Health Crisis Looms as Pharmacies Threaten Shutdown, Issue Ultimatum Over New Drug Fees

By BM

The Uganda Pharmacy Promoters Association (UPPA), an umbrella body representing over 300 pharmaceutical importers and distributors, has issued a stern two-week ultimatum to the government demanding the immediate suspension of newly instituted drug importation fees and regulations.

Failure to act, the association warns, will trigger a nationwide shutdown of pharmaceutical imports and wholesale operations, putting Uganda’s medicine supply at risk.

Uganda’s pharmaceutical sector is now on the brink of a major disruption, as UPPA argues the newly imposed charges by the National Drug Authority (NDA) are unsustainable and threaten access to essential medicines.

At the heart of the standoff is the NDA’s recent decision to implement sharp increases in import-related charges, including Good Manufacturing Practice (GMP) inspection fees, product retention fees, and verification fees on selected essential medicines.

Dr. Hussein Oria, the Secretary General of UPPA, explained during a press conference Sanja Chula Restaurant along Clement Hill road in Kampala that the GMP inspection fee for pharmaceutical facilities outside Africa has been dramatically raised from a flat $8,000 to as much as $24,000 per facility.

The NDA now separates products into three categories, general (non-beta-lactam), penicillin-based beta-lactams, and cephalosporins with each line requiring a separate $8,000 payment.

For facilities manufacturing across all three categories, the cost triples.

“You cannot move from $8,000 to $24,000 it doesn’t make sense,” Dr. Oria stated.

Beyond inspection fees, importers must pay a $500 annual retention fee for each registered product.

This fee is intended to fund NDA’s post-market surveillance to ensure medicine safety and efficacy. However, UPPA contests the requirement to pay for years when a product was not imported or sold.

“If the product wasn’t in the market, then what work did the regulator do? Why pay for nothing?” Dr. Oria questioned.

The new regulations also significantly affect medical devices such as blood sugar monitors, blood pressure machines, and diagnostic tools.

Each item now attracts a $1,500 registration fee regardless of its commercial value.

Dr. Oria warned that such exorbitant fees could limit access to essential diagnostic tools and undermine patient outcomes.

“Without proper diagnostics, doctors can’t prescribe correctly, and patients don’t get well,” he added.

He further raised concern over the heavy tax burden imposed by the Uganda Revenue Authority (URA), which includes a 1.5% infrastructure levy and a 1% import declaration fee on top of the NDA’s 2% verification fee.

For 37 essential medicines such as amoxicillin and paracetamol, the NDA verification fee had already been increased from 2% to 12% in 2020.

As of October 1, 2025, it has now been further raised to 17%, under the pretext of promoting local manufacturing.

However, Dr. Oria dismissed the rationale behind this policy shift, stating that it has not made locally manufactured drugs cheaper or more available.

“The goal should be to provide incentives for local manufacturing such as reducing interest rates, which are currently over 20%, compared to 1-3% in other countries not to tax importers and ultimately burden patients,” he emphasized.

Basic medical supplies like syringes, gloves, and cotton wool are also affected.

According to Dr. Oria, syringes now attract nearly 50% in combined taxes from NDA and URA, while gloves are taxed at around 38.5%.

“These are basic items used in every hospital, in every treatment. Making them more expensive simply raises the cost of care,” he said.

The UPPA further criticized the double taxation on imported medical devices and surgical tools, citing overlapping fees charged by the Uganda National Bureau of Standards (UNBS) and the NDA.

The situation has been worsened by a recent NDA policy requiring post-shipment testing even for products that have already been certified in the country of origin.

“If UNBS already certifies them before export, why repeat the process and charge again?” asked Mr. Kirti Shan, the UPPA Chairperson, a key stakeholder in the sector.

Currently, over 95% of Uganda’s medicines are imported, with local production accounting for less than 5%.

Despite this, the government is steadily increasing financial pressure on importers pressure that will likely be transferred to consumers.

“Over 70% of healthcare in Uganda is self-funded. Only about 30% is covered by the state,” Dr. Oria noted. “Patients are often referred to private pharmacies even after visiting public hospitals.”

If the Ministry of Health does not respond, UPPA has vowed to shut down wholesale and distribution operations, and suspend all pharmaceutical imports.

This could trigger a national crisis, given that the majority of Ugandans rely on private distributors for life-saving drugs including anti-malarials, HIV medications, diabetes and hypertension treatments.

Kirti Shan, the UPPA Chairperson says the association has already engaged a law firm and formally written to the Ministry of Health, calling for an independent committee to review the new fees and suggesting a temporary suspension of the policies while meaningful consultations are held.

Shan also questioned the lack of stakeholder engagement and transparency in how the new policies were developed and implemented.

“These regulations were implemented without input from key stakeholders, despite UPPA being the largest player in the pharmaceutical sector,” he said.

Dr. Oria criticized the timing of the increases, calling them politically tone-deaf during an election season.

“Why introduce such burdens during an election season, when the ruling party is seeking a new mandate? Whose interests are these regulations serving?” he asked.

UPPA has threatened to escalate the matter to the World Health Organization (WHO), arguing that global health guidelines discourage taxation of medicines.

“Our role is to ensure uninterrupted access to essential medicines. But we cannot do that in an environment that punishes the very actors trying to help,” Dr. Oria concluded.

As the two-week ultimatum ticks down, the pharmaceutical sector and the nation awaits the government’s response.

If the standoff persists, Uganda could face severe medicine shortages and a public health emergency.