UGX 66bn approved for Uganda Cancer Institute expansion

Parliament has approved a proposal to borrow US$18.09 million (UGX 66.003 billion) as additional financing for the expansion of the Uganda Cancer Institute (UCI).

The government argues that this loan facility will help reduce the UGX 1.094 trillion Ugandans spend annually on cancer treatment abroad, particularly in India and the United States.

The approval followed the Ministry of Finance’s request to secure additional funding from the African Development Fund to support the East Africa Centres of Excellence for Skills and Tertiary Education in Biomedical Sciences Project – Phase I – Uganda Cancer Institute. The request was considered during the parliamentary plenary sitting on March 5, 2025, in response to changes in scope and delays experienced during the project’s first phase.

Justification for the Loan

Minister of State for Finance, Henry Musasizi, emphasized the urgent need for expansion, citing Uganda’s rising cancer burden.

“Currently, Uganda records 60,000 new cancer cases per year. While most are treated locally, many patients seek care abroad, costing the country approximately US$100–US$300 million annually. This project will significantly reduce that expenditure. Additionally, introducing BMT treatment will be a major milestone in treating blood cancer,” Musasizi stated.

He further explained that the loan is concessional, offering favorable repayment terms.

“The total amount to be borrowed from the African Development Fund is US$18.09 million, to be repaid over 50 years with a 10-year grace period. This loan has no interest but carries a service charge of 1% per annum on the disbursed balance.”

Debt Concerns

Several MPs, led by Emmanuel Otaala (West Budama South), supported the loan, arguing that it would enhance Uganda’s capacity to provide cancer treatment.

“One of the key challenges in Africa is building our own healthcare systems. I commend the government for taking this step to strengthen our health sector. We have highly qualified Ugandan doctors working abroad, and this loan will help us create a robust healthcare system here at home,” Otaala remarked.

However, Seth Wambede (Mbale City North Division) raised concerns about Uganda’s increasing reliance on loans.

“The need for this loan is justifiable. If you visit Mulago Cancer Institute, the conditions are dire. However, we must ask ourselves—how long will we continue borrowing for essential services?” Wambede questioned.

Richard Gafabusa (Bwamba County) also expressed support, highlighting his personal experience with cancer.

“In the last three years, I have lost four close relatives to cancer. The conditions at the Cancer Institute are deplorable. This is a loan we should have secured long ago to build our own capacity. Any of us could be affected, so we must act now,” Gafabusa said.

Santa Alum (Oyam DWR) recounted her late father’s experience at Mulago Cancer Institute, describing the overcrowding and lack of proper facilities.

“At night, when it rains, patients have nowhere to sleep. They are crowded on verandas, and medication is extremely expensive. In memory of my father, I urge this House not to delay but to approve this loan,” Alum urged.

Margaret Rwabushaija (Workers MP) emphasized the need for increased research on cancer causes.

“As we support this loan, we must also invest in research. When you visit Mulago, you find 30–50 children suffering from cancer, with no beds available. We need to understand what is causing this surge in cases,” she said.

UCI Expansion Background

The East Africa Centres of Excellence for Skills and Tertiary Education in Biomedical Sciences Project was first approved by Parliament in 2015 and is jointly funded by the African Development Bank and the Government of Uganda. The project, running from February 1, 2016, to December 31, 2026, aims to enhance UCI’s capacity in cancer education, clinical training, research, and patient care for Uganda and the East African region.

Although initially conceived in 2012 when Uganda’s population was 35 million, with only 20 oncologists, the country now records over 60,000 new cancer cases annually, increasing demand for specialized cancer care. The Centre of Excellence in Oncological Sciences aims to address this gap by training specialized professionals and improving research in cancer diagnostics, treatment, and care.

Need for Additional Funding

Minister Musasizi acknowledged that the project has faced setbacks, particularly delays in civil works.

“The construction of the multipurpose building has been slow due to challenges such as the COVID-19 pandemic, which disrupted global supply chains, particularly affecting procurement of electrical and mechanical equipment. Additionally, financial challenges faced by the main contractor have further slowed progress,” Musasizi explained.

He added that delays in construction have affected other project components, including procurement of laboratory and imaging equipment, ICT systems, and furniture installation. As a result, the project’s Development Objective (DO) rating remains unsatisfactory.

“The growing demand for cancer care, coupled with limited infrastructure, has led to congestion, expensive alternative treatments, premature deaths, and increased referrals abroad. Currently, over 500 adult patients are on the waiting list for nuclear medicine. Expanding treatment and care facilities are a government priority,” Musasizi emphasized.

The African Development Bank has acknowledged that the financing gap resulted from factors beyond the control of the Ugandan government or project implementers. Without additional funding, the project’s objectives would not be met.

Poor Planning Criticized

Robert Migadde, Vice Chairperson of the Committee on National Economy, expressed concern over the government’s frequent requests for additional financing, calling it a sign of inadequate planning.

“Recently, the government has requested additional funding for multiple ongoing projects, including the Masaka-Mutula Road and Greater Kampala Road projects. This trend points to poor planning and implementation delays, resulting in cost overruns and increased financial burdens. The Committee recommends that the government minimize project variations, except in unavoidable circumstances,” Migadde noted.

Despite these concerns, Parliament was informed that upon completion, the new facilities at UCI will be used to train students from Makerere University College of Health Sciences, Mbarara University of Science and Technology (MUST), and Gulu University.

With the loan approved, Uganda now moves closer to strengthening its cancer treatment capacity and reducing dependency on costly medical referrals abroad.