Many Ugandans Unable to Afford Dialysis as Kiruddu Faces UGX 38.3Bn Funding Gap

Many Ugandans suffering from kidney disease are struggling to afford dialysis, with Kiruddu National Referral Hospital warning that inadequate funding for consumables is affecting the frequency of treatment offered to patients.

The hospital requires Shs48.967 billion annually to meet its dialysis consumables needs but received only Shs10.677 billion, leaving a shortfall of Shs38.289 billion, according to the Auditor General’s 2024/2025 report.

Appearing before Parliament’s Public Accounts Committee (PAC) Central, Kiruddu Hospital Director and Accounting Officer Dr Charles Kabugo said the funding constraints had forced the hospital to reduce dialysis sessions for some patients from the recommended three times a week to twice weekly. The affordability challenge is compounded by the high cost of the treatment. Kabugo told MPs that a dialysis kit alone costs about Shs350,000 per session, yet the hospital charges patients Shs60,000, which he described as a modest contribution rather than the actual cost of treatment.

He said patients who cannot afford the contribution are not turned away, although the hospital continues to accumulate unpaid bills as it tries to keep the service accessible. Kabugo said Kiruddu conducts between 80 and 90 dialysis sessions daily, including overnight, reflecting the demand for the service and the pressure on available supplies. He told MPs that the hospital’s dialysis budget had increased from approximately Shs2.5 billion to Shs10.2 billion, but the resources remain insufficient to meet the growing demand. 

The hospital had already exhausted its November allocation for consumables and was making arrangements to procure supplies for December. Kabugo said the hospital had requested supplementary funding from the Ministry of Finance and was engaging Ministry of Health management over the cost of dialysis. Beyond the funding constraints, Kabugo raised concern about patients arriving at national referral hospitals when their conditions are already critical because of delayed referrals.

Kabugo urged Ugandans to seek medical attention early and use regional referral hospitals, which he said are increasingly equipped with specialised diagnostic services, including CT scans and echocardiography machines. He also raised concern about the changing disease burden, saying Kiruddu was seeing fewer malaria cases while complicated conditions, including kidney disease and cancer, were becoming more prominent. Kabugo attributed some of the changing disease patterns to lifestyle, diet, limited physical activity and possible exposure to harmful substances in food and the environment.

On kidney disease, Kabugo said the hospital was treating patients who were not diabetic, including young people in their twenties, raising questions about the factors contributing to the growing number of cases. He explained that kidney injury can result from several conditions, including severe bleeding, childbirth complications, accidents and infections. Some cases of acute kidney injury can be treated if detected early, but delayed intervention can lead to chronic kidney disease.

Kabugo said Kiruddu had introduced a zero-cost policy for mothers who develop kidney complications following childbirth and accident victims who suffer kidney injuries. The hospital is also supporting the establishment of dialysis services at regional referral hospitals, including Mbale, Lira, Mbarara and Hoima, with plans to extend support to Jinja and Arua.

He said Kiruddu trains health workers and helps regional facilities establish the services before handing them over to operate independently. The initiative is intended to reduce the burden on patients who travel to Kampala for dialysis, sometimes relocating to areas such as Muyonyo because they require treatment two to three times a week.