Doctors At Breaking Point: How ₦38 Billion In Unpaid Allowances Exposes Nigeria’s Failing Health System

THE Nigerian Association of Resident Doctors (NARD) has once again raised the alarm over the federal government’s failure to meet long-standing financial obligations to the nation’s doctors and other health workers. This time, the figure is staggering—₦38 billion in accumulated allowances, spanning over a decade of neglect, bureaucratic inertia, and broken promises.

At a press briefing in Abuja, NARD President, Dr. Muhammad Suleiman, declared that the association would embark on an indefinite nationwide strike effective November 1, following the expiration of a 30-day ultimatum issued to the federal government. This strike, if carried out, will mark yet another chapter in Nigeria’s recurring healthcare crisis, one defined by underfunding, poor working conditions, and systemic disregard for those at the frontline of saving lives.

Dr. Suleiman explained that the debt includes multiple layers of unpaid entitlements—ranging from two-year arrears to decade-old errors in allowance calculations. “There’s an allowance error that is over 10 years old,” he said. “The government has failed to review even the basic salary of doctors in 16 years.” According to him, while the unpaid allowances for resident doctors alone may total around ₦400 million, the combined debt owed to all healthcare workers exceeds ₦38 billion—a reflection of the deep rot within the system.

Years of Broken Promises

This latest confrontation is not new. Since the association suspended its five-day warning strike in September 2025, NARD has made repeated attempts to engage the government constructively. During its Annual General Meeting in Katsina, the group extended an earlier ultimatum by another 30 days—hoping for genuine progress on the 19-point demands presented in its communiqué. Yet, the government has remained unresponsive, demonstrating little political will to address even the most urgent grievances.

Among the unresolved issues are the payment of five months’ arrears from the 25 and 35 per cent Consolidated Medical Salary Structure (CONMESS) review, the 2024 accoutrement allowance, and unpaid promotion arrears dating back to 2021. The NEC also expressed grave concern over the continued exclusion of house officers from the civil service scheme, a policy that denies young doctors pension rights and welfare benefits.

Doctors Overworked and Undervalued

The situation has pushed many doctors to their limits. NARD warns that worsening manpower shortages—caused by the government’s refusal to replace doctors leaving the system—have forced remaining personnel to work dangerously long shifts across several days. “This unsustainable practice poses serious risks to physicians’ well-being and patient safety,” the association stated. Nigerian doctors, already among the lowest paid in the world, are now stretched to the brink in both body and spirit.

In hospitals across the country, the effects of this neglect are visible. In Benue State University Teaching Hospital, doctors are owed 18 months’ arrears. At the Federal Medical Centre, Owo, unpaid salaries and allowances have piled up for between four and eight months. The Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, reportedly owes 83 doctors employed under a 2022 waiver and 40 others who have not been paid their March 2024 salaries. Similar cases abound in the Federal Teaching Hospital, Lokoja, and the University of Uyo Teaching Hospital, where doctors remain off the payroll despite active service.

A Health System on the Brink

Nigeria’s public healthcare system is hemorrhaging. Every time the government fails to meet its obligations, it drives another wave of medical professionals out of the country. The result is a deepening “brain drain” that now threatens to collapse critical sectors of the system. Doctors and nurses, frustrated by unpaid wages, poor infrastructure, and lack of basic working tools, are migrating in record numbers to countries where their skills are valued and adequately compensated.

What is at stake is not merely the comfort or welfare of doctors—it is the survival of Nigeria’s healthcare system itself. Each strike, each unfulfilled promise, and each wave of medical emigration erodes public trust and pushes millions of Nigerians further into vulnerability. Patients are left stranded in hospitals without doctors, while lives that could have been saved are lost due to bureaucratic indifference.

Time for Leadership and Accountability

NARD’s appeal to President Bola Tinubu is both urgent and symbolic. “Mr. President, they have been paying themselves their salaries and allowances. It is we who are in the field working that they are not paying,” Dr. Suleiman said, calling on the president to intervene directly. His plea underscores a larger truth: Nigeria’s political class continues to reward itself while those who keep the nation alive—literally—are forced to beg for what they have rightfully earned.

If the government continues to dismiss these warnings, it risks a total breakdown of the already fragile healthcare system. The solution lies not in temporary palliatives or empty promises, but in a genuine commitment to reform: clearing all outstanding arrears, implementing a fair wage structure, and ensuring transparent funding for hospitals nationwide.

A Call for Collective Action

The plight of Nigeria’s doctors is a reflection of a broader national malaise—a culture of governance that tolerates dysfunction and rewards mediocrity. The government must understand that healthcare is not a privilege but a right, and that those who deliver it deserve dignity and fair compensation.

The time for excuses has long passed. Nigeria cannot claim to value life while treating its healers as expendable. If the country fails to act decisively now, the looming strike will not just be a protest by doctors—it will be a grim diagnosis of a nation in critical condition.