‘Boost health sector funding to 20% of National Budget’

Acibadem country representative in Uganda, Dr Jackson Ojera Abusu. PHOTO/file

What you need to know:

  • In line with the Abuja Declaration, adopted some 23 years ago by African Union member states including Uganda, Acibadem country representative in Uganda, Dr Jackson Ojera Abusu, wants the government to commit at least 15 percent of the national budgets to the health sector.
  • After launching Acibadem information office in Uganda, the Public Health specialist in an interview explained to Prosper Magazine’s Ismail Musa Ladu why the national budget should focus on the health sector, the need for collaboration and partnership. Excerpts.

How can the budget that will be read this week help improve the status of the health sector in the country?
Health spending covers about a third of what the country needs to meet its minimum health care package. According to World Health Organisation statistics, Uganda spends about $14 or Shs53,200 per person on health. Of this, $9 or Shs34, 200 is out-of-pocket and $5 or Shs19,000 from the public sector, which is a combination of both government and donor funding.

Going by the World Health Organisation statistics, the government needs to spend at least $28 which is slightly more than Shs100,000 per person and up to $40 or Shs152,000 when ARVs are included. The same study also indicates that health spending has accounted for 7 to 9 percent of the National Budget in the last five years, meaning government funding of the health sector is still below the global standard.

I believe we should be allocating more finances to the health ministry so that it can meet most, if not all, of its demands. There shouldn’t be gaps in the health sector. It is a critical sector that needs proper funding. Anything between 15 and 20 percent of the budget dedicated to the health sector will be a good starting point.
There are serious funding gaps, and this is why we applaud allocations of Shs569 billion for essential medicines and health supplies and provision of Shs26.35 billion for local Government Primary Health Care services. These are good gestures, and I’m hoping for more.
Let us talk about medical tourism. How big an issue is it?
Medical tourism is not a new phenomenon. If you look at the history of Acibadem, you will quickly realise thousands of international referrals that have been handled. So medical tourism is a reality resulting from differences in the level of health sector development. So, in case of a specific condition that requires a particular technology that is not available in your country, you may have to find it elsewhere.

Each year, thousands of Ugandans travel to another country for medical care which is essentially medical tourism by definition. In fact, according to statistics from the Uganda Tourism Board (UTB), less than 1,000 medical tourists visited the country in 2021 compared to over 10,000 Ugandans traveling abroad to seek specialised medical care. This is quite revealing. It is an indication that medical tourism has been on an upward trajectory in recent years.  

The other main issue is cost. I agree that referral to Turkey comes with a cost and that is a challenge. However, you don’t compare life with money. It is important to understand that any Ugandans seeking specialised services would be happy to have them in the country, but the reality on the ground dictates otherwise. The current capacity that we have as a country does not allow us to provide all these services here. That is why we are pleased to see the national budget allocation of Shs38.56 billion towards infrastructure development at the Uganda Cancer Institute (UCI) and the provision of Shs20 billion for the rehabilitation and construction of General Hospitals.

The prohibitive cost of healthcare is a major barrier to access for many Ugandans. What is your view on this?
The cost concern is a big issue for the majority of Ugandans seeking medication not only in Turkey but across other countries as well. The point is only a few patients may need a referral. For example, if a cancer patient case cannot be dealt with at Mulago Cancer Institute then that case could be referred to us.

So our role here is to supplement or if you like complement specialised health care services. As the country gets more developed with more infrastructure, referrals also decline. By that time, we might also be part of the players locally dealing with these cases, therefore helping in the development of the health care system in the country and region.

So for starters, the gap we currently have can be closed with collaboration with other countries such as Turkey and partnership with the likes of Acibadem International, a one-stop international patient centre that serves medical and healthcare tourists. Partnership with hospitals that are far ahead of us technologically in the health services sector is the way to go in terms of helping us deal with some of the teething challenges we are facing in the sector.

Why is collaboration important and where does that leave Uganda?
Collaboration is important. It means you are exposed to world-class healthcare services. Given that Uganda’s vision is to get to the point where Acibadem is, it requires that Uganda gets more information, education, training and access to such an advanced system. And Acibadem can be a friendly force in this collaboration.  Partnership can also result in Acibadem investing in Uganda.

Already, we have partnerships and collaborations with universities like Islamic University in Uganda (IUIU) and Kampala International University. This is because universities are the pinnacle for training our human resources or capital.  
Our collaboration includes but is not limited to Acibadem hospitals in Turkey, capacity development, and enhancement of Uganda health care workers among other areas of collaboration. Our teaching hospitals in Turkey are well equipped with modern teaching facilities, enabling the application of both theory as well as practical.

How relevant is your presence/operations in the growth of the health economic sector?
We have opened the information office in Uganda to eventually set up investment in the health sector here once the potential becomes clear. Our office will be responsible for referral coordination and ensuring collaboration runs smoothly. We think we can be viable players in the health sector and are looking to play a role in accelerating economic growth and development. We are here in Uganda to support, supplement and complement government efforts in health care service delivery.

Will you invest in the health sector to boost Uganda’s medical tourism?
Yes. That is in our plan. The referral office we have established in the country is an important component in helping us assess the need for a modern specialised hospital in the country.

Uganda can be our hub in the region.  We are envisaging that as a group we are looking at increasing foreign direct investment in Uganda. As is the case in the Netherlands, Bulgaria, Macedonia and Serbia. Once the environment is conducive and the indicators are looking good, anything is possible for the group.

How critical is medical insurance in enabling access and delivery of medical services?
It is very important because currently, patients who have medical insurance don’t financially struggle to clear medical bills like those without. Even for referral purposes, some insurance companies can take care of some percentage of the bill. 
Medical insurance for everybody is very important and I wish our country could come to this realisation sooner rather than later. 

Staffing shortages
Challenges persist in healthcare infrastructure, including high patient loads and inadequate budget allocations for medical supplies. Staffing shortages and recruitment bans pose additional hurdles to specialised care services.