INSIDE UCI MELTDOWN! Sh26bn Debts, Drug Shortfall & Jobs Chaos Expose Management Weaknesses at Uganda’s Cancer Hub
A storm is raging at the Uganda Cancer Institute after a hard-hitting Auditor General’s 2025 report exposed deep cracks in management, planning, and accountability—despite the institution receiving an Unqualified Opinion on its financial statements.
Behind the clean audit stamp lies a troubling story of swelling arrears, staffing gaps, delayed projects, procurement irregularities, and a recruitment process now under intense scrutiny, all unfolding under the watch of Board Chairperson Damalie Nakanjako, Executive Director Jackson Orem, and Deputy Director Victoria Walusansa.
The revelations have sent shockwaves through the health sector, raising serious questions about whether those entrusted with managing Uganda’s premier cancer facility are truly in control.
At the center of the crisis is a ballooning debt burden that continues to spiral. The Auditor General noted that the Institute had outstanding arrears amounting to UGX 26.219 billion as of June 30, 2025, a sharp increase from UGX 17.466 billion the previous year.
“This represents an increase of UGX 8.753 billion,” the report states—an alarming trend that signals growing financial pressure at an institution meant to save lives, not sink into debt.
Yet even as the arrears pile up, cracks in procurement management have emerged. The Institute was found to be non-compliant with PPDA regulations, lacking critical contract management plans and reports, while some procurements were never implemented at all.
The Auditor General did not mince words, pointing to “areas of non-compliance” that expose weak oversight and poor internal controls.
Funding gaps are also crippling operations. A comparative analysis of the Strategic Plan cost estimates against actual funding revealed a staggering 65 percent underfunding, leaving key priorities hanging in the balance.
Still, management pushed forward, implementing 10 out of 13 planned strategic interventions—representing 77 percent performance. But even this progress is overshadowed by bureaucratic delays. Although a new strategic plan aligned to the National Development Plan IV was finalized by July 1, 2025, it had not yet received approval from the National Planning Authority, effectively stalling its implementation.
Ironically, while funding remains tight, the Institute demonstrated near-perfect absorption of what it received. Out of an approved budget of UGX 82.258 billion, UGX 82.077 billion (99.8 percent) was warranted and UGX 82.076 billion utilised, translating to a 99.9 percent absorption rate.
But even this efficiency cannot mask the revenue shortfall. The Institute had projected to collect UGX 13.5 billion in Non-Tax Revenue, yet only UGX 6.86 billion—just 51 percent—was realized.
“This underperformance raises concerns about sustainability,” the findings suggest.
Service delivery paints a mixed picture. Of 21 non-payroll outputs reviewed, 13 outputs worth UGX 39.438 billion were fully implemented. However, four outputs worth UGX 9.684 billion were only partially achieved, while another four worth UGX 350 million could not even be assessed due to lack of performance targets.
In perhaps one of the most disturbing revelations, the budget for procurement of anticancer medicines fell short of estimated needs by a massive UGX 83.516 billion—a gap that directly threatens patient care.
Oversight weaknesses extend to reporting as well. Quarterly performance reports were submitted late, in some cases delayed by up to 22 days.
Meanwhile, major infrastructure projects—including the construction of a 350-bed hospital, a pediatric ward, a service building, a reception block, and renovation of a six-level facility—have been plagued by contract management deficiencies, delays, and even expired workman’s compensation policies.
“The Institute did not effectively manage contracts,” the report implies, highlighting systemic lapses in supervision.
Asset management is another ticking time bomb. The Institute lacks a formal asset management policy and does not maintain usage logs, downtime reports, or performance indicators for its equipment.
As a result, some assets are overstretched while others lie idle, compounded by an inadequate maintenance budget.
The human resource situation is equally dire. Out of 1,546 approved positions, only 550 have been filled, leaving a staggering 996 vacancies.
Even as management moves to fill these gaps through an ongoing massive recruitment drive, the process itself has exploded into controversy.
Dubbed a “jobs bazaar,” the ongoing recruitment has attracted thousands of applicants nationwide—but instead of hope, it has sparked anger, suspicion, and allegations of manipulation.
Sources say watchdog agencies are closely monitoring the exercise, amid claims of favoritism, influence peddling, and backdoor dealings.
The numbers alone tell a story of desperation and fierce competition. Hundreds are battling for a handful of positions, with 566 applicants chasing just eight Assistant Nursing Officer slots in Kampala, while 406 candidates are competing for only four Medical Officer positions.
Yet it is the pattern in highly specialized roles that has raised eyebrows. In some cases, only one candidate was shortlisted for critical consultant positions—despite the Institute needing more personnel.
“This has angered many people. Others sat tough exams, but some just appear for interviews directly,” an insider revealed.
Even more explosive are claims that 62 candidates were directly shortlisted for oral interviews without sitting aptitude tests, triggering outrage among applicants.
“Friends, relatives, spouses, tribe mates—everyone is being smuggled in quietly,” another source alleged, describing the process as a “connections game.”
Management has not been accused of wrongdoing, but the recruitment is reportedly being overseen by key figures within the institution.
As this unfolds, the Auditor General also flagged unfinished business from the past. Out of five recommendations issued by Parliament’s Public Accounts Committee for the 2020/21 financial year, only three had been implemented, while two remain untouched.
All this paints a picture of an institution grappling with multiple pressures—financial strain, staffing shortages, operational inefficiencies, and now a credibility crisis in recruitment.
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