By The Ugandan Parliament has approved a supplementary budget of Shs4.2 trillion, which includes a contentious Shs298 billion allocation for the International Specialised Hospital of Uganda (ISHU) in Lubowa, Entebbe Road. This brings the total public expenditure on the 264-bed hospital project to Shs774.4 billion since 2021, despite the absence of a definitive completion date and multiple deadline extensions.
The Lubowa hospital project, initially launched in 2015 and flagged off by President Museveni in June 2017, was intended to be a private undertaking. However, in March 2019, the government sought parliamentary approval for a $379 million (Shs1.4 trillion) loan guarantee, turning it into a public expenditure commitment.
Conflicting Reports on Project Progress
There have been numerous discrepancies in the reported progress of the project. While presenting the 2023/2024 Health Ministry policy statement, Health Minister Dr. Ruth Aceng informed Parliament that construction stood at 32% and that the project owner, Italian investor Enrica Pinetti, had agreed with the government on a revised completion timeline of December 2024. However, in January 2025, Prime Minister Robinah Nabbanja told Parliament that construction was at 61.8% and expected to be completed in February. In contrast, Dr. Aceng, appearing before the parliamentary Health Committee that same month, stated that construction was only at 45%.
Adding to the uncertainty, Finance Ministry officials had earlier claimed the construction was “100% complete, pending final touches.” The conflicting statements have deepened public skepticism regarding the project’s progress and transparency.
Lack of Oversight and Accountability
Despite significant public investment, attempts to conduct parliamentary oversight inspections have repeatedly been blocked. At least two parliamentary delegations were denied access to the site, including one led by Health Minister Dr. Aceng and Permanent Secretary Dr. Diana Atwine in 2019, who were told to seek permission from then-Inspector General of Police, Martins Okoth-Ochola. In February 2024, Leader of the Opposition Joel Ssenyonyi and a group of MPs were also turned away by security personnel.
The site remains heavily guarded by the Uganda People’s Defence Forces (UPDF), and in 2023, a journalist from the Daily Monitor was arrested while attempting to investigate the construction progress.
When asked about the latest status of the project, Dr. Atwine admitted she had no up-to-date information. “I do not have any details or the latest information about the project. I have not been there yet. You should ask Finance about where the money is going,” she told Daily Monitor.
Parliament Divided Over Additional Funding
During the recent budget discussions, junior Finance Minister Henry Musasizi defended the Shs298 billion allocation, explaining that it was part of Treasury operations, which also covered court settlements.
“Treasury operations require Shs380.496 billion, of which Shs298 billion is for promissory note obligations related to Lubowa Hospital’s completion. Additionally, Shs37 billion is earmarked for interest payments on IMF Special Drawing Rights allocations, Shs42 billion for debt management fees under the rural electrification project, and Shs30 billion for court awards,” Musasizi stated.
Opposition lawmakers strongly opposed the additional funding, calling Lubowa Hospital a “bottomless pit” that continues to drain public funds without accountability.
“We cannot continue throwing money at a ghost project,” opposition MPs argued, demanding a special audit before further disbursements.
Kira Municipality MP Ibrahim Ssemujju Nganda, in his minority report, revealed that the Shs298 billion had already been disbursed under the 3% rule, which allows payments without prior parliamentary approval.
“This brings the total amount paid to Pinetti for Lubowa to Shs774.4 billion. I don’t need to remind the country where and when Uganda fell in love with Italian investor Pinetti. Mentioning her name is painful enough,” Ssemujju said.
He further noted that the parliamentary committee responsible for approving the funds has been operating without full access to project progress reports. Even the Owner’s Engineer—the entity responsible for monitoring the construction on behalf of the government—has reportedly been denied access to the site.
Calls for a Special Audit
The Auditor General’s report on Treasury Operations for the year ending June 30, 2023, highlighted concerns that the Owner’s Engineer was issuing milestone certificates based solely on reports from the contractor, as they were not allowed on-site to verify progress.
“There is a significant risk of financial loss for Ugandans if additional funding is allocated to the project. It is recommended that the project be halted until a special audit report is completed and Parliament can deliberate on the findings,” Ssemujju warned.
Despite these concerns, the ruling National Resistance Movement (NRM)-dominated Parliament continues to approve additional funding requests for the hospital.
Civil Society Outcry
Julius Mukunda, Executive Director of the Civil Society Budget Advocacy Group (CSBAG), criticized the project as another example of wasteful public spending.
“It is not only a bad move but also a waste of taxpayers’ money. This is one of the ghost projects we continue to fund, yet there is no oversight,” Mukunda said, questioning why a project initially planned to take two years has now stretched beyond five years with no clear completion date.
Marlon Agaba, Executive Director of the Anti-Corruption Coalition of Uganda (ACCU), echoed similar sentiments, saying the government continues to allocate funds to the project without accountability.
“So many private projects have been pumped with money, and we see no value for it. Lubowa is just another example. I do not know if this is the government’s new way of stealing from Ugandans,” Agaba remarked.
Background of the Lubowa Hospital Project
The Lubowa hospital project was conceived in 2015 as a Public-Private Partnership (PPP) between the Ugandan government and Finasi/Roko Construction Ltd, a consortium tasked with financing, designing, and constructing the hospital. The government initially argued that the hospital would reduce the need for Ugandans to seek specialized treatment abroad, saving the country approximately $73 million (Shs278 billion) annually in medical tourism expenses.
However, the project has been fraught with delays, financial mismanagement, and transparency concerns. Initially estimated to cost $249.9 million (Shs910.4 billion), the price has ballooned to $379.7 million (over Shs1.4 trillion), raising serious questions about financial oversight.
Audit reports have highlighted that payments made to the developer were often not commensurate with the work done. In 2022, the Auditor General found that $76 million (Shs276.8 billion) was paid in excess of the 23% of work completed at the time.
Despite mounting public pressure for accountability, the government continues to pour billions into the project while blocking independent verification efforts. As calls for a special audit grow louder, the Lubowa hospital saga remains a symbol of Uganda’s persistent struggles with public financial management and government transparency.
