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Court Orders Ugandan Government to Regulate COVID-19 Treatment Costs

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Gulu Hospital expands COVID-19 treatment centre

KAMPALA, UGANDA – Edward Bindhe was diagnosed in early June with COVID-19. Upon consultation with a doctor, he bought drugs off the shelf and stocked up on local herbs.

Then, with a collapsed lung, failed breathing and total body weakness, Bindhe, who had just lost two relatives to COVID-19, was admitted to a private hospital.

Bindhe, who is continuing to receive treatment as an outpatient, said that while in the ward, a cashier constantly visited his bed reminding him of his accumulating medical bill.

“After two days of admission, the hospital told me they needed me to advance some money, 2.5 [million shillings or $750], and I did not have it anyway,” he said. “That’s when I was then transferred to the COVID ward. Thereafter, on 29th, like, I started getting better. And the doctor said, ‘No, now we can discharge you.’ So, at discharging me, that’s when they gave me a medical bill of 8.8 [million shillings, or $2,482].”

Overcharging patients, early dismissals

Through June, local media was awash with reports of hospitals overcharging patients, pushing some families to abandon deceased loved ones in hospitals, while some patients were released from hospitals for failure to pay their bills.

It is for those reasons that Moses Mulumba, the head of the Center for Health, Human Rights and Development, a health advocacy organization, petitioned the High Court in Kampala on June 28, seeking intervention.

A woman receives a coronavirus vaccination at the Kololo airstrip in Kampala, Uganda, Monday, May 31, 2021. Africa is…
FILE – A woman receives a coronavirus vaccination at the Kololo airstrip in Kampala, Uganda, May 31, 2021.

The court ruled Thursday that Health Minister Jane Ruth Aceng and the attorney general must intervene by making regulations for reasonable fees payable to hospitals for management and treatment of COVID-19 patients.

The court also ordered the Uganda medical and dental practitioners council to make recommendations to the minister of health regarding reasonable fees chargeable by hospitals for treatment and management of persons suffering from COVID-19.

Mulumba said he was happy they got a consent judgment.

“The government has been watching the pandemic for over a year. And it has done all the steps,” he said. “But many of these steps are toward making sure the individual is contained, the individual is held accountable. And it was a very simple ask: that when it comes to a pandemic like COVID-19, the minister should invoke her powers under the public health legislation to actually regulate the actors. Because we believe that the actors are part of the national response. And if they are part of the national response, they need to look at themselves not just as businesspeople.”

A couple wait for the AstraZeneca COVID-19 vaccine at the Butanda Health Centre III in Western Uganda, Tuesday, April 27, 2021…
FILE – A couple wait for the COVID-19 vaccine at the Butanda Health Centre III in western Uganda, April 27, 2021.

The few Ugandans who were ladmitted to public health centers offering free treatment still faced other challenges.

Irene Nakasita spent three weeks in a referral hospital in Jinja after she failed to get admitted at the Mulago National Hospital, where she was told there were no beds left.

Now, back in a private hospital to deal with the side effects of COVID-19 drugs administered to her at the public hospital, Nakasita said that while the government can intervene in the affairs of private hospitals, they need to improve services in the public facilities to save Ugandans from heavy bills.

‘Pay the doctors’

“I know how I suffered,” she said. “So, let government fix issues in the government facilities so that people are comfortable to go there and get medicine. And then also pay the doctors. Because partly why I suffered in Jinja, some of those doctors were complaining they were not paid and now their lives are being risked to attend to COVID patients. They never attended to us — they left us in the hands of nurses.”

Attorney General Kiryowa Kiwanuka said the court order would be followed.

“We are going to advise the Ministry of Health to comply with the order of court,” Kiwanuka said. “And the Ministry of Health and the medical council need to meet and engage with the medical practitioners and get back to court with the compliance.”

At a government news conference last week, the head of the Uganda health care federation said 45 percent of patient bills are driven by personal protective equipment, oxygen and medication.

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