That Nigeria’s President Muhammadu Buhari is sick is now worldwide news. But he is not sick; he is very sick.  

We know that because the tea leaves tell us so.  We have been here before, a sad set of dynamics that, while it is one human life in danger, it is the lives and fate of 150 million people that really are.

For the second time in under 10 years, the poor health of Nigeria’s leader, rather than public policy and its implementation, has become THE issue.  

When Umaru Yar’adua took office in 2007, it immediately became clear a nation which needed a man with limitless energy and enough health for all had acquired one with the opposite description.  

Like Buhari, Mr. Yar’adua was not telling his country what was wrong with him. Like Buhari, we now know, he was very sick.  

In Yar’adua’s case, he died, leaving a nation which was confused about what was going on wondering what on earth was next. He left a nation that had been unprepared for an incapacitated leader with no option but another who was unprepared and incapable.

Question: What is worse than an unprepared and incapable leader succeeding an incapacitated one? The answer: an unprepared and incapable leader being succeeded by yet another incapacitated one.  

Seven years after Yar’adua, we are back to the same dismal scenario: a leader who cannot. An incapacitated leader has succeeded an incompetent one who succeeded an incapacitated one.  

But let us be clear: Buhari, even when he appeared to be healthy and vibrant in the first few moments which followed his inauguration, offered nothing but a shadow of the leadership he promised. In other words, to be healthy is not necessarily to be effective.

But Buhari’s poor health probably helps his image far more than it hurts it, as his loyalists try to convey the impression he is more than he has been. Last week, Minister of Information Lai Mohammed explained that Buhari was absent at the weekly cabinet meeting because he was ‘resting.’  

It was the third successive cabinet meeting he was missing.  And it also followed a Friday prayer he did not attend. Two days ago, in the midst of considerable apprehension, the president appeared at the Friday prayer, a gimmick aimed at calming some nerves.

No, Mr. Mohammed sir, President Buhari is not resting. ‘Resting’ is for the tired, not the sick.  The sick need treatment.  Buhari is a sick man, not a tired one, and a sick man needs a hospital rather than a couch and the remote control.  

That is particularly important when Buhari’s desire to hold on to power means taking his nation hostage. If I recall correctly, Buhari promised potent and patriotic leadership, not a hostage enterprise in which his victims are the very people who elected him.

In a previous comment, I urged him to declare his medical diagnosis to Nigerians, as an obligation.

I am now dropping that demand down my list of priorities because the situation has become far more serious. The presidency is a public job and Nigerians continue to pay the president’s bills, so he still owes that explanation. However, to prioritize declaration of his diagnosis may be to pay heavily for the impression he is generating that he can run the country on that couch, or even in his sleep.

As I have said, the evidence says he is not resting, but very sick.   

How sick is he?  Remember that upon his return from his medical vacation in London, he declared he had never been so sick, and had even received blood transfusions. Speaking in the past tense, he suggested he had recovered.

But he obviously did not return from London a healthy man. He returned as a politician, perhaps as a manipulated politician eager to convey the impression the presidency is easy. A flurry of official activities followed, but they were mainly appointments, the kind you can do from the couch.  

Anyone who knows how the process works would tell you all he was doing was giving his assent to names being given to him for certain offices, following which big stories were then disseminated to give the impression he was being active. That ruse didn’t last, and the best image now being presented of him is of a man who needs “rest".

But the presidency is no resting lounge, and what is now evident is that Buhari is in no shape, at the moment, to run Nigeria. What he needs is treatment, not a large-scale production to give the impression he will be up and about on Monday morning.

In Nigeria’s first taste of a sick leader, Mr. Yar’adua lost control of his government, pieces of which were being deployed as cudgels by those within his kitchen cabinet who could snatch them. They became known as a cabal.  

Regrettably the self-same kind of sycophancy, in which officials say the leader can run a nation of hundreds of millions from the toilet or while floating in fumes of powerful drugs, has reappeared. 

Worse still, Minister of Transportation Rotimi Amaechi took the matter into the most dubious terrain last week, curiously describing Mr. Buhari as being fit enough to win re-election two years from now, at age 76. 

To be sure, health is different from age. But while citizens are wondering whether Buhari will be well enough this afternoon to sit up for his medication, it is strange a Minister is thinking about re-election.

It is painful how many people need to be reminded that leadership is not a part-time thing and not an election-time thing, but an all-the-time thing. It requires perpetual attention, dedication and determination that is difficult enough for the healthy, and impossible for the sick.  

But that is precisely how Nigerian leaders have always betrayed Nigeria: pretending that their 10th or 15th best is good enough.

Think about it: Nigeria has no water policy. Our diplomats abroad are not getting their salaries, and we have almost no international presence. 

Think about it: There isn’t one Nigerian in the top-1000 in professional tennis, male or female.  We have no viable plans for grooming athletes of championship quality in any sport.  

And yet, look at the euphoria among Nigeria’s leaders last week after Anthony Joshua defeated Wladimir Klitschko in that famous boxing contest. Ogun, the state where Joshua was born, immediately remembered to claim him. The federal government, which 10 years ago denied the young boxer the opportunity to compete for a spot in its 2008 Beijing Olympics squad, announced it would invite him. We love the harvest, but hate the drudgery of the planting season.  

Part of the problem is our continued lack of a leadership that is capable of the 24-hour thinking and toiling that it takes to plant, and therefore to haul a nation into the future.  

This is why, if Buhari considers himself a patriot, he should resist the temptation to tether the nation to himself and his loyalists. He must courageously transfer the presidency to the vice-president, as the constitution demands, until he is fully recovered.  

Anything else betrays that constitution, and the people.