November 29, 2022

The recent suggestion by the Nigerian Medical Association for mandatory physical and psychiatric evaluation of presidential, governorship and legislative seat candidates ahead of the 2023 elections is germane. NMA through its President, Uche Ojinmah, proposed that persons contesting for public offices should undergo “simple medical check-ups such as chest X-ray, cardiac echocardiography, abdominal ultrasound scan, urinalysis, kidney function test, liver function test, blood pressure, and blood glucose assessment.”

Additionally, the doctors recommended “psychiatric evaluation” for such persons. Against the backdrop of the health problems of a past, and of the incumbent president, and their implications for the country, this proposal deserves legislative backing.

Similar calls have been made by other stakeholders. The Chairman of the National Drug Law Enforcement Agency, Mohammed Marwa, also wants political parties to include drug integrity tests as part of the screening processes for political candidates. In 2017, the then Emir of Kano, Lamido Sanusi, canvassed a law compelling public office holders, including lawmakers and governors, to undertake drug tests.

These suggestions resonate following public concerns that some of the leading candidates currently running for office are infirm. The country paid dearly when such concerns about Umaru Yar’ Adua were dismissed in 2007 only for him to spend most his time in office as president abroad as an invalid. His sickness and death in office three years into his tenure created a constitutional crisis that was only resolved by the invocation of the “doctrine of necessity” by the parliament to facilitate the succession to the presidency by his deputy.

Aged 72 and ailing when he took office in 2015, the President, Muhammadu Buhari (retd.), has spent over 200 days cumulatively attending to his health in London at taxpayers’ expense. He not only frequently abandons governance, thereby facilitating its hijack by cabals and cronies; he also routinely breaks the law by refusing to hand over the reins of government to the vice-president when he jets out.

In the present electioneering season, two of the leading candidates are septuagenarians – one is 70, the other 75 – and anxiety has been raised over their physical and mental fitness. Allegations have also been raised of drug abuse by some candidates.

Under the Nigerian constitution, physical sickness does not disqualify political candidates and illness is a human malaise that could afflict anyone. But it is desirable for voters to know the health status of political office seekers just as they should know their sources of wealth, and tax compliance status. This will enable voters to make informed electoral choices.

The Yar’ Adua and Buhari experience should serve as markers. Yar’ Adua flew to Saudi Arabia on November 23, 2009, for treatment and was not seen in public again until February 24, 2010, when he returned surreptitiously to Abuja. He eventually died on May 5, 2010. After several short visits, Buhari once spent 49 days at a stretch on a medical holiday in London. Such waste and tension can be avoided.

Voters should decide if they are willing to gamble on ill candidates. An individual’s health details are protected by the laws of privacy, but candidates should be made to present medical fitness reports to the electoral umpire.

Indeed, Section 131 of the 1999 Constitution on qualifications for election to the office of the president lists Nigerian citizenship, minimum age of 40 years, membership of a political party, and minimum educational status of school certificate. Section 137 that lists instances that disqualify a candidate does not include sickness.

The issue is however about informed choice; just as employers can decide to employ or reject qualified but physically ill job applicants, voters should also be able to decide whether other qualities possessed by a candidate outweigh any serious illness he might have.

Those concerned about the health of candidates are on surer ground based on Section 137 (1) (c) which disqualifies anyone that “under the law in any part of Nigeria, he is adjudged a lunatic or otherwise declared to be of unsound mind.” A maniac should not be president, or governor! Psychiatric tests should therefore be compulsory.

A professor of Public Health at the University of Ilorin, Tanimola Akande, noted that like anyone else aged above 40 years, those seeking elective public office should also undergo regular medical evaluation. A University of Salford, United Kingdom, psychologist, Ashley Weinberg, said that testing politicians’ psychological health regularly would ensure “they are in the best position to make decisions in the national interest.”

Politicians’ hiding their health challenges is a problem several other democracies grapple with. At least five United States presidents – John F. Kennedy, Woodrow Wilson, Franklin Roosevelt, Dwight Eisenhower, and Ronald Reagan – each had health issues they kept from the public while in office. Harold Wilson reportedly concealed his symptoms of colon cancer and Alzheimer while he was British prime minister.

Following the 2016 election of Donald Trump as president, a group of over 70 psychologists, psychiatrists, and lawmakers called for mental health examinations for candidates. Even Trump administration officials expressed concern about his “erratic behavior.”

In the mid-1990s, a former US president, Jimmy Carter, pushed for a panel of physicians who would routinely evaluate the president to decide whether their judgment was clouded by a mental disability, and to prevent the possibility of the country’s most powerful political office holder from becoming disabled, particularly by a neurologic illness.

However, balance is imperative; the Code of Medical Ethics on Privacy, Confidentiality, and Medical Records by the American Medical Association, says “physicians must seek to protect patient privacy in all settings to the greatest extent possible and should minimise intrusion on privacy when the patient’s privacy must be balanced against other factors.” This has universal application, including in Nigeria.

To this end, stakeholders should partner with the National Assembly to consider legislation and a code that will provide a non-intrusive assessment on every political candidate’s general medical fitness.

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