The tragedy of the death of veteran Kenyan opposition leader Raila Odinga, who was “arguably robbed of the presidency” twice, is not that he never got a crack at transforming his country. It’s that the working class hero who spent 50 years fighting autocracy and helped midwife Kenya’s robust multi-party democracy died, ignominiously, the way an inordinate number of African heads of state and elites do: in a foreign country, in a private hospital with resources that no ordinary member of their countries can access or afford, sometimes under the care of specialists from home now working in foreign lands. Odinga died of heart failure on Oct. 15 near the port city of Kochi in India.
It’s shameful that a man who dedicated his life to equality and empowerment of the poor died in a manner no different to the likes of Zimbabwe’s kleptocratic president Robert Mugabe who, during 37 years in power, ran his country’s health system into the ground while frequently travelling at taxpayer expense to Singapore (where he died in 2019) for world-class treatment.
So long as Africa’s political leaders and elites are able to enjoy foreign healthcare, they’re unlikely to tackle the shortcomings of their domestic institutions, including acute shortages of health workers, crumbling infrastructure and inadequate financing. They should be barred from seeking treatment overseas.
Medical tourism is all-too common among African leaders. In July, oil-rich Nigeria’s former president Muhammadu Buhari, who led from 2015 to 2023, died in a London hospital. Buhari had vowed to bring an end to medical trips abroad by government officials but broke the promise a year into his term. In June, Zambia’s former president Edgar Lungu died in a South African hospital. Two of his predecessors, Levy Mwanawasa and Michael Sata, died in foreign hospitals after being carted through clinics in London, New York and Paris. Paul Biya, Cameroon’s 92-year-old president who contested elections last week seeking a term that will last until he’s a centenarian, has disappeared for long periods in the past two decades to seek medical attention in Switzerland.
From Ethiopia’s Meles Zenawi dying in Belgium to Angola’s Eduardo dos Santos (a self-professed Marxist) ending his days in Spain, the continent is replete with examples of leaders taking advantage of superior care available in the US, Europe and Asia. Even countries such as South Africa, which has a world-class and thriving private healthcare system, are shunned by some of the country’s leaders. South Africa’s former president, Jacob Zuma, has taken jaunts to Russia for treatment for alleged poisoning or other ailments.
South Africa’s Health Minister Aaron Motsoaledi was right to ask May the G20 health ministers’ gathering in Johannesburg, “How the world could take Africa seriously if its heads of state did not trust their own healthcare systems.”
Africa should be investing vigorously in its healthcare, but that’s not been the case. The World Health Organization recommends nations spend 11% of gross domestic product on health systems; despite the 2001 African Union Abuja Declaration pledging to allocate at least 15% of national output, average spend across the continent was around 5% in 2022.
Money that could be invested at home flows overseas. The continent’s most populous country, Nigeria, loses at least $2 billion every year to medical tourism, according to the Nigerian Medical Association, with half of it going to India. The WHO projects that the shortage of health professionals in Africa will reach 6.1 million workers by 2030. Nigeria, whose finance minister was flown abroad last week after suffering a stroke, has one of the world’s highest maternal mortality rates — 1,047 deaths per 100,000 live births — after conflict-ridden South Sudan and Chad. It also lost 13,609 healthcare workers to the UK alone in 2021 and 2022; Nigerian physicians make up 45% of all international medical graduates practicing in the US.
Kenya’s President William Ruto visited Odinga’s home on Wednesday and announced a state funeral and seven days of national mourning. That’s the playbook everywhere on the continent when heads of state and ministers die in foreign hospitals. Africa’s leaders would do well to spend the money on better healthcare provision rather than honoring dead heroes. That would be a more fitting testament to Odinga, a left-wing firebrand who named his son Fidel after Cuba’s leader Castro.
Justice Malala is a political commentator and former editor of South Africa’s This Day. He is the author of “The Plot to Save South Africa: The Week Mandela Averted Civil War and Forged a New Nation.”
