With funding, UCI says ready for more bone marrow transplants this year

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Uganda is preparing to expand one of its most advanced cancer treatments, with doctors at the Uganda Cancer Institute (UCI) saying they are ready to carry out at least five more bone marrow transplants this year, only if funding is secured and capacity is strengthened.

The announcement follows the successful discharge of the country’s first bone marrow transplant patient, Sande Steven, on April 24, a historic milestone that demonstrated Uganda’s ability to perform one of the most complex cancer procedures locally, without sending patients abroad.

That breakthrough has now shifted attention from possibility to scale. Specialists at UCI said demand is already high, with at least 50 of its patients in need of the procedure each year, particularly those suffering from blood cancers such as multiple myeloma and lymphomas.

According to Dr Henry Ddungu, a senior consultant hematologist and head of the encology department at the institute, the country has the technical capacity to do more, but remains constrained by limited resources and infrastructure.

“We have many patients who need this treatment. If resources were available, we could even do up to 10 this year. But with our current capacity, we are looking at about five additional transplants if we can have special funding for these procedures,” Dr Ddungu said.

Each transplant takes about 30 days and requires strict isolation, meaning only one patient can be treated at a time with the current setup. The institute currently operates with a single transplant bed, making expansion dependent on increased funding, space, and specialised staffing.

“It is not just about performing the procedure. You need infrastructure, trained personnel, and sustained funding to run a fully functional programme,” Dr Ddungu explained.

Dr Clement Okello, the lead transplant physician, said the milestone was the result of years of setbacks, rebuilding, and determination to establish a local programme which has been persistent and long-term planning.

“This has been a long journey. We started with the idea many years ago after training, but along the way, support collapsed, and progress slowed. We had to rebuild from almost nothing,” Dr Okello said.

He explained that the programme gained momentum in 2023 through government support, training in and out of the country, and the acquisition of specialised equipment. A small, dedicated team developed protocols, trained extensively, and worked toward delivering the country’s first successful transplant.

While the first patient has been discharged, his recovery remains delicate and closely monitored, with strict precautions required to protect his weakened immune system.

“He is a brand-new person. His immune system is completely down to zero, so he has to start life almost from the beginning. That’s why we have to give him all the vaccines that he took 45 years ago when he was a baby because all his immunity was wiped out,” Dr Okello said.

For the next several months, the patient must avoid crowds, limit physical contact, and wear a face mask at all times. Doctors warned that even minor infections could pose serious risks during this recovery period.

Dr Okello warned that the transplant itself, performed to treat multiple myeloma, is not considered a cure but a major intervention that significantly extends life. The disease, which affects plasma cells in the blood, is generally regarded as chronic and incurable worldwide.

“What the transplant does is push the disease far into the future,” Dr Okello explained. “It may come back after many years, like 20-50 years, or it may not. But we have significantly improved the patient’s quality of life.”

Multiple myeloma remains relatively common in Uganda, particularly among men. At UCI, doctors estimate that two to three out of every ten blood cancer patients are diagnosed with the condition, making it a significant burden within the health system.

Despite the medical progress, cost remains a major challenge. A bone marrow transplant abroad can cost between $30,000 (sh112 million) and $50,000 (sh186 million), excluding travel and accommodation. At UCI, the procedure costs about $15,000 (sh55 million), significantly cheaper, but still out of reach for many patients.

Health Minister Dr Jane Ruth Aceng said the government funded the first transplant and will continue to support a limited number of initial cases, but acknowledged that long-term sustainability will require a structured financing model.

“We cannot fund all cases indefinitely. But even at $15,000, this is far cheaper than going abroad and allows patients to receive care here at home. We will continue supporting the institute, and this is not going to be a one-off,” she said.

She noted that for this transplant, UCI used its annual budget meant to do other things, but the government is fully focused on bringing these specialised services closer to Ugandans and highlighted that beginning July, the transplant council will be active after she secured funds for it, which will oversee these specialised operations.

Looking ahead, the institute is already planning to expand the programme beyond cancer treatment. Dr Ddungu, they aim to eventually include patients with sickle cell disease and certain types of leukemia, conditions that could benefit from bone marrow transplantation.

Unlike the first procedure, which used the patient’s own stem cells, treating sickle cell disease would require donor transplants, making the process more complex but potentially curative.

“In the long term, we want to bring sickle cell patients into this programme. That is where we can actually cure disease by replacing the faulty blood system,” Dr Okello said.

However, experts cautioned that such expansion to sickle cell might take time, given the need for donor matching systems, advanced infrastructure, and highly specialised expertise. 

A bone marrow transplant is a highly specialised treatment used for certain cancers and blood disorders. Bone marrow is the soft tissue inside bones that produces blood cells, red blood cells, white blood cells, and platelets. In diseases like multiple myeloma, this system breaks down, making transplantation one of the few effective treatment options.

The milestone comes at a time when Uganda is facing a growing cancer burden. In 2025, the country recorded an estimated 35,968 new cancer cases and more than 20,000 deaths annually, many linked to late diagnosis and limited access to treatment. Cervical, breast, and prostate cancers remain the most common, with nearly 80 percent of patients dying within the first year of diagnosis.