Health
Mak Donates 90 Lifebuoys to Uganda Police Marine Unit
The Makerere University School of Public Health (MakSPH) has donated 90 lifebuoys to the Uganda Police Force (UPF) Marine Unit, to aid the specialised unit in rescuing the drowning victims.
Assistant Inspector General of Police Edward Ochom, the UPF Director in charge of Operations hailed MakSPH for the strong partnership it has forged over time with UPF Marine Unit that bore fruits.
According to Ochom, UPF has for long been financially constrained making it difficult for the officers operate without adequate equipment. He hailed the partnership that has seen research output and now, a big boost of equipment.
He hailed the School for supporting the Marine Unit with 90 lifebuoys citing that they “will go a long way to support life when one drowns.” He was officiating at the handover ceremony of the items on Thursday October 8, 2020 at the Marine Base in Kigo, Wakiso District where he represented Inspector General of Police.
“I am privileged to be informed that this concern has not started now but the School used to offer life jackets to landing sites. Hence the love to preserve human life is well grounded in the School’s ideological mandate,” he said.
AIGP Ongom added that; “…we are really privileged that that we are being given 90 life rings. Our cardinal mandate in the Constitution is to protect life and property. And therefore, we are really concerned especially when people lose their lives on road, in water etc. We are really concerned and it is our duty to ensure that people don’t lose their lives like that.”
A recent study by the School showed that safe boating regulations are flouted, yet police was ill-equipped to ensure safety on the lake even as most drownings are preventable through policies and regulations that reduce risk exposure.
Mr. Abdullah Ali Halage, a lecturer at MakSPH said the intervention arose out of research conducted across the country around drowning, that stressed the limited resources and equipment by the law enforcers. He represented the Dean MakSPH-Prof. Rhoda Wanyenze at the donation of lifebuoys that were supported by the Bloomberg Philanthropies.
Globally, over 90% of the estimated 322,000 people who die in accidents related to drowning are in Low and Middle-Income Countries, making it the third leading cause of unintentional injury death; accounting for 7% of all injuries.
“We have conducted research and actually shared with you some of the reports that show that actually 95% of people using boats do not wear life jackets. Our reports also show that out of those who need to be rescued, very few get that support,” Mr. Halage said.
The results also show that many people drown without benefiting from any rescue attempts, because those who witness the drowning lack either rescue skills or rescue equipment.
According to Frederick Oporia, a Project Coordinator and Injury Epidemiologist at the Injury Epidemiology (Trauma, Injuries and Disability (TRIAD) unit of the School, majority people who drown lack survival swimming skills.” The TRIAD project is housed under the Department of Disease Control and Environmental Health.
The results also show drowning as a major cause of premature death in Uganda especially among young adults whose livelihoods depend on water activities. But Halage says most incidents of drowning are preventable through policies and regulations that reduce exposure to drowning risk and institutional interventions to ensure safety around water.
According to AIGP Ochom, the equipment used in such rescue missions is very expensive and that they can hardly be availed during the budgets. He observes that as police, they are mandated to protect lives irrespective of whether they have the means or not.
“We are really happy when we get institutions that also get their budgets from government and donate part of their meagre budgets that they get to another institution because I think they have seen during the research that we really need to be assisted. They are not doing it for themselves, they are doing it for the good of the nation. The Inspector General of Police is therefore highly indebted to Makerere University School of Public Health for the support they continue to give this specialised unit,” he noted.
The Marine Specialised Unit of Uganda Police Force is responsible for ensuring enforcement of law and order on water, Monitoring and Handling search and rescue.
The unit has 26 establishments/ detachments spread across the four major lakes in Uganda. A total of 17 marine establishments are on Lake Victoria, four (4) on Lake Kyoga, four (4) on Lake Albert, one (1) establishment on Lake George.
Engineer James Apora, the Uganda Police Marine Unit commandant also hailed the School for the big boost and the partnership citing that the equipment will ease their work.
“Our establishments are very few and very far apart. When you talk about emergency response, your response time becomes an issue when you are very far apart. The equipment you are using becomes an issue to take you there fast. The manpower also becomes an issue because you need very many numbers to expand,” says Eng. Apora.
“But the beauty is we have the will from police management to expand the unit. We have submitted our policing strategic plan for the next five years to establish additional 24 detaches that would make us to have at least 50 detaches spread all over the lakes. And we are also now venturing into the in-land lakes. Of recent lake Bunyonyi has become an issue and that is one of the areas we intend to open our detaches,” he hastened to add.
According to Eng. Apora, lifebuoys save about 4 persons at ago. “You can hang about four persons on it who can then be pulled to a safer area. I feel this is the greatest thing a stakeholder can do. The rest we can always talk but when you do it in practice, I think it speaks more.”
Dr. Olive Kobusingye, a Research Fellow and the Principal Investigator says despite the lack of incapacity to ensure safety on the lake, Police Officers have done tremendously well in ensuring they save lives and restore hope to Ugandans.
“We took about a year talking to a lot of people like yourselves [marine officers], we went to all Marine Police detaches and many other places and talked to people that have retrieved bodies, that have saved people from drowning, that have worked with families of those that have drowned and they all tell these stories but their stories go unacknowledged and a lot of work goes unacknowledged and I really would like to say thank you so very much indeed,” Dr. Kobusingye said at the handover ceremony.
About the Study
The report, issued on Thursday, presents findings of a two-phased study that was conducted in 60 districts of Uganda for a period of 2.5 years from a period of January 2016 to June 2018.
In the first phase of the study, records concerning 1,435 drowning cases were found in the 60 districts. Other than stating that the individual had drowned, there was very little information that could potentially guide prevention efforts.
The second phase was limited to only 14 of the 60 districts. In these 14 districts, a total of 2,066 drowning cases were identified by community health workers and confirmed through individual interviews with witnesses, family members, friends and survivors of drowning.
The report on understanding and preventing drowning in Uganda released on Thursday revealed high rates of drowning in both lakeside and non-lakeside districts.
Statistics analysed from the National Population and Housing Census Main Report of 2014, show that a total of 872 drowning deaths and 533 drowning survivors were recorded from the lakeside districts of Mayuge, Rakai, Serere, Hoima, Nakasongola, Masaka, Soroti and Rubirizi.
UBOS data also shows that a total of 402 drowning deaths and 146 drowning survivors were recorded in the reporting period for non-lakeside districts of Mbarara, Arua, Kitgum, Kabale and Mubende. In Kampala alone, the reporting period had a total of 58 drowning deaths recorded and 55 drowning survivors.
During the two-and-a-half-year study period, 1,435 drowning cases were recorded in the district police offices, marine police detachments, fire/rescue brigade detachments, and the largest mortuary in the 60 study districts.
“This is not the number of drowning cases that occurred during that time, but rather the number of drowning cases that were recorded. We learned from this study that many more cases of drowning happen that are never reported or recorded in administrative sources,” says Dr. Kobusingye.
According to the report, majority of the recorded cases were deaths (about 90%).
AIGP Ongom said the research will inform the Uganda Police Force’s top management on the causes of death on water, mitigating factors and strategies that can be put in place to minimise them.
He urged the marine unit to vigorously engage in strategies that can prevent people from drowning.
“For some of those cases that I have known, and also having a background of marine of course, we used to retrieve bodies and conduct investigations. There situations where you would really find it difficult even for the people to save themselves. I would sincerely request that we don’t end at research. We need to do a lot of preventive policing on our water bodies,” AIGP Ongom said.
Article by Makerere University School of Public Health
Makerere’s School of Public Health (MakSPH) is expanding faster than it can house itself. It now hosts more than 1,000 students, runs programmes across multiple countries, and anchors a large share of the University’s research output. Yet parts of its operation still spill into rented space, costing over $113,000 a year, because the infrastructure has not kept pace with its growth.
That constraint sits uneasily with the School’s economic weight. Health research accounts for more than half of Makerere University’s academic output, making it one of the University’s most productive engines. As Vice Chancellor Barnabas Nawangwe put it, “An educated population is a healthy population, and an educated and healthy population is a prosperous population.”
Beyond the university, health is not just a social outcome but a driver of economic performance. Healthier populations are more productive, more resilient, and less costly to sustain. Investments in public health, whether in prevention, systems, or infrastructure, raise an economy’s productive capacity, not just improve outcomes.
Institutions that generate public health knowledge and train professionals are not peripheral to growth; they are part of its foundation.
It is this logic that is shaping how Makerere’s School of Public Health is positioning itself. At its centre is a new, unfinished complex on the University’s main campus, intended to anchor the School’s next phase as a regional hub for research, training, and policy support. But like much of the system it supports, it is being built gradually, in a “build-as-you-go” approach constrained as much by funding realities as by design.
Construction of Phase II of the MakSPH complex is now at an advanced stage, with progress recorded across all sections of the site. As of March 2026, Phase 2B is nearing completion at 98%, while Phase 2A stands at 89%, and Phase 2C at 69%, each tracking close to or slightly ahead of planned targets. Current works are concentrated on interior finishes—including tiling, terrazzo installation, and external rendering—as well as preparations for lift installation, signaling a transition from structural works to final detailing. The project team is working toward a practical completion date of August 31, 2026, with timelines calibrated to align with broader resource flows and implementation considerations.
Six years ago, in February 2020, construction began on what will be the new home of the School of Public Health. The building, a permanent, purpose-built public health facility on Makerere’s main campus, will accommodate a growing student body, provide space for doctoral and postdoctoral fellows, and strengthen the University’s ability to respond to Africa’s most pressing public health challenges.
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, said the construction journey reflects the School’s “ambition, intent, and courage”—a bold step despite limited resources. He was speaking at a public lecture on health financing held at Makerere University on April 9, 2026.
But the ambition behind the project is not modest. “We are not building for today—we are building for the future,” said Professor David Serwadda, reflecting on a decision that shaped the entire construction effort. “We need to build for the next 100 years.”
That long view helps explain both the scale of the project and the risks taken to start it. When construction began, the School did not have the full funding. “We started with about a third of the required budget,” Serwadda said.
The approach was not without setbacks. A major grant from USAID, worth over a million dollars, was later withdrawn, midway through the construction, due to the closure of USAID. “We received what is called a ‘Dear John letter,’” he recalled. “At that moment, we felt the situation was a major blow, almost terminal for the project.”
But the project did not stop. It adjusted. “We said, let us continue, piecemeal,’” he said. “Finish the auditorium first, use it, and keep building the rest.”
“We have come a long way as the School of Public Health,” said Professor Rhoda Wanyenze, the Dean. “We are proud of that history, but we also recognize that it comes with responsibility.”
She argued that responsibility is no longer confined to Uganda. With ongoing collaborative work in more than 25 African countries currently, the Dean says this is “a responsibility to provide leadership in public health not only in Uganda but across the continent.”
The scale of that growth has been visible from what was once a small training unit in the Faculty of Medicine in the 1950s, which has expanded into 12 academic programmes and more than 1,000 students.
“When I came back for my public health training, we were about 40 students,” she said. “Now, we have more than 1,000.” “Public health is growing and evolving,” Wanyenze said. “And we are doing our best to develop the skills needed for this changing landscape.”
That includes new areas such as health informatics and data science, driven by the digitisation of health systems and the growing role of data in decision-making and AI. The School is already coordinating regional platforms on digital health, linking multiple countries in shared learning and practice.
But this growth has outpaced the physical systems needed to sustain it. For the University leadership, the implications extend beyond infrastructure.
“One of the most effective ways to invest in health in Uganda is to invest properly in Makerere University,” said Vice Chancellor Barnabas Nawangwe. “We must recognize Makerere as a research-led university with a special national role—not fund it like any other institution or department. Makerere is one of the government’s greatest assets. Invest in her, and the returns will exceed expectations.”
Professor Nawangwe hailed Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury, who delivered a keynote on investing in health for Uganda’s future in view of Vision 2040. “I wish to thank Dr. Ramathan Ggoobi and his team for their personal intervention in allocating resources in next year’s budget to complete the new School of Public Health building. That support is deeply appreciated,” he said.
Uganda’s progress in health outcomes is evident, but uneven. Life expectancy has risen significantly from about 50 years in 2000 to roughly 68.8 years in 2024, according to the Permanent Secretary to the Treasury, Ramathan Ggoobi. Yet the gains sit alongside persistent financial strain on households. About 4% of Ugandans still spend more than a quarter of their consumption on healthcare, pushing many into poverty as a result of illness.
For Ggoobi, this points to a structural gap that recurrent government spending alone cannot close. “We must mobilise long-term domestic capital without adding fiscal risk,” he argued, pointing to the need for more sustainable financing mechanisms. Central to this is the gradual design and rollout of a national health insurance scheme. Evidence from countries such as Rwanda, Kenya, and Ghana suggests that well-structured contributory models can expand coverage while reducing catastrophic out-of-pocket spending.
“My Ministry and the School of Public Health must be partners. … Evidence framed in fiscal terms drives policy,” said Ggoobi, stressing the need for locally grounded solutions. “What works in Ghana might not work here. We need a model that fits Uganda.”
Uganda’s current macroeconomic conditions, relatively low inflation, currency stability, and expanding private credit may provide a window to move in that direction.
Uganda’s health system is entering a new phase—one where the biggest challenge is no longer building it, but sustaining it. External funding is tightening. Domestic resources are under pressure. Demand for care is rising faster than both.
In this new reality, health is no longer just a social priority but a financing problem and a test of economic strategy.
For years, the system expanded on government investment, backed by strong external support. Infrastructure grew. Services followed. But that model is now under strain. Expectations are rising. Citizens want better care, closer to where they live, and without the financial shock that so often comes with illness.
Uganda is already investing in health. The real question is whether that investment is sustainable and whether it is delivering value.
It was against this backdrop that policymakers, academics, and practitioners gathered at Makerere University on April 9 for a public lecture and high-level dialogue on health financing. At the centre of the discussion was a keynote by Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury under the theme “Investing in Health for Uganda’s Future: Delivering Vision 2040 through Smart and Sustainable Health Financing.”
The event was organised by Makerere University School of Public Health (MakSPH) in collaboration with the Ministry of Health and the Ministry of Finance, Planning, and Economic Development.
Dr. Ggoobi does not think about health the way most people in government do. He is not persuaded by the language of welfare. When he speaks about health, he reaches for the language of growth, productivity, and national wealth. In his view, the sector is not a cost centre. It is an economic engine.
“Health is not merely a social sector issue. It is an economic transformation issue, a productivity issue, and a national competitiveness issue,” he said, arguing that no country has achieved sustained growth without investing in human capital. Globally, human capital accounts for nearly 70% of national wealth. The World Health Organization (2021) estimates that every dollar invested in health can return four to nine dollars in productivity gains.
“Investment in health is not charity. It is growth finance. So, my first message is to treat health spending as an investment, not as consumption. Every shilling must buy measurable economic and social returns,” he emphases.
His views reveal a shift in how Uganda’s Treasury thinks about health financing. Spending must justify itself. Investments must deliver returns. And inefficiency is no longer just a technical issue but a fiscal problem.
Ggoobi’s worldview is shaped by the idea that Uganda’s long-term growth ambitions under Vision 2040, which is 13 years away, to achieve what he describes as a tenfold expansion to a $500 billion economy, will be decided not just by infrastructure or industry but by the quality of its human capital.
Globally, he notes, human capital accounts for the bulk of national wealth. Health, therefore, is not peripheral to development. It is central to it.
If health is an investment, then it must generate returns. If it does not, then something in the system is not working. “Every shilling must buy measurable economic and social returns,” he said.
This is where the optimism gives way to unease. Countries that have achieved and sustained middle-income status did so through deliberate, sustained, evidence-driven investments in human capital.
Uganda is working within tight fiscal limits. The national budget for 2025/26 stands at Shs 72.38 trillion, with about Shs 5.87 trillion going to health.
Government spending on health has increased over time, rising from about Shs 2.8 trillion a few years ago to Shs 4.4 trillion today. But even with this growth, spending per person is still low, around $50 a year, less than half of what is often needed to provide basic health services.
Not all the money is used efficiently. Global estimates suggest that weak systems, poor coordination, and procurement challenges can cause up to a third of health spending to be lost.
According to Dr. Ggoobi, Uganda has made notable progress in strengthening its health system, driven by sustained public investment. Life expectancy has risen from about 50 years in 2000 to approximately 68.8 years in 2024, an increase of over 18 years. Access to services has also improved significantly, with about 91 percent of Ugandans now living within five kilometres of a health facility, while income poverty has declined from 24.5 percent in 2010 to 16 percent.
On the service delivery side, the government has introduced the malaria vaccine for children under five and rolled out electronic medical records across national and regional referral hospitals. Strategic investments have also been made, including 16 high-capacity oxygen plants, three regional blood banks, CT scan equipment in 14 of 16 regional referral hospitals, and 20 digital X-ray machines in general hospitals, with remaining gaps expected to be closed in the next budget. Together, he noted, these efforts demonstrate that sustained investment in health is yielding tangible results.
Beneath that progress, Dr. Ggoobi sees a health financing structure that is fundamentally unstable, noting that external partners still finance as much as 40–45 percent of health expenditure. Government contributes about 22 percent, household’s 31 percent, and insurance remains marginal at less than five percent. This balance, Ggoobi argues, is dangerous. It leaves the system exposed to shocks from outside while pushing risk onto those least able to bear it.
But the issue that troubles him most is government inefficiency. His priorities are to increase and protect domestic health financing, mobilise long-term capital, and improve efficiency.
“We are wasteful even with the little we have. Procurement is a major problem—many fights in government are not about mandate but about procurement. That is why we are moving all entities onto an electronic procurement system to improve transparency, reduce leakage, and ensure accountability,” said Dr. Ggoobi.
The government has enrolled 38 entities on the electronic procurement system. Full adoption is expected by mid-2026.
If you have good audits and we implement their recommendations, then we can expect positive outcomes. Number two is e-government, reducing human contact where it is not necessary. Unless you’re a doctor, you have to examine someone. Why do you have to sit in a hotel to discuss procurement? Humans must get out of discussing procurement. That’s why we are building the eGP and reviewing the procurement law. We are going back to the cabinet; we are going to remove human beings who are not necessary in the chain of procurement,” said Ggoobi.
Across the discussion, one issue drew near-unanimous agreement that prevention remains underfunded.
The Ministry of Health’s position, delivered through John Kauta, the Commissioner in charge of Health Information, Statistics, Monitoring, and Evaluation, is unequivocal that “the cheapest disease to treat is the one we prevent.”
Yet Uganda still spends more on treating illness than preventing it. Freddie Ssengooba, a Professor of Health Economics and Health Systems Management, MakSPH, highlighted malaria as a case study, both costly and preventable, while others pointed to rising non-communicable diseases driven by lifestyle factors.
This imbalance has fiscal consequences. Preventable diseases generate recurrent costs, crowding out other investments and reinforcing the cycle of inefficiency.
Mak Chancellor Hon. Dr. Crispus Kiyonga pushed the debate toward geography and access, citing that while Uganda’s health system was originally designed to follow administrative structures, the ambition to reach every village was never fully realised.
“We must plan based on what we can sustainably afford. We cannot import another country’s system. But where shall we save the majority of our people? It is in the villages. That is where children miss school due to illness. Where young girls drop out due to a lack of basic support, like pads. So, we must choose: given limited resources, what system gives the greatest impact? When the Minister of Health asks for a CT scan—something people travel to Nairobi for—that is important. But in the village, a child needs an antimalarial. The choice is between a CT scan and basic treatment. These are tough decisions,” says Dr. Kiyonga.
While the country is “highly indebted” and resources are limited, the level of care that Uganda can realistically provide to its citizens should borrow from China’s early pragmatic reforms of universal access first and quality later, according to the Chancellor.
“You cannot deliver health from a distance,” he said, arguing for a renewed focus on community-level access.
The Chancellor also strongly supported a shift from tertiary care to primary care. From Mulago National Referral and reducing its congestion to the village by investing in lower health facilities.
He urged the government ministries of Finance and Health to strongly collaborate with academic institutions to improve their work. “This dialogue should not be a one-off. It must be continuous. Makerere must engage the government with well-costed, risk-weighted proposals. We should build structured collaboration between universities and government so that research informs policy, and we reduce reliance on expensive foreign consultants. There is valuable research here,” said Dr. Kiyonga.
Taken together, the dialogue revealed a country’s health system in transition, from scarcity to expansion but not yet to performance.
As Ms. Jane Kyarisiima Mwesiga, Deputy Head of Public Service (Service Delivery), Office of the Prime Minister, framed it, the next phase must move “from expansion to performance, from inputs to outcomes, from financing to public value.”
But the path forward remains contested. Should Uganda prioritise insurance or direct public provision? Prevention or specialised care? Infrastructure or functionality?
The answers lie not in choosing but in sequencing, something Uganda has historically struggled to do.
Dr. Ian Clarke, a Physician, philanthropist, entrepreneur, and Chairman of Clarke Group Companies, speaking while representing the Private Sector during the dialogue, spoke emotionally on national health insurance, whose discussion has been ongoing for close to 20 years, but with minimal progress.
“We have had studies and proposals, but many were rightly rejected because they were not practical. You cannot design a National Health Insurance scheme that looks like private insurance. There is simply not enough money in Uganda—or anywhere—to sustain that. We still think in silos: public sector and private sector. Then we ask, how do we support the private sector? There are many ways—but as has been emphasized, we must focus on prevention and equity, especially in rural areas.”
For Ssengooba, while insurance is important and long-term, its implementation needs to be phased. He called for more investments in the health sector as the first line of insurance for citizens. He also called on the government to partner with institutions such as the National Social Security Fund (NSSF), which already have systems, capacity, and reach in place to support health investments. “If we leverage institutions like NSSF—for collection, for pooling resources—we can make progress. During COVID, they demonstrated that they can support national priorities. So, we should think about how to leverage what already exists,” he says.
Stephen Omojong of the National Social Security Fund highlighted an untapped opportunity. The Fund currently manages about Shs 30 trillion in assets, with millions of contributors.
This pool, he argued, could support health financing either through insurance-linked products or long-term investment vehicles. His example of a voluntary savings scheme now has 68,000 participants and Shs. 114 billion mobilised in a year, suggesting that behavioural barriers may be less rigid than often assumed.
Makerere University Vice Chancellor, Professor Barnabas Nawangwe, framed the dialogue as more than an academic exercise, describing it as a call to action. He urged the government to tap into the University’s research capacity to inform strategic investments, noting that “health research constitutes more than 50% of all research at Makerere University,” with institutions like the School of Public Health and the Infectious Diseases Institute playing a central role.
He referred to their national impact—from supporting over 20% of Uganda’s HIV patients to operating in more than 90 districts—and emphasised that Makerere brings in over one trillion shillings annually in research income. “When you fund Makerere University,” he said, “you should understand that we are not a net consumer—we are a net producer for the country.”
Taken together, the dialogue revealed a system in transition from expansion to performance, from spending to results. Uganda is no longer short of ideas, nor entirely short of resources. The real test is execution.
Whether the country can turn health spending into measurable outcomes will determine not just the future of its health system but the credibility of its economic ambitions.
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