Such fine and righteous words. So there was fury the following year when this leader in his seventies flew to London for treatment of an ear infection. This was “a tragic blot” on Nigeria’s image, thundered Dr Osahon Enabulele, a former head of its medical association. The new president, he added, should have used his minor ailment to focus people on the urgent need for domestic health reform.

But Buhari was not listening. He went off on several more trips and, by the end of his first term last year, had spent at least 170 days in Britain on health grounds.

Buhari is far from the only African leader to display such lack of faith in his own nation. Robert Mugabe died last year aged 95 in a Singaporean hospital, having so wrecked Zimbabwe and its medical system that life expectancy plummeted by 26 years at one point. “It is very symbolic the former president who presided over the system for three decades can’t trust the health system,” said one doctor after his death. Other physicians complained of carrying out surgery without even putting on protective gloves.

Meles Zenawi ruled Ethiopia for 21 years, suckering Western admirers who overlooked his savage repression as they fell for his talk of development — yet this wily despot died in a Belgian hospital. Omar Bongo ran Gabon for 42 years, then died in Barcelona having plundered his country’s wealth obscenely while leaving his tiny 2.2m population trapped in poverty.

Jose Eduardo dos Santos, who ruled and ripped off Angola for almost as long, travelled to the same Catalan city for treatment. Algeria’s former president went to a Swiss hospital after running his nation for 20 years, then suffering a stroke. Benin’s president went to France for surgery. Two Zambian leaders died abroad while receiving medical attention.

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By Dan Knowles

I could keep going with this list of shame — and these are just the leaders. All are surrounded by teams of aides and layers of acolytes, many showing similar hypocrisy as they fail nations filled with impoverished citizens then flit abroad to foreign clinics when falling ill. Almost one in six of the world’s population lives in Africa — yet according to the Brookings Institution think tank, the continent accounts for just 1% of global health spending. Now coronavirus has arrived, with 10,000 confirmed cases and 500 dead so far — which is terrifying, given the creaking state of public services and crowded living conditions in many places.

Yet if there is one glimmer of hope in these torrid times, perhaps the virus might force a few more African leaders to face up to the awful state of their health services. For suddenly many of the continent’s self-serving elites must stay at home if sick. More than half of Africa’s international airports have either closed or limited flights. Lockdowns are being imposed.

Even if the leaders could escape, there are restrictions on movement in many richer nations, while private medical services and doctors are being pressed into action on the pandemic frontline. And there are strong private facilities in some places. But if they or their families become infected, these rich and powerful plutocrats may have to confront the horror of seeking treatment alongside their fellow citizens in local hospitals, relying for salvation on medics who have complained for so long of being forsaken.

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In Nigeria — which identified its first case in February and where a key presidential aide has already been infected — borders have been closed, international airports shut down and private jets grounded. The first fatality was an oil executive in his late sixties who had just returned from medical treatment in Britain.

“It’s going to be a lesson for those who think they can neglect the health system,” said Francis Faduyile, head of the Nigerian Medical Association. “The highest of the government officials, some of them will be infected, and they’ll have no option but to get local treatment.”

When Buhari flew off in 2018 on his fifth health tourism trip, he left behind a strike by healthcare workers. They were angered by the failure to spend adequate funds on medical facilities in Africa’s most populous nation. “There has long been medical tourism because our hospitals are grossly underfunded,” said a union official.

And it is not just politicians who have fled the system: almost half of Nigeria’s registered doctors have reportedly moved abroad to find better-paid or less stressful work. Many have moved to Britain. They leave behind a land with low life expectancy, high infant mortality and dire shortages of skilled staff to treat suffering patients.

Despite the massive oil wealth — much of it stolen by those elites who fly abroad when they fall ill — a baby born in Nigeria is likely to live more than three decades fewer than one born in Britain. One study published three years ago by Bangladeshi and Nigerian public health experts concluded that many of the nation’s citizens were dying from preventable conditions. Among them, they highlighted the worst tuberculosis rate in Africa, with almost half a million cases annually. Yet even basic things such as gloves, masks and paracetamol are often missing from frontline services. Only five laboratories could test for coronavirus in this nation of 190m people.

As I write there have been six recorded deaths and 254 registered cases, although as with many countries this will be a fraction of the real number. “This crisis has exposed in the worst possible way the evident weaknesses of our health system,” said Femi Gbajabiamila, speaker of the House of Representatives. “After this is over and moving forward, we must do everything in our power to ensure that we will never again come upon a moment such as this, as ill-equipped as we are now.”

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Many countries are in a much worse state than Nigeria, where its thriving technology hub is springing into action to plug some deficiencies. Africa has about one doctor per capita for every 16 per head in Europe. Kenya has 130 ventilators for 50 million people. Compare this with Wales, which has more than three times as many for its three million citizens, and just bought another 1,035 to cope with this crisis.

Yet the east African country is better prepared than Sierra Leone — still recovering from the ebola epidemic that killed so many medical workers six years ago — which has one ventilator for 7.5 million people. Or the conflict-torn Central African Republic, which has three for a population of five million. Almost 20 countries have warned the World Health Organisation that they have no intensive care beds for their most severe cases.

African nations are often used to battling infectious diseases. Nigeria’s rapid reaction to ebola six years ago demonstrated an exemplary public health response, with effective screening, tracking and isolation. Populations are also comparatively young, so less likely to die from this disease. Yet there will still be horrible numbers of fatalities; the economic pain could be even more intense than in richer nations, with vital remittances already falling; and it may prove even harder to dampen down pandemic in the continent’s packed cities.

Already the aid industry is gearing up to beg for more funds, although the decrepit state of many African health services offers grotesque proof of persistent failure. The former aid secretary, Rory Stewart, pointed out Britain has pumped £4.5bn into Malawi over half a century yet the country became poorer. Now we discover it is so badly corroded by corruption and bad governance that it has only about 25 intensive care beds in public hospitals that cater to 17 million people.

We hand about £100m a year to Uganda — which is run by a repressive kleptocracy and deceived donors over refugee numbers to obtain more funds — yet reportedly it has just 55 emergency beds for its 43 million citizens.

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These numbers indicate pitiful health systems, even before the virus strikes to expose their deficiencies, and despite the noble efforts of many local health teams. Two weeks ago the pop star Bobi Wine, who has bravely challenged Yoweri Museveni’s festering regime in Uganda, sent me a bouncy new song called ‘Corona Virus Alert’ that aims to spread a message of prevention, social distancing and hand washing. In an interview with a news agency, he argued that Africa’s leaders needed to build better health systems to serve all society instead of spending so much on weapons and silencing their critics.

“For a long time we have been calling out the government of Uganda, like many governments on the African continent that have neglected health care systems,” he said.

“This is the time for them to remember that a functional health care system is not only a benefit for the poor but also the rich, because right now, as we stand, they can’t travel abroad for medical care. They have to face the same ailing medical care to deal with them. And this should be a message to them.”

Bob Wine is right, like many other activists making similar points in other parts of the continent. So dare we hope that amid the fears and tears of this vile pandemic, some of Africa’s most venal politicians and grubbiest elites might finally be forced to accept the devastating consequences of their selfish actions? Or will they just waltz away again once their dance with this deadly virus has ended?

When the ZANU leader achieved power in Zimbabwe in 1980, the average life expectancy was just under 60. By 2006, when Mugabe had been ruling – or immiserating – that land for a little over a quarter of a century, he had achieved something that was, in its own way, remarkable. For now, Zimbabwean life expectancy was down to 37 for men and 34 for women. Indeed, the situation was so bad that average life expectancy for women had fallen by two years in just two years.

That statistic within a statistic is worth dwelling on. With a greater or lesser degree of acceptance, all human beings understand that every year we live is one year closer to the grave. But Zimbabwean women in the era of Mugabe weren’t just heading at the normal human pace towards the terrible silence, because at the time same they were moving towards it, it was moving towards them at the same speed. (By way of contrast, in Kenya during that same period, life expectancy increased 10 years in a decade, so that in 2013, the average Kenyan was no nearer to death than he had been in 2003.)

There were two reasons why the citizens of Zimbabwe found themselves in such a dreadful situation. The first was the dire economic system that Mugabe oversaw, one of incompetence, corruption and grand-scale theft that turned one of the breadbaskets of Africa into a basket case. Hyper-inflation was just one consequence, but for the average Zimbabwean this translated into food shortages, medical shortages and eventually shortages of just about everything.

The other nightmare unleashed on the Zimbabwean people was Aids. The scourge, which had affected every country in sub-Saharan Africa, rode through Zimbabwe with especial ease because it was helped along by what might be regarded as the precise opposite of a public information campaign.

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Indeed, the Mugabe government’s attitude towards the pandemic might more correctly be described as a public disinformation campaign. It was designed to keep the general public not just in ignorance but actively misinformed about the way in which the virus is transmitted, how irreversible it then was after infection, and how it could best be avoided.

Again, Zimbabwean women were at the forefront of this scourge, being more likely than men to catch the virus. The ignorance that Mugabe promoted, and his reluctance to accept outside intervention to deal with the crisis, was another singular part of his legacy.

So there, in a single statistic, is the total life achievement of Robert Mugabe. At a time when living standards around the world were rising, when hundreds of millions of people were being raised out of extreme poverty and life expectancy was slowly rising, Mugabe managed to rob the average Zimbabwean woman of half her life. And this man, whose miserable achievement on earth might be summed up in that fact, has died – presumably as peacefully as his looted wealth allowed him to die – at the age of 95, in a private hospital in Singapore.

Zimbabwe has spent this past decade trying to find its way back from the brink, but the lesson of Mugabe’s life is precisely the inverse of the motivational instructions that most school children learn. If it is true that one person can make a difference, that one person can do an almost untold amount of good for the world if they put their mind to it, then the opposite is also true. The force of one wicked or evil individual can be enough to create an almost unimaginable amount of harm.

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Why should Boris trust Channel 4?

By Douglas Murray

And while Mugabe, during his interminable presidency, presented the ruin of Zimbabwe either as some unavoidable fact, or the consequence of the wicked former colonialist power, so he managed only to demonstrate the fact that if the country had ended up in other hands – literally almost any other hands – the results could at the very least not have been worse.

Now that he is no longer with us, perhaps it is also worth reflecting on what lessons there are outside of Zimbabwe for how to deal with a figure like Mugabe. It is true that, for Britain, in particular, the relationship was a complicated one. Even low-level forms of soft-diplomatic pressure, such as throwing Zimbabwe out of the Commonwealth, could be portrayed domestically as the former colonial rulers attempting to impose themselves once more. The history of the post-colonial period is no longer anywhere near being fully written, but when it is, we will need to ask how the likes of Mugabe (not that there were many like him) were able to get away with things simply by dint of not being European.

Almost every part of the leeway Mugabe was able to exercise – promiscuously at the start of his rule, though with diminishing returns towards its close – was predicated on that one simple fact: that he was not the colonial power. There is something to be said for the attitude, of course, but it is clear that the pendulum had swung too far.

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Meghan and Harry are playing a dangerous game

By Douglas Murray

In his memoir Gentle Regrets, the philosopher Roger Scruton recalls an occasion in 1985 when he was due to speak at Glasgow University. Various student organisations had found out that Scruton was a conservative, and specifically the then editor and publisher of the conservative journal The Salisbury Review, and so he was, not for the first or last time, subjected to a no-platforming at the university. And, by his own account, as Scruton wandered forlorn around the university grounds as his hosts tried to find a room anywhere on or off campus where they might safely hold his talk, he had the opportunity to watch a bit of Glasgow university pomp — a ceremonial procession in session to bestow the honour of an honorary degree on (Dr) Robert Mugabe.

It is easy at times like this to pass around photographs of the Queen and various British prime ministers with Mugabe, as though having to meet them in the course of official duties in any way suggested that any or all of them approved of him. But much more telling is that small vignette from Glasgow University 30 years ago, because, of course, the University did not have to meet Mugabe nor honour him, a man already responsible for a brutal massacre by this point. They chose to.

And in a snippet like that, one gets a glimpse of the larger question that will at some point have to be addressed: how Robert Mugabe was able to die so close to his centenary when his sole legacy on earth was stopping millions of his own people from reaching a third of that age.