Cancer project in jeopardy as minister, director clash

The Minister of Health, Dr. Jane Ruth Aceng, on Wednesday, stunned a meeting chaired by Prime Minister Ruhakana Rugunda when she turned around and denied knowledge of a project to build a cancer treatment centre in northern Uganda which she had led her team to present.

The minister confirmed to Sunday Monitor on Friday that she indeed pulled the plug on the project before the Prime Minister, despite her ministry having had the project in plan for many years.

In fact, we understand, the project was in plan over a decade ago when Dr Rugunda himself was minister of Health, but did not proceed to implementation stage due to lack of funding.

A source of the money has now been identified, with the government of Austria willing to provide a ‘soft’ loan of €7.5m (about Shs30b) to build the cancer centre in Omoro District, northern Uganda. The centre is one of four that have been envisaged, with the other three set to be built in Arua, Mbale and Mbarara.

President Museveni has on a number of occasions promised to build the regional cancer treatment centres. Currently, all cancer cases are referred to the Uganda Cancer Institute (UCI) at Mulago National Referral Hospital.

The disagreement

But disagreements over the implementation of the proposed projects came to a head on Wednesday when Dr Aceng told Prime Minister Rugunda that she was not fully aware of the project. One would hear a pin drop as the room was engulfed in silence, a source who attended the meeting said.

According to the existing Cabinet standing orders on the acquisition of loans, any government ministry, department or agency seeking to contract a loan can only present the idea through the line minister. UCI, therefore, must do so through Dr Aceng, the minister of Health. But, sources say Dr Aceng and UCI executive director Dr Jackson Orem, have had misunderstandings for some time.

Dr Aceng had led a ministry of Health team and top officials of UCI led by Mr Richard Tumwesigye to present the loan request to the prime minister. The prime minister must first be briefed to his satisfaction before the loan request is forwarded to Cabinet, and then to Parliament.

The loan meant for the construction and equipping of the Northern Uganda Oncology Centre to be situated in Omoro District, Sunday Monitor has learnt, has for about five years been under the pipeline after it was negotiated between the UCI and the financiers, ERSTE Bank, Austria.

The loan was also sanctioned by President Museveni in June 2017, the Ministry of Finance, the office of the Solicitor General, and the Public Procurement and Disposal of Public Assets Authority (PPDA) had already given UCI the nod to sign the financial contract with the Austrian government.

However, sources who attended the loan presentation meeting in the Office of the Prime Minister (OPM) on Wednesday, told Sunday Monitor that Dr Aceng poured cold water on the request by insisting that the UCI team had not briefed her about the “nitty-gritties” of the loan. “The loan request was deferred because the minister told the prime minister that she does not know about it,” a source said.

The interest-free loan is supposed to be repaid within 29 years, but with the first deposits to be made after the first eight years of implementation.

Sources privy to the plans told Sunday Monitor that the plan is for the Austrians to operate a ‘turnkey’ model and intend to build a centre and just hand over the keys to the government. The plan, we have learnt, is for the Austrians to first build the one in Omoro and then embark on a centre in another place, most likely Mbarara, until all the four are built. Sources say there has been a jostle for contracts for building the centres.

In Omoro, the place where the first centre is planned to be constructed, sources say Deputy Speaker of Parliament Jacob Oulanyah played a key role in securing the land, working hand-in-hand with the district’s administration.

Aceng fires at UCI Speaking to this newspaper on Friday, Dr Aceng confirmed to this newspaper that she indeed denied knowledge of the loan before the prime minister because UCI had sidelined her ministry during the process of negotiating for the loan, but instead proceeded with the Ministry of Finance, which will not be implementing the project.

“I am the one who presented and I said; ‘Right Honorable, I cannot present this loan because it has never been presented to us in the ministry; I don’t know the loan. I know it is for a good cause; I like, I support (the idea) but I can’t present it. Because in presenting, I have to give the nitty-gritties and defend it; I don’t know it. I can’t,” Dr Aceng said.

She added: “Secondly, I said how can we negotiate for a loan of €7.5m to put up only one regional centre when in our previous budget speeches, we have been telling the country that we are going to open four regional centres? Now we are only putting one, why should we spend a lot of time negotiating for a loan of €7.5m? Why can’t this loan cover the four centres and we go full blast?”

Sunday Monitor could not get a comment from the UCI boss, Dr Orem, concerning the minister’s claim about not being briefed about the loan because his known telephone contact was off on Friday and Saturday.

Mr Tumwesigye, the project coordinator at UCI, who attended the meeting, referred us to his boss.

“I am not allowed to speak about that meeting (with prime minister) because it is only the executive director (Dr Orem) who has the authority to do so,” Mr Tumwesigye said.

Minister Aceng’s stand

The minister, who was the director general of Health Services in the Ministry of Health at the time when the loan was first negotiated, insisted that she had all along advised that UCI negotiates for a bigger loan to fund the construction of all the four proposed regional cancer centres.

She said neither her two deputies – Ms Robinah Nabbanja (General Duties) and Dr Joyce Moriku (Primary Healthcare), nor the permanent secretary, Dr Diana Atwine – is aware of the fine details of the loan and that it would be difficult for any of them to account for it if approved.

Dr Aceng, who said she had been angered to learn that the matter had reached the media, also threatened to block the UCI boss from presenting the loan to the ministry’s management committee next week as had been directed by the prime minister.

“Procedures must be followed. I am a very principled person and I follow things to the book. If Cabinet said I must own that loan, I must own every detail so that every time you ask me, I will be able to tell you. Are they hiding something there that they don’t want us to know?’’

The ping pong

Whereas Dr Aceng said her ministry was not briefed about the loan, Sunday Monitor has seen a copy of a letter signed by former State Minister for General Duties, Ms Sarah Opendi, requesting the prime minister to clear the loan for consideration by Cabinet.

Ms Opendi, who even attached Cabinet papers to the letter, has since been transferred to Ministry of Energy and Mineral Development and handed over office to Ms Nabbanja hardly three weeks ago.

“The proposal to borrow a soft loan up to €7.5m from [the] Austrian government to start with northern Uganda cancer centre project was submitted to Cabinet Secretariat for consideration and approval. This, therefore, [is] to present to you, with a request that you review and provide clearance of the above mentioned loan for the consideration of Cabinet,” Ms Opendi’s letter dated September 27, 2019, reads in part.

About two months later, in November 2019, Dr Aceng herself wrote to the Minister of Finance, Mr Matia Kasaija, referring to the same process as she requested the Treasury to consider the offer.

Meeting financiers

Dr Aceng also confirmed to Sunday Monitor on Friday that she had two weeks ago met with officials from the Austrian Embassy, who flew in from Nairobi, Kenya, to discuss the loan.

Asked for details of what was discussed in the meeting, Dr Aceng said: “I don’t discuss details of what we are going to do with the loan with those offering it. I discuss with the implementing agency, in this case UCI. But I told those people that the loan is good but let cancer institute first present it to the ministry.”

AME International GmbH, an Austrian company that is supposed to construct and install equipment in the facility, has over the recent years been in close contact with the government as seen in the letters exchanged with a number of officials, including the Secretary to the Treasury, Mr Keith Muhakanizi.

This newspaper has also seen a letter dated April 12, 2018, in which Health Ministry PS, Dr Atwine, explains to Mr Muhakanizi the need to implement the project funded by the Austrian loan in the ministry’s budget of 2018/19.