The federal government, yesterday, acknowledged the stretched conditions of public hospitals nationwide following the exodus of over 16,000 doctors in the last seven years.
The mass migration, according to official records, has left the country with less than 40,000 doctors to cater to about 220 million people.
The exodus has shrunk the country’s doctor-to-population ratio to 3.9 per every 10,000 Nigerians, well below the World Health Organisation’s (WHO) set average of 25 doctors per 10,000 patients and a 17.3 global average per 10,000 population size.
To this end, the federal government is engaging in bilateral discussions with key destination countries for the migrating health workers, guided by the WHO Global Code of Practice and is advocating for reciprocal frameworks ‘train-for-train’ model to ensure that nations recruiting professionals also invest in the country’s training pipelines.
Minister of Health and Social Welfare, Muhammad Ali Pate, who disclosed this yesterday in Abuja at the seventh Annual Capacity Building Workshop of the Association of Medical Councils of Africa (AMCOA) being hosted by the Medical and Dental Council of Nigeria (MDCN), lamented that the trend is not just about people leaving as it represents a fiscal loss.
Pate stated that the estimated cost of training one doctor exceeds $21,000 — a figure that reflects the magnitude of public financing walking out of our countries.
Pate observed that Africa is confronted with the exodus paradox as an increasing number of talented healthcare professionals aspire to work in other countries, driven by factors such as economic opportunity, better working conditions, more advanced training, and superior research environments abroad.
He said, “I also migrated in the early 1990s. In 1993, I started at the MRC Lab in The Gambia, and the ECFMG pathway that many here know well. So, I understand the drivers—because they haven’t changed.
“The migration of health professionals from developing countries is not new. But it has accelerated in recent years. It deeply affects our health systems, leaving many of our rural communities critically underserved. Nurses and midwives have also thinned in numbers. This is a timely convening of regulatory leaders, policymakers, and stewards of our institutions.
“Beyond the enduring impact of the last several decades and, more recently, the COVID-19 pandemic—and the global changes we are now seeing—our continent, Africa, is facing a silent but far-reaching emergency: the depletion of our health workforce. Considering the theme of this workshop—Integrated Healthcare Regulation and Leadership in Building Resilient Health Systems—the need for a resilient health workforce cannot be overemphasised,” Pate said.
The minister noted that the government is also unlocking the value of the diaspora and is collaborating with NiDCOM and regulatory councils to create structured reintegration pathways, streamlined credentialing for returnees, support for setting up private practice, academic reintegration opportunities, remote teaching, mentorship, and digital exchange.
He said: “We have seen oncologists, surgeons, and professors return—from Wales, the UK, the U.S.—establishing world-class centres in Lagos, Maiduguri, and other cities. Just this week, the Association of Nigerian Physicians in the Americas (ANPA) hosted its conference in Lagos—with thousands in attendance. This is the diaspora leaning in—not out. Many have already re-registered with MDCN. And they’re not doing it for nostalgia—they’re doing it because they sense things are changing.”
Pate revealed that the MDCN is mapping the domestic and diaspora workforce, monitoring international recruitment agencies, guiding the reintegration of returning professionals, and leading regulatory harmonisation across the continent.
“This is the new order we are building—grounded in evidence, collaboration, and mutual respect. Let us not be mistaken; health workforce migration will continue. But we cannot remain passive. We are retaining workers by improving dignity in the workplace—pairing limited financial incentives with housing schemes, better security, and digital connectivity to reduce professional isolation and reduce the workload for younger doctors. We’re addressing these concerns with MDCN.”
Pate emphasised that Africa must lead in forging a new global compact on health workforce mobility anchored on Pan-African training and accreditation standards, shared planning tools, evidence and data, continental negotiating platforms with destination countries, and sustained investments in the people who care for our people.
The minister stressed the need to shift the narrative from brain drain to brain gain and from talent loss to system strengthening.
He explained that the government would not try to stop doctors from moving abroad, but it is building a system where they no longer feel the need to leave or settle for second-class status in someone else’s country.
“This is not the end of migration. It is the beginning of smart, ethical, and dignified governance of it.”
He added that the National Policy on Health Workforce Migration is designed to address health workforce migration with dignity—dignity for health workers, for the country, and the profession.
According to him, the objectives of the policy are to retain and motivate health workers currently serving in Nigeria, thousands of whom work under difficult conditions; to establish ethical norms and explore bilateral frameworks for recruitment, aiming to correct global asymmetries; to enable structured reintegration for the thousands of Nigerian professionals abroad and to strengthen governance, improve regulatory coordination, and build real-time data systems.
“This is not a restrictive policy, nor is it one born out of resignation. We understand that the global health workforce shortage is at 18 million, and countries in the Global North face their human resource crises due to demography and other factors. But our response is based on stewardship—balancing the rights of health professionals to seek opportunities abroad with our duty to protect the integrity and viability of our national health system.”
In her opening remarks, MDCN Registrar, Prof. Fatima Kyari, stated that in a rapidly globalising world, Africa needs to integrate and ensure that it has a resilient healthcare system that is adapting to the changing trends and responding to the challenges facing it.
Earlier, the Chairman of the Local Organising Committee, Prof. Afolabi Lesi, told the participants that as regulators of healthcare professionals, they are charged with the responsibility of ensuring that we adhere to the highest standards of training (curriculum and practice) in line with international best practices while reflecting the unique peculiarities of the various countries.
He noted that even though they have committed and clear directions at the level of governance, implementation of actions is bedevilled by the fractioned and fractious relationships among health workers who ought to be working as a team, with the patient’s wellbeing and safety as the primary focus of all our actions.
Lesi observed that the workshop will enhance the experience and skills of medical regulators and other healthcare regulators so that the best practices we desire will lead to true integration and ultimately build resilient and sustainable health systems.
He said: “We are not unmindful of the major threats facing our health systems, such as health workforce migration and mobility as well as burnout of those left behind to pick up the slack. We hope to discuss these and other matters arising and identify a roadmap for mitigating some of these effects.”
