a country · NigeriaNigeria

Africa's largest source market by reputation and the one where the size of the outflow is least settled. Nigerian ministers have put the annual cost at figures ranging from roughly one billion to two billion US dollars; the country's own central bank publishes health-related travel outflows in its balance of payments, and the numbers reported from that series differ between accounts by orders of magnitude. This record carries no annual dollar figure, and the reason it does not is the subject of the page.

The claim in widest circulation is that Nigeria loses about two billion dollars a year to treatment abroad. It is attributed to Professor Muhammad Ali Pate, Coordinating Minister of Health and Social Welfare, reported in April 2025, who tied it to a lack of confidence in local care. Earlier ministers gave other numbers: an information minister put it between 1.2 and 1.6 billion in 2022, a health minister at two billion before that. Inference — a figure that moves by a factor of two between cabinet members, with no series named behind it, is a rhetorical quantity being used in an argument about domestic investment. It may still be roughly right. It is not a measurement, and this directory does not print it as one.

The counting problem has a second half. India, the destination Nigerian patients are most often said to use, publishes arrivals for medical purposes by source country: in 2025 it named Bangladesh, Iraq, Uzbekistan, Somalia, Turkmenistan, Oman and Kenya as its leading seven. Nigeria is not among the seven that release names. Inference — either the Nigerian flow to India is smaller than the rhetoric implies, or it travels on visa classes India does not count under a medical purpose, or it goes elsewhere — to the United Kingdom, to Dubai, to Egypt, to Türkiye. Each of those is a different policy problem and the single dollar figure conceals which one it is.

What is not in dispute is the distribution. The people who fly out are the people with foreign exchange: officials, executives, the diaspora's relatives, the insured. The people who do not fly are treated in the same hospitals the fliers declined, by staff who watch the complex cases leave.

A referral, or more often a self-referral through an agency, a visa, and payment in foreign currency at a time when foreign currency has been rationed. Nigerian insurers sell overseas benefits on the upper tiers only. The Central Bank's foreign-exchange allocations are themselves part of the mechanism, which is why the Nigerian argument about treatment abroad is conducted by the central bank as much as by the health ministry.

As of September 2026 this record carries no annual outflow figure for Nigeria. The ministerial figures are named above with their dates; the central bank series exists and this project could not open a page stating it directly, so it is described rather than quoted.

Nothing here says the outflow is small. It says the published quantities disagree with each other and none of them names a method.