The Uganda Cancer Institute (UCI), located in Kampala, stands as a beacon of hope in the fight against cancer in East Africa. Designated as East Africa's Centre of Excellence in Oncology, UCI is a public, specialized, tertiary care medical facility owned by the Uganda Ministry of Health. Affiliated with the Makerere University School of Medicine and Mulago National Referral Hospital, UCI is a cancer treatment, research, and teaching center.
Aerial view of Mulago Hospital where UCI is located.
The Origins of UCI
The story of UCI began in 1965 with a meeting focused on the treatment of Burkitt's lymphoma. In August 1967, the Lymphoma Treatment Center (LTC) was established in a vacant room at old Mulago as an 18-bed ward, dedicated to Denis Burkitt. This was the result of discussions between America’s Paul Carbone and Sebastian Kyalwazi. Kyalwazi was the first surgeon practicing in the whole of the East African region according to Dr. Charles Olweny who was a medical student at the time.
In 1969, the Solid Tumor Center was added, focusing on adult cancers. Together, the LTC and Solid Tumor Center formed the Uganda Cancer Institute. During the 1960s and early 1970s, UCI emerged as a leading international medical research center in its areas of specialization.
The Uganda Cancer Institute is dedicated to advancing cancer treatment.
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Challenges and Resilience
The departure of Idi Amin was characterized by booms of rockets in Kampala that people called “saba saba”. So chemotherapy on the war in the 1980s and 1990s was referred to as “saba saba” because the drugs “also made the body boom”.
In 1972, following the expulsion of Ugandan Asians by dictator Idi Amin, nearly all of UCI's scientists left. Professor Charles Olweny, a Uganda researcher, interrupted his studies at NCI in the US and returned to become the first Ugandan director of UCI. In 1982, following the overthrow of Idi Amin, Olweny was forced to leave Uganda for security reasons, leaving leadership of UCI in the hands of Professor Edward Katongole-Mbidde. When Katongole-Mbidde left UCI to become the director at the Uganda Virus Research Institute in 1995, Dr. Jackson Orem took over the helm at UCI.
Despite the challenges posed by political instability and limited resources, UCI persevered, continuing its vital work in cancer treatment and research. Turns out the institute did very well during the Obote II and Amin years. There were publications documenting clinical trial research and reports during the Amin years. Patient follow-up and even patients showing up to the hospital might have suffered - but the Institute director at the time, Charles Olweny wrote of the time: “If you did your work and avoided confrontation with [Amin’s] soldiers, you were safe.” And so they did their work. And the President - the nationalist that he was - appreciated it. He made sure that he brought every guest through the institute to show how well Ugandan institutions were running smoothly and efficiently.
Key Developments and Partnerships
From the beginning of the alliance, a new building was seen as an essential part of the plan. In recent years, Linda Cheever, who is married to the Hutch’s Mac Cheever, has become involved in the Rotary Club’s Malaria Partners program, which also works to eradicate Burkitt lymphoma.
The Fred Hutch partnership with the UCI began as a pilot program that year, developed by Dr. Larry Corey, now Fred Hutch president and director emeritus, with the support and funding of Dr. Two years later, Casper joined the faculty and then took over the program. By then they'd also been joined by Dr. It offered fellowships to young Ugandan doctors to study at Fred Hutch and the University of Washington so that they might return to the UCI to treat patients and do research.
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Private grants allowed the alliance to add clinical care to research and training, starting with a pilot project on Burkitt lymphoma, with innovations that are being adopted by other UCI teams.
In October 2011, ground was broken for a three-story, integrated cancer training, research, and treatment facility, measuring nearly 16,700 square feet (1,550 m2).
In 2016, the institute installed a "Flexitron Cobalt-60 High Dose Rate" brachytherapy system from Elekta. In March 2016, the "Cobalt-60 Teletherapy" unit at UCI, which had been in use for the previous 20 years, broke down. A brand new teletherapy machine, manufactured in the Czech Republic, arrived in Uganda in August 2017. The machine was purchased at a cost of €642,000 (more than UShs2.7 billion), contributed by the government of Uganda and the International Atomic Energy Agency (IAEA). In February 2020, UCI commissioned a new Bhabhatron II Cancer Therapy Machine, donated to Uganda by the government of India.
In October 2023, Madhusudan Agrawal, Uganda's honorary council to India, based in Mumbai donated a second mobile cancer screening van to UCI. This is in addition to the mobile mammography van donated by the same person in 2018.
Current Status and Future Directions
As of September 2023, UCI's bed capacity was reported to be 100 in-patient beds, of which 75 are general and 25 are for private, paying patients. At that time, a new 360-bed inpatient facility was under construction to accommodate an increased influx of patients. Since the beginning of 2023, there has been a significant increase in private patients, who previously were seeking cancer care outside the country.
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UCI’s remit extends to oncology services within medical oncology, gynaecological oncology, surgical oncology, paediatric oncology, radiation oncology, cancer therapeutics, palliative care, diagnostics (laboratory and radiology), research and training, with palliative care services integrated throughout these main disciplines. Advocating a comprehensive approach, the overall goal of UCI is to reduce the burden of cancer in Uganda and within the East African Community (EAC). This spans the entire continuum of cancer control, primary prevention, early detection, diagnosis and treatment, palliative care, survivorship, and surveillance.
UCI is currently in the process of implementing four new treatment centres throughout Uganda that effectively service the entire population. As the designated East Africa Centre of Excellence in Oncology (EACEO), the construction of a new state of the art facility is also underway, due for completion later this year.
The research program continues and now includes Kaposi sarcoma, Burkitt and other non-Hodgkin lymphomas, cervical cancer, breast cancer and Hodgkin lymphomas.
Cancer Care in Uganda: Past, Present, Future | UIC Global Health Colloquium
Cancer Incidence and Mortality in Uganda
As of August 2024, it was reported that over a 5-year period, an average of 35,968 new cancer cases were diagnosed in Uganda every year. Also every year, on average, 24,629 people died from their cancer diagnoses. Between 1 January 2017 and 31 December 2022, the leading cancers in women in Uganda were (1) Cervical cancer (2) Breast cancer (3) Stomach cancer (4) Esophageal cancer and (5) Liver cancer.
The Kampala Cancer Register, established in 1954, is the longest-established cancer register on the continent. It can be used to determine trends in incidence rates to show the effects of changing lifestyles in urban Africa and the effects of the epidemic of HIV-AIDS.
Cancer Statistics in Uganda (2017-2022)
| Cancer Type | Ranking in Women |
|---|---|
| Cervical cancer | 1 |
| Breast cancer | 2 |
| Stomach cancer | 3 |
| Esophageal cancer | 4 |
| Liver cancer | 5 |
Cancer Institute Commissions Radiotherapy Machine Donated To Uganda By India.
The Uganda Cancer Institute has come a long way since its humble beginnings in 1967. Today, it stands as a symbol of hope and progress in the fight against cancer in Uganda and East Africa, driven by a commitment to care, research, and training.
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