By Chibuzor Uwadione, MHA
This is not criticism but a call for action because “No One is Exempt. ”
The night the private jet can’t save you
Picture it: 2 a.m. in Asaba, Warri, or Ughelli. A prominent businessman, a retired commissioner, an oil contractor worth billions of naira, clutches his chest or watches a loved one seize with a stroke. He has the money. He has the connections. He has, in some cases, a private jet parked at the airstrip. But none of that matters at 2 a.m., because there is no functioning cath lab within reach, no neurosurgeon on call, no ICU bed with a working ventilator, and no flight — chartered or commercial — that can wait for dawn while a brain bleeds or a heart starves of oxygen.
Abuja is forty-five minutes away by air and impossibly far away by need. Lagos may as well be another country. The golden hour, the window in which stroke and cardiac care actually saves lives, closes long before the aircraft’s engine even turns over.
This is the uncomfortable truth Delta State’s elite have not fully reckoned with: wealth can buy distance from poverty, but it cannot buy distance from a broken health system at midnight.
You can send your children abroad to study — Canada, the UK, the United States — and shield them from failing schools. You cannot send yourself abroad in the middle of a hypertensive crisis. Private jets need pilots who must be roused, flight plans that must be filed, and airstrips that must be lit and clear.
Emergencies do not wait for logistics. In that narrow, terrifying window, the oil magnate and the market woman are, for once, standing in the same line — a primary healthcare centre with no doctor, a general hospital with no blood bank, a state with no functioning trauma or cardiac referral system of its own.
The numbers behind the neglect
This isn’t rhetorical. Delta State’s healthcare budget rose 152% between 2018 and 2024, from ₦18.96 billion to ₦47.84 billion, yet it has stayed under 5% of the state’s GDP — nowhere near the 15% African governments pledged to health under the Abuja Declaration.
At the national level, the picture is worse: Nigeria’s 2026 federal health allocation is proportionally lower than 2025’s, even as the naira buys less every day. Budget lines mean little without disbursement — of ₦218 billion appropriated for the Health Ministry’s 2025 capital projects, only ₦36 million was actually released.
And Delta is not unusual in this failure: across Nigeria’s 36 states, the number releasing less than half their approved health budgets jumped sharply in 2025, and health workers in at least 20 states went on strike between 2021 and 2025.
Meanwhile, capital spending on roads, flyovers, and grassroots infrastructure projects continues to expand — Delta’s 2026 budget commits huge sums to local government development. Infrastructure matters. But a state can build every flyover in the Niger Delta and still lose its governor’s own relatives to a condition a well-equipped hospital in Asaba could have handled in twenty minutes.
The social determinants no one can fly away from
Healthcare outcomes are never just about hospitals. They are shaped by the conditions people are born into, grow up in, work in, and age in — the social determinants of health:
• Water and sanitation. Communities across the Niger Delta still rely on contaminated creeks and boreholes, driving cholera, typhoid, and chronic waterborne illness that no amount of private wealth fully insulates against once an outbreak starts.
• Environmental exposure. Decades of oil spills and gas flaring have degraded air, soil, and water quality across the state — exposure that doesn’t check a person’s bank balance before causing respiratory disease, cancer, or birth complications.
• Road and transport infrastructure. Poor roads mean ambulances (where they exist at all) take hours to reach patients, and referral from a rural primary health centre to a general hospital can be the difference between a treatable emergency and a fatality.
• Workforce flight. Doctors and specialist nurses trained in Delta State leave for Lagos, Abuja, or overseas because of poor pay, poor equipment, and unsafe working conditions — leaving even well-funded facilities unable to function.
• Education and health literacy. Antenatal care uptake, immunization rates, and early disease detection all track with education levels, which remain uneven across the state’s riverine and upland communities.
• Poverty and income. Out-of-pocket healthcare costs push families into debt or force them to delay care until conditions become emergencies — the single largest driver of preventable deaths in the state.
None of these determinants respect class lines completely. A contaminated water source, a collapsed referral pathway, or a mass exodus of specialist doctors doesn’t ask whether the next patient through the door owns a jet.
Why this is a collective problem, not a poor person’s problem
It is tempting for the wealthy and politically connected to treat healthcare investment as charity for the underserved — a line item for “the masses” while their own care happens elsewhere. But a health system is not a private amenity; it’s shared infrastructure, like the air or the road network.
A handful of private hospitals catering to the elite cannot manufacture specialists, cannot stockpile trauma-ready blood banks, cannot build a functioning ambulance corridor, and cannot control disease outbreaks, on their own.
When public health infrastructure collapses:
• Outbreaks spread from underserved communities into gated estates.
• Skilled health workers leave the state entirely, shrinking the pool available even to private facilities.
• Emergency response — the one thing money can’t outrun at 2 a.m. — stays broken for everyone.
• Economic productivity falls as a sick, undereducated, undernourished workforce cannot sustain the businesses the elite depend on.
A strong public system doesn’t just protect the poor — it is the insurance policy the rich haven’t realized they’re under-buying. The billionaire’s driver, cook, security guard, and their children all depend on the same crumbling primary healthcare centres. Their illness becomes his risk, his household’s risk, his workforce’s risk.
A plea for a rethink
This is a plea, not just a policy brief: to Delta State’s business elite, political class, and returning diaspora — the health system you may never personally need until the one night you desperately do is the same system your drivers, workers, and neighbours rely on every single day.
Investing in it isn’t charity. It is self-preservation, dressed as public good.
What better investment could look like
1. Fund and staff a real emergency and trauma referral network — at minimum one fully equipped tertiary trauma and cardiac centre per senatorial district, with a functioning ambulance and air-ambulance protocol, so care doesn’t depend on a commercial flight schedule to Lagos.
2. Close the disbursement gap, not just the budget gap — publish quarterly, independently audited releases against capital health budgets so appropriated naira actually becomes equipment, drugs, and salaries.
3. Retain the health workforce — competitive pay, hazard allowances, housing, and continuing education to stop the exodus of Delta-trained doctors and nurses to Lagos, Abuja, and abroad.
4. Invest upstream in the determinants — clean water and sanitation projects, gas flaring reduction, and road access to rural health centres, since prevention is cheaper than any emergency flight.
5. Build a state health insurance scheme with real teeth — expand the state’s contributory health scheme so catastrophic out-of-pocket costs stop pushing families into poverty.
6. Create a public-private co-investment model — invite the diaspora and local business elite to co-fund specific tertiary facilities (with transparent governance), so private wealth strengthens shared infrastructure rather than substituting for it.
7. Establish a state-level health data and accountability dashboard — track maternal mortality, referral times, and disease outbreaks publicly, the way infrastructure spending is already publicized.
None of this is unaffordable for a state with Delta’s oil-derived revenue. What has been missing is not resources but priority — and the will to see healthcare not as a cost the wealthy can privately opt out of, but as the one system in the state that, in its darkest hour, treats everyone exactly the same.
Respectfully,
Chibuzor Uwadione, MHA
*citation:
-Budget and health-financing figures drawn from the Nigerian Health Journal, THISDAY, The Guardian, and Dataphyte reporting on state and federal health budgets, 2025–2026.
