The recent proposal by the Nigerian Medical Association (NMA) for mandatory physical and psychiatric evaluations of presidential, governorship, and legislative candidates ahead of the 2023 elections is both relevant and timely. NMA President Uche Ojinmah suggested that individuals running for public office should undergo basic medical assessments, including chest X-rays, cardiac echocardiograms, abdominal ultrasound scans, urinalysis, kidney function tests, liver function tests, blood pressure, and blood glucose evaluations. The doctors also recommended that psychiatric evaluations be included. Given the health challenges of past and current presidents and their impact on the nation, this proposal warrants serious legislative consideration.

Similar calls have been made by other prominent figures. The Chairman of the National Drug Law Enforcement Agency, Mohammed Marwa, urged political parties to include drug integrity tests in their candidate screening processes. In 2017, the former Emir of Kano, Lamido Sanusi, advocated for a law mandating drug tests for public office holders, including lawmakers and governors.

These suggestions have gained traction in light of public concerns over the physical fitness of some of the leading candidates for office. Nigeria has previously suffered the consequences of dismissing health concerns. For instance, when Umaru Yar’Adua’s health issues were overlooked in 2007, it led to a constitutional crisis after his prolonged absences due to illness and subsequent death three years into his presidency. This situation was resolved only by invoking the “doctrine of necessity” to allow his deputy to succeed him.

President Muhammadu Buhari (retired), who took office in 2015 at the age of 72, has faced significant health issues, spending over 200 days in London for medical care. His frequent medical absences have left governance in the hands of unelected cabals, and he has often failed to transfer authority to the vice-president when he leaves the country. Currently, two of the leading presidential candidates are in their 70s, with one aged 70 and the other 75, raising concerns over their physical and mental fitness. Allegations of drug abuse have also surfaced against some candidates.

While the Nigerian constitution does not disqualify candidates based on physical illness, it is crucial for voters to be aware of the health status of those seeking office, just as they should know about candidates’ sources of wealth and tax compliance. This would allow voters to make informed decisions at the polls.

The experiences with Yar’Adua and Buhari should serve as cautionary tales. Yar’Adua left for medical treatment in Saudi Arabia in November 2009 and was not seen publicly until February 2010. He passed away in May of that year. Similarly, Buhari once spent 49 consecutive days in London for medical treatment. The nation can avoid such disruptions by requiring candidates to present their medical fitness reports to the electoral commission.

Section 131 of Nigeria’s 1999 Constitution lists the qualifications for presidential candidates, including citizenship, a minimum age of 40, political party membership, and a school certificate. However, it does not account for physical health. While illness is a universal issue that can affect anyone, it is essential for voters to know if a candidate’s health condition might impact their ability to govern effectively. Just as employers can decide whether to hire someone based on their health, voters should be able to weigh a candidate’s qualities against any serious health issues they may have.

Concerns over mental health are even more clearly addressed by the constitution. Section 137 (1) (c) disqualifies any candidate who has been legally declared to be of “unsound mind.” Clearly, a person with significant psychiatric issues should not hold high office, and psychiatric evaluations should be mandatory for all candidates.

Tanimola Akande, a professor of Public Health at the University of Ilorin, argued that, like anyone over the age of 40, political office seekers should undergo regular medical check-ups. Ashley Weinberg, a psychologist at the University of Salford in the United Kingdom, emphasized that evaluating politicians’ mental health ensures that they are capable of making sound decisions in the national interest.

Other democracies also struggle with politicians concealing health issues. In the United States, presidents like John F. Kennedy, Woodrow Wilson, Franklin Roosevelt, Dwight Eisenhower, and Ronald Reagan all faced significant health problems while in office that were kept from the public. Similarly, Harold Wilson reportedly hid his colon cancer and Alzheimer’s diagnosis while serving as British prime minister.

Following Donald Trump’s election as U.S. president in 2016, over 70 psychologists, psychiatrists, and lawmakers called for mandatory mental health assessments for candidates. Concerns were raised within Trump’s administration about his erratic behavior. In the mid-1990s, former U.S. president Jimmy Carter pushed for the creation of a panel of physicians to regularly assess the sitting president’s mental and physical health to prevent incapacitation due to neurological conditions or other health issues.

However, privacy must be balanced with public interest. The American Medical Association’s Code of Medical Ethics emphasizes the need to protect patient privacy while balancing it against other important considerations. This principle should apply universally, including in Nigeria.

Stakeholders should work with the National Assembly to draft legislation that ensures a non-intrusive yet effective assessment of all political candidates’ general medical fitness. By doing so, Nigeria can protect its democratic process and ensure that those seeking public office are fit to serve the nation.