BY OUR REPORTER
The Equal Opportunities Commission (EOC) convened a stakeholders’ consultation meeting on the financial burden of accessing healthcare in Uganda, bringing together representatives from the Uganda Cancer Institute, the Uganda Heart Institute, the Uganda National Association of Private Hospitals, the Pharmaceutical Society of Uganda, and social protection specialists. The session was moderated by Susan Atukunda, Principal Research Officer at the Commission.
Setting the Agenda: Who Bears the Greatest Burden?
In his opening remarks, the Secretary to the Commission, Dr. Shaft Nasser Mukwaya, thanked participants for their candour and committed to following up with institutions such as the Heart and Cancer Institutes for further statistics to strengthen the Commission’s evidence base.
He reminded attendees of the consultation’s central purpose: to understand who bears the greatest financial burden of healthcare, and to generate credible evidence capable of shaping policies toward more affordable and equitable access.
Referencing a challenge posed by the World Health Organization’s Director-General on whether poverty should determine who lives or dies from lack of access to care, Dr. Mukwaya urged participants to keep that question at the center of their deliberations throughout the session.
Uganda Cancer Institute: Free Treatment, but Hidden Costs Remain
Representing the Uganda Cancer Institute, Dr. Daniel explained that patients receive cancer screening, laboratory testing, and diagnostic services free of charge. The process moves from an initial consultation through blood tests and further diagnostics before a treatment package is determined based on the patient’s specific condition and stage of disease. Chemotherapy, he confirmed, is also provided at no cost, though patients occasionally have to purchase medicines privately when the institute’s drug supplies run short.
Beyond direct treatment costs, he noted that indirect costs weigh heavily on patients. Transportation alone accounts for an estimated 36% of patient spending, since many must travel long distances to access care at the main center in Kampala. Extended treatment schedules also often require patients to pay for lodging near the facility for days, weeks, or even a month at a time.
To reduce this burden, the institute is expanding regional centers in Gulu, Arua, and other areas, alongside plans for a dedicated patient accommodation facility to ease the costs associated with prolonged stays.
Uganda Heart Institute: The High Cost of Cardiac Care
A representative of the Uganda Heart Institute, referred to as Dr. Sulaiman, described the institute as a cost-sharing facility where nearly all services, except medicines supplied through the National Medical Stores, require payment, with prices set at roughly half of what a private facility would charge.
He outlined the significant costs associated with cardiac care:
- Cardiac echoes: approximately 70,000 UGX for children and 100,000 UGX for adults
- Closed-heart surgery: between 3.5 and 5 million UGX
- Open-heart surgery: approximately 19 million UGX, itself only half of the true cost of around 40 million UGX, driven largely by the expense of imported surgical equipment such as perfusion circuits, which alone can cost 7 million UGX per patient
He further explained that capacity constraints, including a single operating theatre shared between adult and pediatric patients, force doctors to limit consultations to 20 patients per day, though critical cases are still attended to outside this cap.
The institute treated roughly 30,000 patients in the most recent financial year, up from 27,000 the year before. A new facility under construction in Naguru, currently at 65% completion and expected to open by mid-2027 — is intended to expand capacity, alongside an existing waiver mechanism for patients who cannot afford treatment.
Private Hospitals: Structural Costs Drive Higher Prices
The Uganda National Association of Private Hospitals attributed the high cost of private healthcare to several structural factors, including the expense of acquiring land and constructing facilities, the high cost of importing nearly all medical equipment since little is manufactured locally, and the ongoing cost of recruiting and retaining skilled staff such as doctors, nurses, pharmacists, and laboratory professionals.
Unlike the public sector, which benefits from a centralized procurement system through the National Medical Stores, private facilities must independently source medicines through private pharmacies, adding further cost that is ultimately passed on to patients, alongside standard operating expenses such as electricity and water billed at market rates.
Despite these high costs, the association noted that many patients continue to choose private care over public alternatives, largely due to a perception of higher-quality, more timely, and more effective service delivery.
Pharmaceutical Society: No Medicines “for the Poor” or “for the Rich”
Dr. Jonas Ssuuna, President of the Pharmaceutical Society of Uganda, addressed concerns around drug shop regulation, explaining that all pharmaceutical outlets are now governed under the newly enacted National Drug and Health Products Authority Act of 2026, which replaces the 1993 National Drug Authority Act and continues to prioritise the safety, efficacy, and quality of medicines.
He dismissed the notion of medicines being categorized as “for the poor” or “for the rich,” clarifying that price differences simply reflect the distinction between branded, patent-protected drugs and their cheaper generic equivalents, both of which must meet the same regulatory safety standards once licensed.
The Household Burden: Falling Into Poverty Over a Single Illness
Turning to the household-level impact of healthcare costs, social protection specialist Mr. Ongen explained that Uganda adopted a National Social Protection Policy in 2015 aimed at introducing a form of universal health insurance. He noted that Ministry of Health data indicates out-of-pocket healthcare spending accounts for nearly 20% of total household expenditure, equivalent to roughly 8.4 trillion UGX.
He described the coping mechanisms households commonly resort to when faced with catastrophic medical expenses, including borrowing money and selling productive assets such as livestock or land, warning that a single serious illness can push an entire family into lasting poverty.
Mr. Ongen closed his remarks with a call for stronger, evidence-based policy action to protect vulnerable households from this cycle.
Building an Evidence Base for Equitable Healthcare
The consultation forms part of the Commission’s ongoing effort to build a credible, evidence-based picture of Uganda’s healthcare cost burden, one that can inform practical policy toward more affordable and equitable access for all Ugandans, regardless of their low income.