Every day, an average of 278 people walk through the Uganda Cancer Institute seeking care.
Some need a diagnosis. Others return for chemotherapy, laboratory tests, blood products or specialist treatment. Behind each visit is a patient and a family confronting an illness that is becoming an increasingly visible test of Uganda’s health system.
THE PRESSURE IS GROWING
Uganda Cancer Institute registered 8,764 new cancer patients in the past year, a 10 per cent increase from 2024, according to figures presented during a visit by the ministry of Health permanent secretary Dr Diana Atwine last week.
Patient visits rose to 67,000. Some cancers are rising particularly sharply. Breast cancer cases increased by 18 per cent, prostate cancer by 17 per cent, bone tumours among children by 46 per cent and childhood lymphomas by 42 per cent.
Those percentages matter because each increase means more people competing for already stretched diagnostic services, specialists, treatment slots and essential supplies.
The human cost was recently felt in Uganda’s football community following the death of former Soltilo Bright Stars goalkeeper Sanon Mulabi after his battle with cancer. His death came as UCI reported that growing patient numbers are putting additional pressure on a system that is expanding sophisticated treatment while still struggling to meet some basic needs.
ONE OF THE CLEAREST GAPS IS BLOOD
UCI says it received only 59 per cent of the blood products it required during the period under review. Put another way, about 41 per cent of its need was not met. For cancer patients, that is not a marginal shortage.
Blood and blood products can be an important part of treatment and supportive care, meaning shortages can complicate doctors’ ability to provide care consistently. The institute’s laboratories are under similar pressure.
More than two million tests were conducted during the past year, illustrating the volume of diagnostic and treatment-related work being handled as patient numbers rise. Yet the story of Uganda’s cancer system is not simply one of shortages.
The government is also investing in services that were previously unavailable in the country. UCI has successfully conducted two bone marrow transplants, with both patients reported to have undergone successful procedures.
The institute is preparing to introduce a PET scan, while longer-term plans include a cyclotron and proton therapy. These are highly specialized technologies. A PET scan can help doctors detect and monitor disease by showing how tissues and organs function.
A cyclotron can produce radioactive materials used in certain diagnostic scans and treatments. Proton therapy is an advanced form of radiation treatment designed to target tumours more precisely.
The ambition is to reduce the number of Ugandans who must travel abroad for specialized cancer care and eventually position Uganda as a regional treatment centre. But sophisticated machines create another challenge.
They require specialists to operate them, technicians to maintain them, medicines and other supplies to support treatment, reliable financing and functioning referral systems.
A multimillion-shilling machine provides little benefit to a patient if the health system cannot keep it running or provide the professionals needed to use it. Atwine acknowledged that tension.
“We are in the process of coming up with serious reforms, and those reforms are really not just reforms, but we are focusing on the patient at the same time,” she said.
She said the government’s plans for “tenfold growth” in health services should go beyond constructing infrastructure. The ministry of Health wants to improve service delivery, attract resources, strengthen medical tourism and research, and address shortages of specialized skills.
That human-resource question may become one of the biggest tests of UCI’s expansion. The institute says it now has specialists in cancer surgery, oncology, haematology and other fields, while also training professionals for Uganda and the wider region.
Fourteen fellows graduated from its specialist training programmes last year, and UCI has introduced a fellowship in neurological oncology. But more patients and more sophisticated services also mean demand for skilled workers will continue to rise.
“If in six months, one year, the infrastructure development that we are planning comes to pass, then it must be matched with the right human resource,” Atwine said.
Another problem affects patients long before they reach a specialist: geography. Much of Uganda’s specialized cancer treatment remains concentrated in Kampala.
For a patient living hundreds of kilometres away, treatment can mean repeated journeys to the capital, with the additional burden of transport, accommodation and time away from work or family.
UCI says regional cancer centres are being developed to bring services closer to patients and relieve pressure on the main institute. Management expects them to become fully functional over the next two to three years as the necessary health workers are trained.
The idea is that patients would receive some treatment closer to home, while complicated cases would continue to be referred to Kampala.
The need is already visible. UCI recorded about 1,300 new patients in western Uganda, a 15 per cent increase from 2024, while its northern regional centre is also treating more patients.
Decentralization could therefore change cancer care substantially. But a building labelled a regional cancer centre will not, by itself, solve the problem. It must have specialists, medicines, diagnostic equipment, blood products and reliable operating budgets.