Buhari’s Health Reemerging as a Factor in 2019 Nigerian Elections

On May 7, President Muhammadu Buhari left Nigeria for an announced four days of medical treatment in London. Following his meeting in Washington, DC, with President Trump on April 30, President Buhari did not return directly to Nigeria but instead made a stop in London where, according to his staff, he received medical treatment. The New York Times calculates that the president, presuming he returns to Nigeria on May 12 (which he may not), will have been in London on medical leave for more than 170 days since he was inaugurated president in 2015. In other words, out of just over one thousand days in office, he will have spent around 15 percent of his time receiving medical treatment abroad.

President Buhari has announced that he will seek reelection in the national elections scheduled for February 2019, despite calls for him not to run because of his health. Meanwhile, there is a comprehensive strike in Nigeria of seventy-two thousand medical services personnel represented by a variety of unions. The strike, now underway for three weeks with growing participation, is united by fundamental discontent over the level of funding of medical services; according to the Times, in 2018, Nigeria is spending 3.9 percent of its budget on health, compared with the a UN target of 15 percent. For many years, Nigeria has exported medical doctors and nurses to all parts of the world, as a visit to the emergency room of almost any big American hospital will show. A general complaint of Nigeria medical personnel is the poor quality of medical facilities and the pervasive shortage of medical supplies, including pharmaceuticals. Nigerians that can afford it routinely go abroad for medical treatment. President Buhari has in the past denounced Nigerian “medical tourism” and called on Nigerians to seek medical care at home. The president’s lengthy stays in London in light of these comments are seen by many Nigerians as evidence of his hypocrisy. However, such charges are unlikely to do much damage to his campaign for reelection. Though there is much criticism of his presidential performance, especially in the south and west of the country, his northern base remains firm, and he has the advantage of incumbency. Thus far, no strong opposition political figure has come forward who will seriously challenge him, though it is still early in the election cycle. 

What ails the president? He is not saying, and the Lagos rumor mills are accordingly working overtime. African chiefs of state almost never make public their health issues, unlike in the United States. In Africa there is a long tradition of public statements about the robust good health of an African chief of state up until the day he dies, usually in a hospital abroad. Should President Buhari in fact choose not to run for reelection in 2019 because of his health, Nigerian domestic politics, often chaotic, would be further upended as politicians scramble to secure maximum advantage from the changed political landscape.