Nigeria’s healthcare system faces an increasingly uncertain future as thousands of doctors continue to leave the country while hospitals struggle with inadequate infrastructure and workforce shortages, according to medical experts speaking at the 42nd reunion of the University of Ilorin College of Health Sciences’ 1984 graduating class.

Delivering the keynote address, Professor Olufemi Adelowo said the country’s health indicators remain among the poorest globally and argued that years of underinvestment and the migration of skilled professionals have weakened the healthcare system.

His warning comes as Nigeria continues to battle one of the world’s highest maternal mortality rates while public hospitals face increasing pressure from a growing population.

What evidence supports the concerns?

Professor Adelowo cited figures showing infant mortality at 70 deaths per 1,000 live births, neonatal mortality at 39 per 1,000 live births and maternal mortality at about 1,000 deaths per 100,000 live births. He also said average life expectancy remains between 53 and 56 years.

Many of those figures broadly align with estimates previously published by the World Health Organization and other international health agencies, although mortality statistics can vary depending on the reporting year and methodology.

The professor also pointed to the growing exodus of Nigerian doctors.

According to his presentation, more than 15,700 Nigerian-trained doctors are now practising in the United Kingdom, while thousands more have relocated to the United States and Canada. He cited Federal Ministry of Health estimates that about 16,000 doctors emigrated between 2019 and 2024.

The migration of healthcare workers commonly referred to as the “Japa” phenomenon, has become one of the most significant workforce challenges confronting Nigeria’s health sector.

Why does it matter?

Nigeria’s population is estimated at more than 230 million people, yet the country continues to face shortages of doctors, nurses and specialists.

Professor Adelowo argued that many hospitals lack reliable electricity, water supply, functioning medical equipment and adequate accommodation for resident doctors. He also criticised the management of some hospitals and called for improvements in specialist training and supervision.

He warned that these deficiencies contribute to staff burnout, declining clinical skills in some facilities and poorer patient outcomes.

Technology offers opportunities but is Nigeria ready?

Looking ahead, Professor Adelowo said artificial intelligence is likely to complement rather than replace doctors by improving diagnostic accuracy, interpreting medical images, identifying drug interactions and supporting personalised treatment.

He questioned whether Nigeria’s healthcare system is prepared to adopt such technologies while still struggling with basic infrastructure.

Calls for stronger regulation

Another concern raised during the lecture was the spread of medical misinformation and the sale of counterfeit medicines.

Professor Adelowo called for stricter regulation of fake drugs, stronger enforcement against illegal medical practice and tighter oversight of misleading health advertising.

While counterfeit medicines remain a recognised public health concern in Nigeria, estimates of their prevalence have varied widely over the years. More recent regulatory efforts by agencies such as NAFDAC have sought to reduce their circulation, meaning older estimates should be interpreted cautiously.

Doctors reflect on four decades of service

The reunion also celebrated 42 years since the class graduated from the University of Ilorin.

Programme Coordinator, Dr Festus Oshoba said members of the class had embraced a culture of giving back through philanthropy, mentorship and healthcare interventions.

He said the group had donated specialist ophthalmic equipment to the Lagos University Teaching Hospital (LUTH) through The Tunji Olowolafe Eye Foundation to support the training of eye surgeons.

Dr Oshoba urged younger Nigerians to pursue education, reject shortcuts to success and contribute positively to society.

‘National progress begins with personal responsibility’

Professor Patrick Igbigbi, another member of the graduating class, said Nigeria possesses greater financial resources than some African countries where he has worked, including Uganda and Malawi, but has not translated those resources into better healthcare outcomes.

Rather than placing responsibility solely on government, he argued that corruption and poor accountability exist at multiple levels of society and that meaningful national reform requires personal integrity.

What happens next?

The issues raised at the reunion echo concerns repeatedly expressed by professional medical associations and health policy experts over recent years.

Whether governments can reverse the migration of healthcare workers, modernise public hospitals and improve patient outcomes will depend not only on policy announcements but also on sustained investment, better governance and effective implementation.

For millions of Nigerians who rely on the public health system, those decisions will shape access to quality healthcare for years to come.

Healthcare strategist Dr Adetutu Afolabi has called on Nigerian pharmacists to redefine their role in the country’s healthcare system, arguing that the profession’s greatest challenge is not a lack of value but a lack of visibility.

Addressing pharmacy directors and hospital leaders from Federal Health Institutions in Lagos, Dr Afolabi said pharmacists must embrace innovation, technology and stronger collaboration if they are to play a bigger role in improving healthcare delivery across Nigeria.

The presentation formed part of a conference themed “Pharmacy Excellence in Nigeria: Strengthening Collaboration, Driving Transformation.”

Why it matters

Nigeria’s healthcare sector continues to face rising costs, increasing cases of chronic diseases, shortages of healthcare workers and growing pressure to deliver better outcomes with limited resources.

Experts say pharmacists are increasingly expected to help reduce medication errors, improve patient safety and support preventive healthcare, making their role more critical than ever.

Dr Afolabi argued that these challenges require pharmacists to expand beyond traditional responsibilities and become visible contributors to healthcare policy and system reforms.

“Pharmacy does not have a value problem; pharmacy has a visibility problem,” she said.

“Every day, pharmacists prevent medication errors, improve patient outcomes, optimize therapies, reduce healthcare costs, and save lives. Yet much of that value remains unseen because it is not consistently measured, communicated, or translated into evidence that healthcare leaders can act upon. To change this narrative, we need to tell our stories of impact loudly and clearly.”

Looking beyond Nigeria

During her plenary session, titled “The Future-Ready Pharmacist: Driving Value Through Innovation, Wellness and Collaboration,” Dr Afolabi highlighted healthcare systems in the United Kingdom, Canada, Australia, Singapore, Saudi Arabia and Spain.

She said reforms in those countries have expanded pharmacists’ responsibilities to include independent prescribing for chronic diseases, vaccine administration, population health management and closer collaboration with other healthcare professionals.

According to her, Nigerian pharmacists should increasingly adopt artificial intelligence, rely on clinical data for decision-making, strengthen preventive healthcare and work more closely with other medical professionals.

A call for a new generation of leaders

Dr Afolabi challenged younger pharmacists to become leaders capable of shaping healthcare policy and driving innovation rather than simply maintaining existing systems.

“Every generation inherits a profession. Only a few generations transform it. We have inherited a proud profession. Our responsibility is not merely to preserve it but to advance it, to create value, to lead innovation, to champion wellness, to influence policy, and to transform healthcare.”

She added:

“When the story of healthcare transformation in Nigeria is written, may it be said that this generation of pharmacists chose not merely to practice pharmacy, but to redefine what pharmacy could become.”

Expert perspective

Healthcare policy analysts say pharmacists are becoming increasingly important in strengthening primary healthcare, managing chronic diseases and improving medicine safety.

They note that expanding pharmacists’ clinical responsibilities—supported by clear regulation, training and evidence-based practice—could help reduce pressure on Nigeria’s overstretched healthcare system while improving access to quality care.

Industry reaction

Many pharmacy professionals have welcomed growing conversations around expanding pharmacists’ roles, particularly in preventive healthcare, digital health and multidisciplinary care.

Professional bodies have also advocated reforms that allow pharmacists to contribute more directly to patient care while supporting national efforts to achieve better health outcomes.

What’s next?

Whether such proposals translate into policy will depend on collaboration between government agencies, professional regulators, hospitals and healthcare institutions.

As Nigeria continues to reform its healthcare system, discussions around expanding pharmacists’ responsibilities are expected to remain a key part of broader efforts to improve healthcare access, efficiency and patient outcomes.

Bisola Osundairo, a 30-year-old young and passionate Nigerian-American Public Health Expert, is on a mission.

A mission to leverage knowledge to drive public awareness and sensitization against the devastating effects of Sickle Cell Disease in the Nigeria.

SCD is one of the global public health emergencies identified as a leading cause of over 150,000 neo-natal deaths annually in the country. 4-5 million people are carriers of SS trait in Nigeria while about three million of them are suffering from SCD.

SCD is a condition that is primarily caused by wrongly matched genotype (blood category), due to the naïve or ignorant decisions of two lovers or partners coming together on a marital or procreation journey without giving preference to genotype compatibility.

When an individual with AS genotype sexually cohabits with a partner with similar trait, the chances of producing an offspring with SCD is 50%. The risk is increased to 75% chances in the case of AS marrying SS, and 100% chances in the case of SS marrying SS.

SCD, according to the World Health Organisation, is a complex and lifelong health crisis that should be avoided altogether in the interest of producing healthy children and avoiding expensive hospital maintenance and painful lifetime fragility.

Born in Chicago, the United States of America – to a father from Abeokuta and a mother from Ijebu, all in Ogun State – little Osundairo grew up to know she was a carrier of the SS trait herself. This discovery and the sufficient knowledge she obtained thereafter would inform her career path later in life and shaped the person she grew up to become – a public healthcare expert and an advocate.

For her, the highlighted figures of SCD mortality and prevalence are not merely public health data. They represent lives and a real human story – A family struggling to cope; Parents burdened by emotional and financial pressures; And a young person forced to suspend dreams and ambitions because of a condition they never chose. Hence, she has decided, preventing avoidable suffering has become the mission around which she has built her advocacy.

“I just want to do my best to help Nigeria drive down the incidences of sickle cell related sufferings and death,” she said, explaining that she is convinced that, “the best way is through public awareness campaigns and policy advocacy.”

As part of her strategic interventions, she is developing animated audio-visual series for children with SS, staging nationwide sensitisation campaigns, and adopting and raising funds for struggling SS sufferers.

“Besides, I have equally decided to adopt fundraising programmes to provide special funding supports for sickle cell patients facing management crisis or difficulty in accessing healthcare,” she said.

Growing up, she said, education, discipline, empathy and service to others were values strongly emphasised in the home. That foundation would later shape both her academic pursuits and her commitment to public health.

The fourth of five children, Osundairo believed she was raised well. “I am a respectful person. I smile a lot and greet people. I believe in hard work and personal integrity. There is no substitute for a life lived well and in service to humanity,” she told this writer.

Just as impressive her childhood, also is her educational journey. While still in high school, she participated in a dual enrolment programme that enabled her to earn an associate degree in Web Graphic Design alongside her secondary school education. She later obtained a Master of Public Health degree from the University of Illinois Urbana Champaign. At the University of Illinois Urbana Champaign, she served in the Illinois Student Senate and also worked as a community service representative for the African Cultural Association.

Her passion for service extended beyond the classroom, as she also studied in Cape Town, South Africa, volunteered in different communities and spent time in China, where she studied Wushu at Shanghai University of Sport.

With her education, international exposure, and frequent travels to Nigeria, she had registered NextGENE Advocates, a not-for-profit organization with focus on mitigating and preventing the SCD through public awareness campaigns, dialogues, workshops, policy advocacy, and rehabilitation of the carriers, among others. The NGO recently organized a major one-day public outreach and workshop on the theme: “Genotype Compatibility and Sickle Cell Anemia: Looking beyond physical, emotional, and material factors before choosing life partner.”

The event, which was held at the Lagos State University, LASU Ojo Campus, in partnership with the National Association of Psychology Students (NAPS-LASU), saw experts converged to illuminate the minds of the young participants to the implication of choosing other conveniences over genotype compatibility while seeking suitors. Nearly 200 students attended, including lecturers. More than 40 people volunteered to support future advocacy activities.

For Osundairo, however, the success of the programme could not be measured solely by attendance figures. What mattered most was the conversation it sparked.

Many of the students had heard about sickle cell disease before. Yet few fully understood genotype compatibility or the lifelong consequences that can arise from incompatible unions. The workshop had revealed an uncomfortable reality.

Osundairo, said she did not arrive at advocacy through politics, activism or personal ambition. Rather, her decision to Lunch NextGENE Advocates was borne out of the conviction from a lifelong commitment to service and a belief that knowledge can prevent suffering.

“I have always been in the forefront, fighting for the good of humanity,” she recalled, with reference to her leadership at the university.

Yet for all her academic achievements and international exposure, it was a simple question that continued to trouble her. Why were so many Nigerian families still experiencing avoidable pain associated with sickle cell disease? The answer, she concluded, lay partly in awareness.

“Apart from the annual commemoration of Sickle Cell Day, at nextGENE Advocates, we have resolved to stage a sustained nationwide campaign across the nooks and crannies of the country, sensitizing parents, couples, adults, adolescents, community, and religious leaders to the importance of Genotype Compatibility,” she explained.

“As it is now, too many young people,” she observed, “approached relationships and marital discussions without understanding the implications of genotype compatibility. Many only discover the consequences when emotions have already become deeply invested,” she worried.

For Osundairo, the issue is personal. As a carrier of the AS genotype trait herself, making her vulnerable to certain decisions, she had vowed to not let ignorance push other people into such position.

“Yes, in the past, I have actually turned down multiple suitors due to genotype compatibility,” she recalled.

“There was one that I felt was the full package but could not proceed due to the AS trait. Having to end what could have been was not a good feeling but I knew it was the responsible choice,” Osundairo, demonstrating the courage required to do the right thing regardless of temptation.

This particular experience reinforced a message that has now become central to her advocacy.

“Love is not enough,” Osundairo, warned.

The statement often generates debate. Some disagree with it. Others find it uncomfortable. But the Public Healthcare Expert remained unapologetic.

To her, the phrase is not a rejection of love. “It is a call for responsibility.”

While love matters, she argues, so do health, compatibility, informed decision-making and the wellbeing of future children.

“Making informed decisions is part of loving your partner and your future family.”

That philosophy was the premise upon which NextGENE Advocates was established. The organisation was founded on a simple principle: Informed decisions save lives, with the mission to educate young people about genotype compatibility, encourage early screening and normalise conversations that many families often postpone until it is too late.

In many discussions around relationships and marriage, conversations about physical attraction, finances and social status often take precedence over health considerations.

That reality concerns Osundairo deeply.

Meeting people living with sickle cell disease has transformed statistics into faces and names. She has listened to stories of interrupted education, lost economic opportunities, broken relationships and families struggling under the weight of medical expenses.

For many households, managing the condition is not only emotionally exhausting but financially devastating. Those experiences have also shaped her policy advocacy priorities.

She believes government intervention must move beyond periodic awareness campaigns.

Nigeria, she argues, requires stronger preventive healthcare systems, wider access to genotype screening, expanded health insurance coverage, improved support for people living with sickle cell disease and more robust community, based education programmes.

She also advocates the integration of genotype compatibility and sickle cell education into school curricula across the country.

For her, prevention remains the most humane and cost effective response.

“If we can prevent even one child from going through that pain, then the effort is worthwhile.”

Building NextGENE Advocates has not been without challenges. Funding remains difficult. Awareness gaps persist. Logistical obstacles are constant. Yet each challenge has strengthened her resolve. Leadership, she believes, is ultimately about service. Not titles. Not recognition.Not applause. But impact.

For Osundairo, success is measured by lives changed, knowledge shared and suffering prevented.

Somewhere in that auditorium sat young men and women who will one day make decisions about love, marriage and family.

Long after the workshop ended, many will probably remember Mercy’s tears.

That memory is precisely what Bisola Osundairo hopes remains with them. Not to frighten them. Not to discourage love. But to encourage informed choices. Choices that could spare another child from telling the same story.

And for Osundairo, that possibility alone makes the work worthwhile.