1. QUESTIONING 2O YEARS OF THE 1995 CONSTITUTION OF UGANDA ON HEADWAYS TO
LEGITMISING HEALTH ENTITLEMENTS1
Introduction
The 8th
of October 2015 marks twenty years of the 1995 constitution. The commencement date
of the 1995 Constitutional framework is the 8th
of October 1995. The Constituency assembly of
1994 adopted, enacted for Ugandans and their posterity the Constitution on the 22nd
of
September 1995.
According to Patricia Nangiro2
’3
‘about 120 amendments have been made so far in the nineteen
years of the 1995 constitution operation; this will be the seventh time it will have been tinkered
with.’ Political will for the constitutional inclusion of the right to health is still wanting4
.
There are various approaches at the disposal of Ugandans for a frame work that facilitates the
enjoyment of the right to health for all Ugandans. This essay acknowledges CSOs role, their
tactics, identifies success stories and makes proposals for the realisation of the right to health
using the legalisation approach.
Background
The progressive weakening of public health systems, the growing privatization of health care
and the erosion of universal access to health care are worldwide phenomena. The Abuja
declaration demands of African governments while funding through the budgetary allocations
to the health sector, the back and forth health budget fails the test of progressive realisation.
Public health must be linked to a return to social justice. Denial of care to those who do not pay
is simply legitimized in the free-market system. The commodification of health care reduces
people from citizens with rights to downright consumers with (or without) purchasing power.
This leaves those who are economically marginalized also marginalized from accessing
comprehensive health care.
People Central Constitutional Amendments, a politician’s fright
Is it enough that citizens are consulted by Constitutional Commissions or public hearings on
Constitutional (Amendment) Bills held at the precincts of parliament or assigned committee
1
Talibita Moses, LLB, PGD, MSC.NRM.
2
http://www.monitor.co.ug/OpEd/Commentary/Forget-piecemeal-amendments--our-Constitution-needs-an-
overhaul/-/689364/2411732/-/y25tkq/-/index.html. Accessed7
th
October 2015.
3
Amending the Uganda Constitution: Isn’t It Time to Rethink the Process and the Key Issues?
4
Empowering Citizens to Demand for a Health Sector That Is Accountable and Relevant http://t.co/VC5C3DgHs7
via @HealthRightsFilm

2. goes regional? What makes a constitutional amendment process popular- the outcome or the
enabled framework?
Public involvement in constitution making is increasingly considered to be essential for the
legitimacy and effectiveness of the process. It is also becoming more widespread, spurred on by
constitutional advisors and the international community. Yet we have remarkably little empirical
evidence of the impact of participation on outcomes (Ginsburg 2008)5
.
Citing Opiyo, Bainomugisha, and Ntambwireki6
(Nangiro 2015 ) recounted ‘that the reports of
the Constitutional Reform Commission (CRC), and in cases where public proposals where sought
so as to build political consensus and ownership, recommendations were completely ignored,
and legislations hurriedly passed without quorum. The most recent legislations such as the
Public Order Management Act (2013), Anti-Pornography Act (2014), Anti-Homosexuality Act
(2014), Press and Journalist Regulations (2014), Non-Governmental Organization Registration
(Amendment) Bill (2013), and the pending proposal to amend article 42 of the Mining Act (2001)
to take away land ownership rights from citizens into the hands of the state, are such examples
of a narrowing civil engagement space and a fragile human rights, of which the same
constitution is mandated to protect.
Citizens surrender their power and authority to government and its organs from the constitution
which in turn derives its authority from the people when they consent to be governed
(Government of Uganda 2006 )7
.
Constitutional changes are very central to the power of citizens and it is good practice and a
tenet exclusive to good democracies that the citizens are privy to the amendment processes, it
must be acknowledged that Article 2 of the Constitution [ibid] defines the same as the supreme
law of Uganda and shall binding force on all authorities and persons throughout Uganda8
.
It leaves a lot to be desired on the timings of the proposals when introduced to parliament,
length of debate, the non-translation of proposed amendments and compilations or whether
consultations can change the form or purpose for which the proposals intend to remedy. The
Tobacco Control Act, 2015 that operationalises article 39 that enjoins Ugandans to the right to a
clean and heathy environment was people participatory given its import in fronting Public health
of Ugandans.
5
The Citizen As Founder: Public Participation In Constitutional Approval
6
Breaking the conflict trap in Uganda, Proposals for Constitutional and Legal Reforms: ACODE Policy Research
Series No. 58, 2013
7
Article 1 clauses (1), (2), (3), (4) on the sovereignty of the People
8
Article 2 Supremacy of the Constitution.

3. According to (Bireete 2015) ‘The 9th Parliament has a duty to ensure that the amended
Constitution has acceptability and legitimacy from all the stakeholders. Constitution-making
processes have no room for party positions and the only victors are the people.’
The intersection of Civil Society Organisations, Media (traditional or social), pressure groups,
Parliament, donors and critical ministries of Finance and justice is a stop gap to the impasse.
Claimability of health entitlements for Ugandans
The supreme law of Uganda does not explicitly guarantee all Ugandans to Health entitlements
even when she is signatory to most international legal instruments pronouncing universality of
the enjoyment of health entitlements (right to health9
).
The nearest to health rights enjoyment is in Uganda’s National objectives and Directive
principles of State policy, to which article 8 A (1) defines and pledges that ‘ Uganda shall be
governed on principles of national interest and common good enshrined in the national
objectives and directive principles of State Policy.
Whereas objective XIV promises that the ‘… state shall endeavour to fulfil the fundamental rights
of all Ugandans to ... in particular ensure that – all Ugandans enjoy rights and opportunities and
access to ….. Health services….’ And XX ‘The state shall take place all practical measures to
ensure the provision of basic medical services to the population.’ Article 8A clause 2 takes away
by qualifying with an imposition of a legislative process thus: ‘Parliament shall make relevant
laws for the purposes of giving full effect to clause (1) of this article.
Article 34 (3) provides that ‘No child shall be deprived by any person of medical treatment … by
reason of religious or other beliefs.’ This article restricts its self to denial to access or utilise
health goods or services and leaves the ambiguity of other beliefs. This does not make health
goods and services claimable is the complete sense of the right to health within the meaning of
the welfare principles in the Children’s Act cap 59 laws of Uganda.
There cannot be cause of action occasioned by the victims of the nodding disease for instance
in the northern parts of Uganda. According to (Romaniec 2014 )10
to date over 4000 children
have been afflicted with ‘nodding’ disease in Uganda alone, with over 200 children dying. In
Sudan the numbers are also rising into the thousands, possibly as high as 8,000. Unfortunately
for most of the children in these African countries, access to health care is limited. While the
children in Europe were being cared for in hospitals, the children in Uganda were being
9
Committee on Economic, Social and Cultural Rights (CESCR), General Comment No. 14 on the right to the highest
attainable standard of health, 11 August 2000, UN Doc. E/C.12/2000/4
10
http://www.ageofautism.com/2012/03/ugandas-children-are-dying-are-pharmaceutical-trials-to-blame.html

4. abandoned and left to die by their parents who could not, or would not, continue to care for
them. It was reported that children with the disease were significantly deficient in Vitamin B6,
which raised a red flag. The CDC, whose field team includes nutrition specialists and neurologists
as well as infectious disease experts have begun conducting tests to check for levels of Vitamin
A, B6, B12, heavy metals as well as genetic markers in the southern Sudan population. It has
begun to sound eerily familiar. Is it possible the CDC may actually be looking into the direction
of vaccine trials gone bad? Probably not, but the testing of these biomedical markers is
warranted—and suspicious.
Isn’t the poor state of Uganda’s health sector purely a policy and legal issue?