functioned effectively, financing transparent, and health workers respected as partners in policy, planning, and service delivery across all levels nationwide.

The recent Central Bank of Nigeria Balance of Payments figures indicate a sharp decline in outward medical spending, highlighting changing patterns in overseas healthcare utilisation during the review period.

Data covering January to June 2025 showed medical tourism expenditure fell by 96.2 per cent compared with the same period in 2024, according to CBN statistics released under its balance framework.

CBN data showed medical tourism spending totalled 2.38 million dollars in the first half of 2024, driven largely by a January spike of about 2.30 million dollars recorded that year alone.

Spending dropped steeply afterwards and remained subdued across subsequent months, reflecting reduced foreign exchange availability, delayed travel decisions, and heightened economic uncertainty affecting households and healthcare providers nationwide during period reviewed.

In contrast, total spending in the first half of 2025 was just 0.09 million dollars, with monthly outlays never exceeding 0.06 million dollars during review months compared with January spike earlier.

Overall, the period recorded a year-on-year contraction of about 2.29 million dollars, underscoring the scale of decline in outward medical tourism spending relative to preceding year levels and trends observed nationally.

Analysts said the sustained decline might reflect tighter foreign exchange conditions, increased domestic healthcare utilisation, or economic pressures restricting overseas travel among Nigerians across income groups and regions nationwide in period.

However, analysts cautioned that falling expenditure did not necessarily signal restored confidence in local healthcare, warning that suppressed demand could mask persistent trust deficits within institutions, communities, and professional relationships nationwide.

Managing Partner at Park Harmon Advisory, Dr Muyiwa Tegbe, said trust loss appeared in travel abroad and local health-seeking behaviours, revealing avoidance of formal care across households, clinics, and community settings.

He said many Nigerians chose home births, self-medication, or informal treatments instead of early consultation, increasing risks, complications, and delays in accessing life-saving care especially for mothers, infants, and chronic patients.

Mr Tegbe expressed concern that some health investments were framed mainly to curb capital flight, rather than essential infrastructure to build reliable, responsive, patient-centred systems trusted by citizens and professionals over time.

He called for health sector development to be viewed primarily as an investment in regaining citizen and workforce trust, not merely as a fiscal containment strategy for sustainable national health security.

On his part, Founder of Health-Hub Africa, Dr Benjamin Obire, said the 1.3 billion-dollar medical tourism bill represented a crisis of trust, not just economics, because each overseas treatment signalled perceived incapacity locally.

Mr Abubakar Obire said the annual outflow could fund about 50 tertiary hospitals, noting a 120-bed specialist facility could be built for roughly 25 million dollars each, expanding access, capacity, and regional equity.

He added that human losses were severe, with more than half of Nigeria’s registered doctors practising abroad, equating to about two billion dollars in lost training investments since 2010 according to estimates.

He recalled Nigeria’s 2001 Abuja Declaration pledge to allocate 15 per cent of spending to health, yet budgets had remained below five per cent, undermining system resilience, capacity, and workforce retention.

He said trust could be rebuilt when professionals were respected, leaders chose accountability, policies were implemented, and hospitals delivered care with dignity, consistently supported by funding, oversight, and ethical governance nationwide.

(NAN)