Op-Ed: Mr Ramathan Ggoobi, Expenditure On Medical Interns Is Not A Waste—It’s Health System Investment

By Moses Kintu

Mr Ramathan Ggoobi, that is not how “economics that works” is supposed to work.

Expenditure on medical interns is not a waste. It is an investment in Uganda’s health system, in human capital, and ultimately in the lives of ordinary citizens who depend on public hospitals at their most vulnerable moments.

On 9 August 2021, President Yoweri Museveni wrote to the Prime Minister with a clear directive: medical interns were to be paid UGX 2,500,000 per month half of the initially proposed UGX 5,000,000. This followed consultations with the Ministry of Health and the Ministry of Finance, Planning and Economic Development. At the time, interns were earning about UGX 750,000, a figure the President himself acknowledged was insufficient to meet basic needs.

These are young doctors, dentists, pharmacists, nurses, and specialists in training working 24-hour shifts, often on the frontlines in casualty wards, emergency rooms, and surgical theatres. Many are housed in unsafe, low-cost rentals far from hospitals, buying their own meals, and operating under intense pressure with little rest.

Four years later, however, the Permanent Secretary and Secretary to the Treasury at the Ministry of Finance, Planning and Economic Development, Ramathan Ggoobi, has communicated that medical interns will not be paid, citing the need to curb government expenditure. The Ministry of Health has remained largely silent on the matter.

This raises a fundamental policy contradiction.

If Uganda’s economic thinking is grounded in “economics that works,” then it must begin with the basics: human capital is not an optional expense it is the foundation of productivity and public service delivery. Medical interns are not administrative overhead. They are the working backbone of overstretched public hospitals.

It is also important to recall that the 2021 directive did not emerge in isolation. It followed engagement between government officials, the Uganda Medical Association, and the Federation of Uganda Medical Interns, where the realities of internship life were clearly presented. The conclusion at the time was straightforward: UGX 750,000 was not sustainable for frontline medical work, and an adjustment was necessary.

To now characterize such expenditure as unnecessary risks reversing that earlier policy understanding. If anything, it undermines the logic that motivated investment in health workers in the first place.

Beyond economics, there is also a practical reality. Medical interns are the first point of contact for many Ugandans in public health facilities—whether it is trauma cases from road accidents, emergency obstetric complications, or critical care in district and regional hospitals. These are not theoretical roles; they are life-and-death responsibilities carried daily in places like Kiruddu Hospital, Gulu Regional Referral Hospital, and countless others across the country.

To suggest that such work can be sustained without remuneration is not only economically questionable—it is structurally risky for the health system itself. Motivation, retention, and accountability in healthcare are directly tied to fair compensation. Undermining that balance risks encouraging absenteeism, burnout, and eventually brain drain.

There is also a broader national interest at stake. When public health systems are weakened, the burden shifts to households, out-of-pocket spending increases, and inequality deepens. In that sense, investing in interns is not simply a wage bill issue it is preventive financing for the entire health system.

Uganda cannot simultaneously depend on young doctors to keep public hospitals running while treating their labor as expendable. That contradiction needs urgent resolution.

A credible “economics that works” must be consistent: if human capital is truly the most important form of capital, then it must be funded accordingly even when budgets are tight. I sign out!