Medical tourism spending falls by $5.24m – CBN

Nigerians spent about $3.82m on foreign healthcare-related services from January to December 2023, findings by The PUNCH have shown.

Compared to $9.06m  spent on medical tourism in 2022, there was a reduction of $5.24m in 2023.

This is according to a report obtained from the Central Bank of Nigeria on the amount spent on health-related and social services under the sectoral utilisation for transactions valid for foreign exchange.

Our correspondent observed that the amount spent on foreign healthcare-related services in the first half of 2023 (January to June 2023) was more than that spent in the second half of 2023 (July to December 2023).

While the figure for the first half of 2023 was $3.13m, that for the second half of the year was $0.69m. The whole amount summed up to $3.82m.

A breakdown of the report showed that $0.34m was spent in January; $0.32m in February;  $0.38m in March; $0.50m in April; $1.28m in May; and $0.31m in June.

Also, in July, $0.01m was spent on medical tourism, and the amount jerked up to $0.26m in August, but the figure fell to $0.02m in September. In October, the amount increased to $0.10m, in November, it dropped to $0.02m again, and the figure rose to $0.28m at the end of December.

Meanwhile, the 2022 spending on medical tourism was $9.06m.

A breakdown of the 2022 spending revealed that $0.74m was spent from January to March 2022. In April, $3,02 was spent, in May, the figure reduced to $1.00, and there was a further decline in June to $0.42.

In July, the figure rose slightly to $0.46, and it increased to $0.80 in August. But in September, it reduced to $0.44 and climbed to $0.62 in October. However, the figure stood at $0.78 in November and $0.78 in  December.

58% reduction

The figures showed that there was a 58 per cent decrease in the amount spent in 2023 compared to that of 2022.

Experts say the decrease may not be unconnected with the scarcity of foreign exchange, depreciating naira currency, amid the economic hardship.

Many Nigerian leaders and politicians travel abroad to seek medical treatment in the face of crises in the nation’s health sector, poor primary health care system, poor facilities, brain drain, and disease outbreaks, among others.

Meanwhile, the 2023 budget proposal showed that N476.52m was allocated to the State House Medical Centre and medical expenses.

Upon assumption of office, the Coordinating Minister of Health and Social Welfare, Prof Muhammad Pate, promised to reverse the trend of medical tourism, prioritise health security and improve the health outcomes in the country.

Pate said, “When you fly from Addis Ababa to India, you see a lot of people going for medical tourism; it is not a thing we should see as normal. We should do something about it and improve our health outcomes.”

Commenting on the report, the President of the Nigerian Medical Association, Prof Bala Audu said while it was commendable that there was a reduction in the amount spent on medical tourism, the government must invest in the health sector, and improve the workplace environment for health workers in this country.

Audu pointed out that patients would always go to wherever they would get the best quality of care for their health conditions, as long as they could afford it.

‘Nigerian doctors well-trained’

The NMA President said, “In Nigeria, we have well-trained, high-quality health professionals, but we know that we have some challenges regarding our workplace environment, ranging from issues of infrastructure to issues of equipment, and the issues of conditions of service, especially their emoluments. And because of this, many doctors, as we know, have emigrated out of this country to where they work under better working conditions, and they have been known to perform very well.

“If we can do this, our expectation is not just that Nigerians will travel abroad to seek medical care. We expect to see people from other countries coming into this country to seek medical care, and in so doing, they will bring a lot of capital into this country. This can be achieved through public sector engagement as well as private sector engagement.

“In the private sector, we have highly specialised private settings that perform wonderful services that attract many wealthy Nigerians who are seeking health care in their facilities, and with government input, and investments, such private settings and tertiary public settings can be made attractive that highly specialised Nigerian doctors will dedicate their time in those facilities, and there will be a flight of capital into this country to seek medical services.”

Corroborating, the President of the Medical and Dental Consultants Association of Nigeria, Prof. Aminu Muhammad, urged the Federal Government to invest in the healthcare sector.

“Though the rising exchange rate is making the figure to decrease, but then, we can reduce it to the barest minimum. The government must work with medical practitioners, even in the private sector to reduce the trend.

“The government should also ensure that we have the best of equipment to work with because we have the best manpower and the requisite skill in the country,” Muhammad noted.

The Vice Chancellor of the University of Medical Sciences, Ondo State, Prof Adesegun Fatusi, highlighted that forex, naira value, and patriotism might be responsible for the decrease in the number of people seeking medical care abroad.

Fatunsi said, “The Naira value to the dollar can be one major issue. If what you are going to pay is above what you have or budgeted for, then you are going to have a rethink.

“The fact that increasingly, people are also being aware that many of the things they are going to do, particularly India, are done in Nigeria. Sometimes, medical personnel refer people to places like India, not because they don’t know that the thing can’t be done in Nigeria, but because the Indians do marketing, and they pay their commission.

“Also, a couple of new hospitals in Nigeria now are doing great things with new and sophisticated equipment. Again, you see what they’ve done with Massey Children’s Hospital in Lagos, they are modernising it, and people are getting good services.”

Hospital well-equipped

A professor of Public Health at the University of Ilorin, Kwara state, Tanimola Akande, noted that Nigerians who could afford it explored medical care outside Nigeria because of the perceived better quality of care.

Akande said, “Hospitals in such countries are well -equipped with ultra-modern equipment, unlike the situation in Nigeria. Nigeria lost a huge sum of money over the years to these developed countries through medical tourism. Such funds, if channelled to the health sector in Nigeria, would go a long way to transform the health sector with improved health outcomes.

“The encouraging news is that mega hospitals that are well-equipped are coming up in Nigeria through the private sector. It is hoped that this will reduce medical tourism. The government will need to significantly increase the funding of the health sector to reduce medical tourism. To reduce medical tourism, Nigeria must work hard to reverse the brain drain of highly skilled health workers.”

Also commenting, the Deputy National President of the National Association of Nigeria Nurses and Midwives, Abubakar Shehu, attributed the drop in the amount spent on medical tourism in 2023  to the hike in the exchange rates.

“The number did not drop because we have a good system in place, the number dropped because of this hike in the dollar. The dollar is extremely high and when you look at the exchange rates, if somebody is reasonable enough, he may not travel again. Sometimes, some people travel because such cases cannot be handled well in Nigeria, and sometimes some people travel for fashion, not because we don’t have experts that will handle it but because they just want to travel for fashion. Honestly speaking, I think this has to do with the increase in the exchange rates.

“The government needs to be proactive because if you look at our healthcare system, it is very bad. The rates and the conditions at which our doctors, nurses, laboratory scientists, pharmacists, and all other healthcare workers leave the country are very pathetic. So if we want to reduce medical tourism, the government needs to be very proactive by providing a very conducive atmosphere for practice and also consider the remuneration for health workers,” Shehu added.

On his part, the National Secretary of the Joint Health Sector Unions, Martin Egbanubi, said, “I still believe there should be legislation against politicians travelling abroad for medical tourism, especially with public funds. The reduction in the amount spent on medical tourism does not mean that the health sector has really improved.

“Healthcare workers are still leaving the country, the remuneration is still poor, the working conditions are still poor, and the government needs to fix all the issues to see the true reduction in medical tourism because it is clear that the reduction is as a result of forex scarcity in the country, and the fact that people are struggling.

“You will see that some people who could afford travelling abroad for medical services can no longer do so because of the economic situation in the country,” Egbanubi stressed.

Earlier this month, the Minister of State for Health and Social Welfare, Dr Tunji Alausa,   who spoke during an interview on Channels Television, said people were travelling from Europe, India, and Sub-Saharan Africa to access healthcare services in Nigeria.He said, “Go to the hospital in Lagos, people are coming from India, sub-Saharan Africa, and even Europe to come and get health care in Nigeria.

“Getting surgical operations is cheaper; you will be glad to know that today we have almost 900 aesthetic hospitals all around Nigeria.

“People are coming to get plastic surgeries. Go to the Lagos University Teaching Hospital, Idi-Araba, today at the cancer centre – the Nigeria Sovereign Investment Authority-LUTH cancer centre has state-of-the-art equipment, whatever you can get anywhere in the world.”