Research
Uganda’s National ID Delivers $1.35 for Every $1 Invested
KAMPALA – The National Digital ID (NID) has significantly transformed Stella Nakazibwe’s role as a SACCO Administrator. “In my day-to-day work, I use my National ID to carry out financial transactions in the bank. Without it, I can’t access funds,” she says, her voice filled with a quiet confidence. “Now, I also use it to register for my school. You can’t sit for ICPAU papers without registering, and a National ID is essential.”
Nakazibwe’s story represents the promise of Uganda’s ambitious National ID system, launched in 2014 with the aim of streamlining government services, enhancing security, and boosting financial inclusion, with 97 percent believing it is essential.
A sound national ID system should meet key principles of inclusion, design, and governance, according to the World Bank. However, a 2017 study by the US government’s Center for Digital Development, formerly USAID, found that many digital ID systems are fragmented and focused on short-term goals, lacking clear evidence of their long-term social and economic benefits.
Ugandan law requires all citizens aged 16 and above to obtain a National ID linked to their demographic and biometric data. To support this, the National Identification and Registration Authority (NIRA) launched a mass registration campaign nationwide, followed by smaller drives to capture more people. The requirement for SIM card registration further boosted this effort, making telecom companies major users of the National ID database.
But a new study, “Understanding the Benefits, Costs, and Challenges of the National Identification System in Uganda,” published in Digital Society, reveals a more nuanced picture, stressing both the successes and the persistent challenges in ensuring that the National ID truly benefits all Ugandans.
The research, led by Roy William Mayega from Makerere University School of Public Health’s Resilient Africa Network (MakSPH-RAN), surveyed nearly 3,000 Ugandans and analyzed government data to assess the system’s impact. Other researchers were Dr. Dorothy Okello, Christine Muhumuza, Nathan Tumuhamye, Julius Ssentongo, Dr. Allen Kabagenyi Mulerwa, Brandon Kwesiga, Dr. Agnes Nyabigambo, Anthony Ssebagereka, and Professor William Bazeyo.
The findings confirm that the National ID has been a worthwhile investment for the government. The study estimates that for every US$1 invested in the NID system, the return on investment is US$1.35. These savings stem from reduced fraud in social programs and more efficient management of public funds.
But beyond the numbers, the research also illuminates the human experiences behind the National ID. For many, like Nakazibwe, the ID has unlocked opportunities previously out of reach. It has become a key to accessing mobile money services, opening bank accounts, and participating more fully in the formal economy.
However, the research also shows that not everyone is benefiting equally. The study found that while 94% of Ugandans sought to register for an NID, nearly one in five still don’t have one. And those who are most likely to be left behind are often the most vulnerable.
“We found that reasons for not having a National ID were more prevalent in the lowest wealth quintile,” explains Mayega. “This suggests that the poorest Ugandans face greater hurdles in accessing the system, whether it’s due to challenges in navigating the registration process or the cost of transportation. Illiteracy was also a key contributor.”
The most common reasons for not having a National ID included incomplete registration (33.7%), not registering (21.2%), lost IDs (19.9%), failure to collect IDs (9.4%), and slow processing (7.7%). Women were more likely to mention long queues and registration costs, while men cited ID loss and non-citizenship. Urban residents more often pointed to lost IDs and slow processes, while rural participants highlighted limited registration time.
The study also uncovered concerns about data privacy and the potential for misuse of personal information. Many Ugandans express concerns about the potential use of their National IDs for surveillance or fraudulent activities. These anxieties point to the need for greater transparency and robust data protection measures.
From the study, the common National ID errors included misspelled names (45.0%), incorrect or missing dates of birth (16.6%), unclear fingerprints (8.9%), and improper signatures (3.6%). Of the 169 participants with errors, only 28.5% attempted corrections, and just a third succeeded, often after waiting an average of six months. Most (77.1%) described the correction process as difficult, with transport costs from 0 to 400,000 shillings and other related expenses around 525,000 shillings (US\$ 145.8).
To ensure that the National ID lives up to its full potential, the researchers recommend a series of concrete steps: launching targeted registration drives to reach those who have been left behind, simplifying the registration process, strengthening data protection measures, and expanding the use of National IDs in government programs.
“It’s crucial that the government addresses these concerns and builds trust in the system,” says the Executive Director of the Africa Freedom of Information Centre (AFIC), Gilbert Sendugwa.
In Uganda, a National ID is more than just identification—it’s a key to accessing rights and services, Sendugwa explains.
“However, the issue of data security persists. For example, a woman in Ntungamo District faced legal trouble after her stolen ID was misused to secure a Parish Development Model loan before tighter controls were in place. The government must do more to teach people to protect their IDs and reassure them that their data is used to empower, not control, them,” he says.
Of the participants with National IDs, 7.7% (186 people) reported they had lost them, with higher rates among women (9.1%), urban residents (9.7%), and those in the lowest wealth quintile (9.3%). However, only 28.5% of those who lost their IDs attempted to replace (8.6%) or recover (19.9%) them, with mixed success. While 75% of those seeking replacements succeeded, only 45.4% of those trying to recover lost IDs managed to do so. About half of those attempting replacements described the process as difficult, with some waiting over three months.
Millions of Ugandans risk being excluded from essential services without national digital IDs, according to the Collaboration on International ICT for East and Southern Africa (CIPESA). Vulnerable groups like older persons in poverty and those with disabilities, who often struggle to reach NIRA offices for enrollment, face the greatest challenges. Without IDs, they are unable to access senior citizens’ grants, healthcare, land titles, social security benefits, driving permits, SIM card registration, bank accounts, passports, and voter registration.
“Uganda’s digital ID system needs to ensure the necessary safeguards for both data protection and access to essential services; otherwise, it risks not only entrenching exclusion and inequality but also increasing concerns about personal data privacy and protections. Gaps in solid data protection can result in discrimination, profiling, surveillance of data subjects, and identity theft,” says Juliet Nanfuka, a digital rights advocate and communications officer at CIPESA.
Uganda’s experience with the National ID system provides helpful lessons for other African countries aiming to leverage the power of digital identification. As NIRA prepares for a nationwide mass ID renewal and registration campaign on May 27, 2025, the redesigned IDs are expected to feature enhanced security technologies like Multiple Laser Images (MLI), Machine-Readable Zones (MRZ), QR codes, and 2D barcodes. These upgrades are intended to improve identity verification and expand access to digital services.
Researchers argue that by addressing citizen concerns, ensuring equitable access, and genuinely listening to the voices of its people, Uganda can transform the National ID from a mere card into a critical lifeline for all.
Davidson Ndyabahika is a Health and Science Communication Specialist, School of Public Health, Makerere University
Uganda’s latest national HIV survey reveals lower viral suppression among adolescents and young adults living with HIV than among older adults, even as the country records substantial improvements in controlling the virus. The findings come from Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey examining HIV prevalence and whether people living with the virus know their status, receive treatment, and achieve viral suppression.
Releasing the preliminary UPHIA 2025 findings at the Uganda Media Centre on 1 October 2026, Minister of Health Hon. Dr. Chris Baryomunsi called for earlier prevention and testing, particularly among adolescent girls and young women, alongside support for treatment adherence. “We must reach out to the young people, ensure that they have information, they test, take treatment, and adhere to the treatment guidance,” he urged.
Hon. Baryomunsi recalled how fear had discouraged testing during his university years: “I remember when we were at university, we went for testing at the university hospital. We sat there for three hours. Some of us left without even testing because it was scary.” Today, he explained, “even if you test HIV positive, you can be initiated on treatment, and you live normally like the rest of those who don’t have HIV.”
UPHIA 2025 was locally led under the Ministry of Health’s overall leadership, with Makerere University School of Public Health serving as the prime implementer, a role ICAP at Columbia University held in the previous two surveys. The Uganda Bureau of Statistics led sampling, while the Uganda Virus Research Institute and National Health Laboratory and Diagnostic Services led laboratory operations. Regional referral hospitals and local governments supported implementation, and the U.S. government provided US$10 million through PEPFAR, along with technical assistance from the U.S. CDC.
UPHIA collected data from July to September 2025 among people aged 15 and above, including those outside routine treatment services. Of 6,283 eligible households, 94.4% completed interviews. Researchers interviewed 13,801 people and tested 13,477 for HIV.
Testing followed Uganda’s national algorithm, with laboratory confirmation of positive samples, viral-load measurement, and checks for antiretroviral medicines to establish treatment use. Researchers weighted the estimates to account for the sampling design. Participants received counselling and results, and those who tested positive were referred for treatment.
Hon. Baryomunsi thanked participants and their families for welcoming survey staff and contributing their time, information and samples, without which the national evidence would not have been available.
National progress and the youth gap
The survey estimated HIV prevalence, which means the proportion of people living with HIV, at 5.9% among those aged 15 and above, corresponding to about 1.496 million people in this age group nationwide. Prevalence was 7.3% among women and 4.1% among men, ranging from 1.3% in Karamoja to 8% in the South Western region.
Among people aged 15 and above living with HIV, 86% had achieved viral suppression, meaning a low amount of HIV in the blood, measured in UPHIA as fewer than 1,000 copies per millilitre. Suppression stood at 69.3% among adolescents and young adults aged 15–24 living with HIV, compared with 89.9% among those aged 50 and above. These estimates cover people living with HIV regardless of whether they know their status or receive treatment.
HIV prevalence among people aged 15–24 was 1.5%, including 2% among young women and 1% among young men. Among young women, prevalence was 1.3% at ages 15–19 and 2.8% at ages 20–24. These differences support attention to earlier prevention and testing, although they do not establish when infections occurred.
The highest prevalence estimates occurred among middle-aged adults: 15.7% among women aged 40–44 and 11.7% among men aged 45–49. Lower suppression among young people therefore requires attention alongside the higher HIV prevalence among middle-aged adults. Comparing the same age group across both surveys, viral suppression among people aged 15–64 increased from 74.9% in 2020–21 to 86.1% in 2025, while HIV prevalence remained at 5.9%.
Diagnosis and the path to 2030
The treatment results identify diagnosis as the main national gap. Among people aged 15 and above living with HIV, 85.3% knew their status. Of those aware, 99.1% were receiving treatment; among those receiving treatment, 96.5% had achieved suppression.
The 95-95-95 targets aimed for 95% of people living with HIV to know their status, 95% of those diagnosed to receive treatment, and 95% of those receiving treatment to achieve viral suppression by 2025. Among people aged 15 and above, Uganda exceeded the treatment and suppression targets, while diagnosis remained below target. UNAIDS’s Global AIDS Strategy 2026–2031 retains these targets towards ending AIDS as a public health threat by 2030.
According to WHO, viral suppression protects health and helps prevent HIV transmission. Uncontrolled HIV weakens the immune system, increasing the risk of serious illness. With continued treatment as prescribed, sexual transmission risk is negligible when HIV remains suppressed but detectable, and zero when undetectable. The Uganda AIDS Commission estimated over 34,000 new HIV infections in 2025, underscoring the importance of early diagnosis, timely treatment, and sustained suppression alongside other prevention measures.
The demographic stakes are substantial. People aged 15–24 constituted 21.2% of Uganda’s population in the 2024 census. The country’s Fourth National Development Plan, covering 2025–2030, prioritises a healthy, knowledgeable, skilled and productive population and reducing HIV through primary health care. Protecting young people’s health, therefore, supports their participation in education, work, and national development; UPHIA helps identify where services need greater attention.
Turning evidence into action
The study’s conclusions identify three priorities: sustain treatment outcomes, find people unaware of their status, and improve suppression among younger people. Permanent Secretary Dr. Diana Atwine connected the findings to the Ministry’s planning.
“We do believe that these results are a true reflection of what is happening in our country as far as the HIV status is concerned, and we do believe that it will give us a very clear direction and the roadmap that we are going to take in the next five years to target and to get our targets achieved.”
Acting on these priorities requires funding for services and research. Hon. Baryomunsi outlined plans to target resources where needs are greatest, strengthen district services and align partner support with government priorities. Responding to journalists’ questions, he noted the government’s intention to increase domestic funding for the HIV response, including research.
“The HIV/AIDS response, including research and surveys such as this one, has largely been funded by partners in the past. The government of Uganda is committed to allocating more resources from our domestic budget to support the response and research,” he noted.
For the first time in the UPHIA series, the survey assessed selected noncommunicable disease indicators among people aged 15 and above: 15.5% had elevated blood pressure, 24.8% were overweight or obese, and 0.9% had raised random blood glucose. These screening findings align with the Ministry’s integration agenda and Hon. Baryomunsi’s call to bring HIV and chronic care services together to address people’s wider health needs.
Speaking at the release of the preliminary results, U.S. Embassy Chargé d’Affaires Mikael (Mika) Cleverley described UPHIA 2025 as the first Population-Based HIV Impact Assessment worldwide fully led and implemented by the country itself.
“The study was led by Ugandan scientists, Ugandan managers, Ugandan public servants, Ugandan field teams, from design to data collection to analysis. And this is what two decades of focused strategic U.S. foreign investments in the public health sector was meant to produce, is to reinforce Ugandan leadership and Ugandan-led efforts.”
At the survey launch on 29 May 2025, MakSPH Dean Prof. Rhoda Wanyenze highlighted the partnership’s contribution: “The partnership between Makerere University and CDC has not only helped build national capacity in surveillance and epidemiology, but has also strengthened our ability to lead high-quality, large-scale national surveys.”
The Dean added: “After two decades of joint work, we are proud that UPHIA is now a fully Ugandan-led effort. This is critical to the sustainability of the skills and knowledge generation to inform our local response.”
UPHIA 2025 shows how far Uganda’s HIV response has advanced and where gaps remain. As the country works towards ending AIDS as a public health threat by 2030, reaching young people with testing, treatment, and continued care will be essential to extending those gains.
Read the full UPHIA 2025 summary results here:
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