Akii-Bua started his athletic career as a hurdler on the short distance, but coached by British-born coach Malcolm Arnold, he was introduced to the 400 m hurdles. After finishing 4th in the ]1970 Commonwealth Games and running the fastest season time in 1971, he was not a big favourite for the 1972 Olympic Games in Munich, having little experience. But he won the final there in 1972 setting a new World Record.
The government in Uganda did not appreciate the attention the athlete received, and he was place under house arrest. After missing the 1976 Olympics because of the African boycott, police officer Akii-Bua was even arrested . He was freed by his shoe-manufacturer, Puma, and lived in Germany until the regime of Idi Amin ended in 1983.
Akii-Bua died a widower, survived by 11 children. He was given a state funeral.