Musevenomics and Healthcare, The defeat of Ebola was not miraculous, but a demonstration of resilience of our people and systems built since 1986

By Dr. Dickson Niwasasira, MD, MBA, HCM

On 28 July 2026, Uganda’s Ministry of Health made an announcement that, to the casual observer, might have seemed almost routine: the country was officially free of Ebola. The outbreak, caused by the Bundibugyo strain of the virus, first identified on Ugandan soil in 2007, had been closed out in just 74 days, with only 20 confirmed cases and zero spread into the wider community. Across the border in the Democratic Republic of Congo, at the very same time, the same virus was tearing through communities in what has been described as the fastest-growing Ebola emergency in recorded history, already past 3,200 confirmed cases.

Same virus. Same region. Radically different outcomes.

It would be tempting, and lazy, to call Uganda’s success a miracle. It was not. It was the product of a health system, and a people, that have been tested and rebuilt, outbreak after outbreak, since 1986. To understand why, we first have to go back to where Uganda’s health system very nearly died altogether, and then trace the deliberate, decades-long philosophy that brought it back.

A State Built from Wreckage

Uganda’s story is, in some respects, unlike that of any other African nation. The country itself was assembled at the turn of the twentieth century from an amalgamation of kingdoms and non-kingdom areas, and when independence arrived in the early 1960s, it came substantially on the terms of the departing colonial power. The 1962 Constitution, negotiated on British soil rather than grown out of Uganda’s own political settlement, proved divisive and poorly grounded in the country’s realities. What followed was more than three decades of governance conflict and, at various points, outright political collapse. Healthcare was among its most visible casualties.

By 1986, the numbers told a grim story. In a country of only 14 million people, close to 800 mothers were dying for every 100,000 live births, and more than 140,000 children under the age of five were dying every single year. Today, with a population approaching 50 million, more than three times what it was, the annual under-five deaths have fallen to around 50,000, according to World Bank and Uganda Bureau of Statistics figures. It is a comparison worth sitting with: the population more than tripled, while child deaths fell by more than half.

Musevenomics as a Concept

It is against this backdrop that the philosophy popularly known as “Musevenomics” has to be understood. First articulated in the earliest days of the NRM government and elaborated across President Museveni’s own writings, most notably in “What Is Africa’s Problem”? and Sowing the Mustard Seed, Musevenomics is best described as a home-grown, pragmatic development philosophy: private-sector-led growth, guided and supported rather than commanded by the state; macroeconomic and political stability as the precondition for everything else; and a patient, deliberate effort to transform Uganda from a peasant economy into a modern, commercial one.

Applied to healthcare, this philosophy takes a distinctive shape. Government does not attempt to be the sole provider of health services. Instead, it sets the policy framework, invests in core infrastructure and training, and regulates standards through bodies like the Uganda Medical and Dental Practitioners Council, while leaving much of actual service delivery to a mix of private providers and faith-based Private-Not-For-Profit institutions. Today, PNFP facilities, run overwhelmingly by the Uganda Catholic and Protestant Medical Bureau, account for roughly 35 to 40 percent of Uganda’s health service delivery, according to recent health-system assessments. That is not an accident of history; it is a deliberate, decades-old partnership, and it is Musevenomics applied to medicine.

Rebuilding the System

When the NRM took over power, H.E Y.K. Museveni, in his charismatic voice and gesture said “Ours is not a mere change of guard; it is a fundamental change. People will not have another choice soon”

That promise, in my view applied to health and education well, where it set the recovery in motion and it happened in distinct, deliberate phases rather than all at once. These stages are not obvious to all, but when you study the transformation closely, you see them.

The first priority was a Minimum Healthcare Package, designed to extend basic preventive services to the majority of the population who had, for a generation, gone without. Second but alongside it came deliberate investment in science and technical education and the opening of new medical training institutions. Mbarara University of Science and Technology stands out among the most consequential of these, pioneering a community-based medical education model that has meaningfully expanded the health workforce serving Uganda’s most underserved districts. Other universities would them follow, including Gulu university where personally I studied the MBChB. 

Thirdly, followed the reforms to how health professionals are trained, and then the liberalization of both medical education and private practice. Party due to these reforms, Uganda moved from a single public university offering medical training to a landscape of multiple chartered medical schools today. Liberalization of practice followed and we moved from a system where opening a private clinic was a bureaucratic ordeal to one where private practice, properly licensed through the Uganda Medical and Dental Practitioners Council, is easily achievable for a trained professional. This liberalization is itself a case study in Musevenomics: the state opened the field and set the rules, and private capital and private ambition did much of the rest of the building.

The Resultant Transformation

The cumulative effect of four decades of this approach is difficult to overstate. Uganda’s population has grown from 14.7 million in 1986 to over 46.5 million by January 2024, one of the youngest populations on Earth. Life expectancy has climbed from just 48 years in the early 1990s to 64 years today and among the fastest gains recorded anywhere over that period. Maternal mortality, which stood at roughly 781 deaths per 100,000 live births in 1986, has fallen to under 150 better than any other country in East and Central Africa. And the health workforce itself has expanded many times. Uganda Medical and Dental Practitioners Council registration show roughly 7,000–7,800 actively registered and practicing doctors as of 2022.

No other country that shares Uganda’s history of conflict and post-colonial disruption has moved at anything like the same pace on these measures over the same period.

Uganda as Africa’s Epidemic-Control Laboratory

Perhaps nowhere is this resilience clearer than in Uganda’s repeated encounters with epidemic disease.

In the late 1980s, as HIV prevalence surged toward an estimated 15 to 21 percent of adults nationally and as high as 30 percent in parts of Kampala, Uganda did something few nations dared: it confronted the epidemic openly and publicly. The government’s ABC campaign; Abstinence, being faithful, correct and consistent Condom use combined with community-based organizations like The AIDS Support Organization, founded in 1987, to build one of the first and most effective HIV responses in the world. By the early 2000s, national HIV prevalence had fallen to around 6 percent. TASO’s community-based care model has since been studied and adapted by health systems as far afield as Eswatini, Kenya, and Malawi. Uganda did not simply fight HIV within its own borders; it taught much of the continent how to fight it.

That same institutional muscle memory now defines Uganda’s approach to viral hemorrhagic fevers. Since Ebola’s Bundibugyo strain was first identified on Ugandan soil in 2007, the country has faced the virus repeatedly, including outbreaks in 2007, 2011, 2012, 2018, 2022, 2025, and 2026 and has, almost every time, gotten faster and more effective at containing it. The 2022 Sudan ebolavirus outbreak, 142 cases and 55 deaths, was closed out in 69 days without an approved vaccine. The 2025 outbreak saw all ten diagnosed patients survive. And the 2026 outbreak, the one that opened this article, was closed in just 74 days with zero community spread, even as the same virus overwhelmed health systems across the border. As the World Health Organization’s Regional Director for Africa observed during the 2025 outbreak, Uganda has never once exported a case of Ebola beyond its own borders.

This is not luck. It is what happens when rapid detection, trained emergency medical teams, mobile laboratories, and community trust are built deliberately, outbreak after outbreak, across decades. This is the same institutional capacity Uganda leaned on again during COVID-19, and researchers has pointed directly to the country’s, in their words, “long experience in successful control of HIV and AIDS in the 1980s, measles in the 1990s, Ebola and Marburg” as the foundation of its pandemic response.

What Next?

Some time back, President Museveni, while opening of the 8th African Leadership Forum, Speke Resort Munyonyo said; “A baby must grow. At some stage, you must undergo transformation, just like in biology where a caterpillar turns into a butterfly.” ~

In my opinion, none of the above forms a ground for complacency. The aspirations Ugandans hold for their own healthcare remain, in many respects, far from met. As someone who has spent a decade in healthcare practice as both a front-line practitioner and in leadership, I believe the next phase of transformation must be led by deliberate policy innovation, not by the assumption that past success will simply continue on its own. A few priorities stand out to me.

• Investment incentives: tax breaks, exemptions, and goal-oriented human resource planning to attract and retain clinical talent in the sector. At some point, the health workers (especially doctors) had requested to have vehicle tax waived to enable them have personal mobility since the government may not have a fiscal space for cars. H.E, also recent talked about waiving payee as a motivation for the doctors. This is a good start and ideas that could attract and retain clinical talent in the sector. 
• Local financing for health SMEs: Let’s havespecial gazetted funds and equipment-financing facilities, so that Ugandan-owned clinics and hospitals can access the capital that larger, often foreign-owned players take for granted.
• Effective regulation and consumer protection: closing the gap that currently allows unlicensed herbalists and unqualified providers to operate unchecked, often at real cost to patient safety.
• Modernizing health professional training: In a recent conversation, our elder statesman of Ugandan medicine, Professor Peter Mugyenyi, made a simple but striking point to me: doctors in much of the United States today rarely perform hands-on physical examinations; even palpating a patient’s abdomen can now invite litigation there. Uganda still teaches and practices medicine largely the old way. That is not necessarily wrong, but our training and practice must consciously engage with where modern technology is taking the profession, rather than assume the old ways will remain sufficient indefinitely.
• Private-sector-led infrastructure development: Positioned deliberately for regional competitiveness, helping Ugandan healthcare companies expand across the East African market rather than simply serving it.
• A hybrid national health financing mechanism: Blending public and private health insurance risk-pooling, to spread the cost of care more fairly across the population.
• Continued policy innovation: Grounded in evidence and local context, in the same pragmatic spirit that has defined Musevenomics from the outset.

Conclusion

Uganda did not defeat Ebola in July 2026 through luck, and it did not rebuild its health system since 1986 through miracle either. Both were the product of deliberate choices, sustained across decades, under a philosophy that Ugandans have increasingly come to call Musevenomics: private effort, publicly supported; patience, publicly rewarded. The next chapter of that story is still unwritten and it is ours to write.

ABOUT THE WRITER

Dr. Dickson Niwasasira, is a Medical Doctor, an entrepreneur, and a student of Law at Cavendish University. Born and raised in Rukungiri, he writes and speaks on health, governance and community development.