In August 2024, the Nigerian Federal Ministry of Health and Social Welfare unveiled the National Policy on Health Workforce Migration, a 56-page document designed to stem the tide of health worker emigration, widely dubbed the “Japa Syndrome.” The policy was heralded as a long-overdue lifeline for a healthcare system on the brink, with its objectives encompassing the retention of healthcare professionals, the attraction of emigrated talent back home, and the mitigation of further skilled labor losses. Yet, less than a year later, the government’s actions have blatantly contradicted the spirit and substance of its own policy, effectively abandoning its implementation and deepening the sector’s dysfunction.
On 27th June, 2025, the National Salaries, Incomes and Wages Commission (NSIWC) issued a circular that was expected to reflect long-awaited adjustments to health workers’ compensation under the Consolidated Medical Salary Structure (CONMESS). Instead, the circular was met with outrage by the Nigerian Medical Association (NMA), which described it as “grossly inadequate, misleading, and a violation of collective bargaining agreements.” The NMA at a press conference on 2nd July 2025 highlighted the circular’s failure to honor long-standing agreements from 2001, 2009, and 2014, and demanded its immediate withdrawal. The Association then issued a 21-day ultimatum to the federal government, warning of a potential disruption of healthcare services across the country.
If this internal crisis weren’t enough, President Bola Ahmed Tinubu’s subsequent action has further widened the rift between policy and practice. On 3rd July 2025, the NMA again reacted to the president’s Technical Manpower Assistance (TMA) agreement with the government of St. Lucia, an agreement that requires Nigeria to deploy doctors and other healthcare workers to the Caribbean island nation. The Association condemned the move as “morally unjustifiable,” especially in light of the dire working conditions and neglect faced by healthcare workers at home.
According to the NMA, the deployment plan not only neglects the demands of doctors in Nigeria but also incentivizes the very brain drain that the 2024 National Policy on Health Workforce Migration was designed to prevent. While Nigerian doctors in St. Lucia will be paid ₦40.8 million annually by the Nigerian government, those serving at home receive as little as ₦11.9 million, an unflattering contrast that reflects the government’s misplaced priorities. St. Lucia pay it own doctors about ₦131.7 million annually.
This contradiction between stated policy and actual governance raises a fundamental question: Has the Nigerian government quietly abandoned its health workforce migration policy?
A Policy Full of Promise, Short on Action
The National Policy on Health Workforce Migration aimed to achieve several key goals which include to: incentivize health workers to remain in Nigeria, improve conditions in training institutions, support career progression and continuing education, enhance healthcare in rural communities and establish bilateral agreements to manage emigration flows responsibly.
However, there is little evidence that these goals are being pursued meaningfully. Instead, the actions of the federal government suggest a preference for short-term image laundering over long-term systemic reform, for instance, one of the most pressing concerns among healthcare workers, poor remuneration, has not been addressed effectively. The NMA list of 18 demands at its 2nd July press conference include payment of backlogs, implementation of hazard allowances, and equitable treatment for house officers and consultants. These are not new requests; they are reiterations of promises already made and broken in multiple Collective Bargaining Agreements (CBAs) of the past.
The Medical Residency Training Fund (MRTF), meant to support the development of future specialists, remains unpaid for 2025 according to the NMA. Without it, residency programs across Nigeria could be stalled or disrupted, compounding the shortage of specialized care providers.
Contradictions That Undermine Trust
The St. Lucia agreement is a stark symbol of the policy incoherence plaguing the Nigerian health sector. Rather than creating a conducive environment for health professionals to stay, the government is exporting them for prestige or foreign diplomacy, paying them about four times of what they earn at home. Though still very far below what the St. Lucian government pay its own doctors.
What message does this send to the thousands of Nigerian healthcare workers currently working under harsh conditions? That their well-being is less of a priority than international appearances? That the government finds it more feasible to deploy its scarce human resources abroad than to invest in making Nigeria a place worth staying?
Such contradictions only serve to erode the credibility of any policy efforts the government may claim to support. As long as words are not matched with action, the health workforce migration policy remains a paper tiger with no effect.
Nigeria is already reeling from a shortage of healthcare professionals. In 2022 alone, over 3,000 doctors left the country, a 250% increase compared to a decade earlier. The United Kingdom and Canada continue to attract Nigerian talent, offering not just better pay but more stable work environments and clearer career paths.
The continued exodus places a heavier burden on the dwindling number of doctors who remain. Many now face long hours, burnout, and increased risks of mental health issues. It also directly affects patient outcomes, rural and underserved communities are left with little or no access to skilled care, contributing to Nigeria’s persistently high maternal and child mortality rates.
Where Do We Go From Here?
If the Nigerian government is serious about addressing brain drain, it must stop undermining its own policies. The first step is to withdraw the NSIWC circular, as demanded by the NMA, and open transparent dialogue to implement a fair, competitive remuneration structure. The MRTF and other allowances must be paid promptly, and infrastructure in training institutions and hospitals should be prioritized.
More importantly, any bilateral agreements involving the deployment of Nigerian health workers should be linked with investments in the domestic health sector. Nigeria cannot afford to serve as an outsourcing hub for medical professionals while its citizens suffer from inadequate care.
The Nigerian health workforce migration policy was a bold, well-intentioned step toward reversing the nation’s health sector decline. But recent events, from the disputed wage circular to the controversial St. Lucia agreement, reveal a government disconnected from its own reform agenda. If this trend continues, the policy will become another tragic example of how Nigeria writes excellent plans, only to abandon them at the altar of expediency.
