Why Annual Medical Checkups Are No Longer Enough

Eighteen years ago I started my career as a medical laboratory scientist and my intial job description at its core was running laboratory tests, but as the years went by with the resultant professional growth and experience, I started to vet and sign off on labooratory results. After all these years of clinical practice, I have lost count of how many normal and abnormal results I have signed off on but I do remember the ones that weren't abnormal yet but were clearly heading there and nobody or system was in place to monitor it.

The Hidden Problem with Normal Laboratory Results

I particularly remember an Architect in his late thirties who came through our laboratory for his routine annual screening and all his biomarkers including fasting blood sugar (92mg/dl ) were within their normal ranges. He returned three years later and this time, his fasting blood sugar had hit 119mg/dl, which crosses into prediabetic territory. He was surprised by his latest result because, according to him, his previous three annual screenings, conducted at other laboratories, had all been reported as being within the normal range. Each year he was told his result was fine, because each individual number was within the normal range but nobody put the three numbers side by side for trend analysis. The system simply tested him three times and forgot about him each time. His story is a perfect illustration of why preventive healthcare falls short in Nigeria - a fragmented health system.

When a lab report says a value falls within normal range, that range was built from a large population sample, most of whom you share nothing with beyond an age bracket, gender and/or sometimes race. It tells you where you sit compared to thousands of other people but says nothing about where you sat last year, or the year before that. For example, a creatinine level that sits comfortably in range but has climbed steadily for three years is no longer reassuring; It is an early signal of declining kidney function, often years before symptoms or a formal diagnosis appear. Similarly, an HbA1c that moves from 5.0% to 5.3% to 5.6% over three annual checkups would, on its own, never trigger a conversation but as a trend, it is the clearest possible warning that someone is heading toward diabetes, with enough time to change course through diet and activity alone, before medication becomes necessary.

Why Biomarker Trends Matter More Than Individual Test Results

When news of the untimely death of Nigerian actor Alexx Ekubo from complications of advanced kidney cancer broke, social media was abuzz with conversations about the importance of regular medical check-ups but what a lot of people do not understand is that preventive healthcare goes beyond medical check-ups and it It is not a once-a-year exercise or a box to be ticked and then forgotten until the following year. Preventive healthcare is continuous and strategic, akin to investment management where long-term success depends on consistent measurement, monitoring, and timely intervention. Nobody hires an investment manager to tell them they've already gone bankrupt. They hire one to monitor trends, manage risk, and preserve long-term value.

At individual level, preventive healthcare means establishing a personal health baseline, monitoring biomarkers and longitudinal monitoring of one's health data in order to detect risks earlier and act before it becomes pathological. At systemic level, It is structured national preventive screening programmes, diagnostic infrastructure and population health surveillance and these require a centralized infrastructure with seamless access to an individuals health data irrespective of where diagnostic screening and other medical assessments were carried out; so that results are no longer interpreted in isolation and an individuals data is compared to his/her last results and not a population average.

Lessons from Japan's Ningen Dock Health Screening Programme

Advanced Healthcare systems around the world like Japan's worked this out decades ago. Japan has run a nationwide system of comprehensive annual health checkups called Ningen Dock - the name comes from the shipyard docks where vessels go for routine inspection and repair, and the comparison is deliberate - for decades which covers roughly 1,727 facilities nationwide and around 3.7 million people every year and researchers have pointed to it as one of the contributing factors behind Japan's long life expectancy.

Health Intelligence: The Future of Preventive Healthcare

The genius of Ningen Dock is it's repetittive approach to testing where the same person sits for the same test panel year after year, and a personal archive builds up that a doctor can actually use; hence, a cholesterol reading for example, means something specific in the context of a person's last five readings. This is called Health Intelligence - the strategic use of diagnostic data, trend analysis, and proactive monitoring to understand and manage one's health before disease develops.

Why Nigeria Needs a National Preventive Healthcare Strategy

Apart from Japan, countries like South Korea, Singapore, Taiwan, Germany, and the UK all operate structured preventive screening programs. Sadly, Nigeria has nothing resembling this at population scale despite non communicable diseases accountIng for roughly 29 to 30 percent of all deaths in the country, according to the World Health Organization, and the figure is rising. These chronic conditions also represent the largest share of healthcare expenditures worldwide hence, the economic implication is that healthcare systems designed to wait for diseases inevitably spend far more than systems designed to detect risk earlier.

Early Detection Saves Lives and Reduces Healthcare Costs

Disease progression follows an exponential cost curve, with early intervention costing little while delayed intervention can become extraordinarily expensive. Just as financial intelligence transformed how individuals manage wealth, health intelligence will reshape how societies manage disease risk, because the most powerful medical and economic intervention may not be treatment but simply knowing earlier; hence healthcare systems that ignore the early signals of disease will ultimately bear far greater medical and economic costs.

Research by Deloitte Center for Health Solutions estimate that shifting healthcare systems toward proactive prevention and early disease detection could reduce healthcare spending in the United States by up to $2.2 trillion annually by 2040. The question then is, if advanced healthcare systems like the United States' with far greater funding than Nigeria’s are retrofitting their health systems for practive prevention, to not only improve outcomes but also to drastically cut costs, Why is Nigeria with an abysmally low healthcare funding and poor health outcomes not considering same?

The Future of Preventive Healthcare in Nigeria

Looking at trends in other sectors of the economy - energy, finance, education etc., I can confidently say that the future of preventive healthcare in Nigeria, in terms of continuous biomarker tracking, personalized baselines, longitudinal monitoring and predictive analytics will be pioneered by private innovation delivering personalized, data-driven care to those who can access it. I am certain of this because we're building it here at The White Coat.