Health
Address Drivers of Non-compliance to COVID-19 Guidelines, Researchers Urge Government
By Joseph Odoi
Makerere University researchers and local leaders have asked government and other key stakeholders in refugee management to address community drivers of non-compliance to COVID-19 guidelines as increased cases continue to be registered across the country.
This call was made at the dissemination event of a study conducted by Makerere University titled Refugee Lived Experiences, Compliance and Thinking (REFLECT) in COVID-19. The REFLECT dissemination was undertaken at multiple sites in Kisenyi (Kampala), Kyaka II Refugee Settlement (Kyegegwa) and Adjumani (West Nile) on 14th December 2020.
The REFLECT study observed that compliance levels around COVID-19 guidelines drastically declined between May-August 2020 and continue going down despite increased infections from community transmission. The stakeholders at this event cautioned that addressing the drivers of non-compliance was necessary in light of the overwhelmed health system, currently ongoing political campaigns and massive social gatherings in the Christmas season and beyond.
Since March 2020 the Uganda government and its partners have conducted a fairly successful awareness campaign on the prevention of COVID-19. However, this knowledge has not translated into sustainable behavioural change and while there was strict observance of COVID-19 at the start of the pandemic, compliance has drastically dropped due to a number of reasons. This is why all prevention efforts should now focus on addressing the barriers to non-compliance as the country enters into the second wave and peak period of COVID-19 transmissions.
A study conducted from among 2,092 people in refugee settlements in Uganda has found a serious disconnect between the high knowledge levels and levels of compliance with the recommended COVID-19 preventive measures. A total of 13 settlements were considered for this study including Kisenyi in Kampala, Kyaka II in Kyegegwa district and 11 settlements in Adjumani district, West Nile.
Presenting findings of the study at Kyaka II Refugee Settlement in Kyegegwa, South-Western Uganda, the research team led by Dr Gloria Seruwagi observed that compliance levels had declined over time (between March/April and July/August); unfortunately coinciding with increasing number of COVID-19 cases and deaths.
Inappropriate use of masks was found prevalent in some of the study sites – including sharing of masks, and only wearing them when the refugees meet the Police. Researchers say these practices constitute a source of risk for infection, rather than being protective.
Scarcity of Facemasks
Sifa Mubalama, a Woman Councillor in Kyaka II while speaking to study investigators at Kyaka II Refugee Settlement in Kyegegwa, South-Western Uganda late last year, revealed that there is non-compliance to COVID-19 guidelines due to inadequate masks and materials at the settlement.
“We were all given one mask each in Kyaka II settlement which you have to wash often and use again, hence becoming too old getting torn after some time. There is also inconsistent supply of soap and water. Because of this, some of the community members have not been washing their hands consistently’’ Mubalama revealed.
According to Mubalama, each family gets Shs. 22,000 every month, which is she says is not adequate to sustain the families. As a result, majority refugees go out in the communities to do manual work, to supplement on the income citing that this puts their lives at risk of COVID-19 infection.
Mubalama further contends that children in the settlements were not adhering to the Standard Operating Procedures (SOPs) because their parents were not.
“It would be easier to implement these guidelines if the parents were adhering to them. Because the parents are not adhering to the guidelines, most children are also not. It’s really important that if we are to implement the SOPs, it should start from the parent,” she said.
According to Happy Peter Christopher, the Kyegegwa Sub County Speaker, ever since the lockdown restrictions were eased, the refugees abandoned following the COVID-19 guidelines like social distancing, wearing masks, sanitizing or frequent washing of hands with soap.
“People are not putting on masks and are careless. Refugees also buy food from the nationals and there are intermarriages. So, the spread of COVID-19 is very possible. For us we would like, if possible, to ask government to bring back the total lockdown so that we are protected”.
He also reported that, up to now, some areas in Kyegegwa had still not received the government distributed masks and called upon government to deliver masks to all refugees and also add more efforts in enforcing SOPs.
It is against this background that researchers at Makerere University and local leaders have appealed to government and other stakeholders in the refugee management to address the community drivers of non-compliance to COVID-19 guidelines as cases continue to surge in Kyaka II refugee settlement in the South Western district of Kyegegwa.
Government has been asked to address the drivers of non-compliance, as a necessity in light of the overwhelmed health system, by the currently ongoing political campaigns and the massive social gatherings during the festivities.
Dr. Misaki Wayengera the Chairperson of the Scientific Advisory Committee on the COVID-19 Taskforce in the Ministry of Health explained why some districts did not get enough masks, saying there was an urgency to distribute to candidates returning to school.
“We intended to distribute masks to the entire 139 districts of Uganda. However, this was not possible because we opened up schools. As the Ministry [of Health], we had to negotiate with the Ministry of Education to prioritise the candidate students who were going to school; every student receiving 2 masks. As a result, we have not been able to distribute masks across the entire country,” he explained.
According to Dr. Wayengera, there is a need for all stakeholders dealing with refugees to appreciate that they are equally susceptible to COVID-19 like any other person.
“In terms of providing support, we must ensure that we provide things like masks, soap, sanitizers and also educational materials around the SOPs,” he said.
Adding that; “there are targeted efforts to make sure that we roll out Rapid Diagnostic Tests to make sure that we can screen the populations especially as children go back to school, we screen them but most importantly know who is infected and pull them out from the community”.
Discussion of Study Results
Dr. Gloria Seruwagi, also the Principal Investigator notes that whereas more than half (about 60 percent) of the members of the refugee community are well informed about COVID-19; up to 40% were found to have knowledge gaps on the nature, transmission, symptoms and dangers of COVID-19.
The study results also showed that between 1-40% of the refugee population across the different study sites adopt at least one risk behaviour likely to lead to transmission of COVID-19 including behaviours related to hygiene and social interactions including related to hygiene, congestion, and physical activity.
While men appeared more knowledgeable about the virus compared to women and children, women were found to be more compliant than men. Also, refugees who were Muslims were more compliant to COVID-19 guidelines compared to their Christian counterparts while younger refugees appeared more knowledgeable about COVID-19 than the elderly.
A wide knowledge gap was found among the children and adolescents, with up to 75% not fully knowledgeable on causes, transmission, risk/protective factors and management of Covid-19.
The Myths
Study results show that refugee communities had a belief that Africans have immunity against COVID-19; and that COVID-19 is not real but is instead a fabrication of scientists and politicians; and that their religious faith would protect them.
On threats and opportunities towards compliance, social media and the diaspora were reported as the key knowledge agents among refugee communities whose effect is divisive by simultaneously encouraging both compliance and non-compliance.
While a lot of information about COVID-19 has been provided by government and other stakeholders including implementing partners from civil society, UN bodies and local leadership, researchers revealed that children, youths and s the elderly and people with disabilities were not particularly targeted with appropriate information; and had largely not been reached.
Children and COVID-19
During the investigations, researchers found that despite government and other key and agencies churning out COVID-19 related information, it largely focused on adults and missed out children and adolescents.
“The fact that they (children and adolescents) have not been targeted means that no one has even given them masks. The masks which are on the market are all big and if a child wears it, it is going to fall down. We decided to channel some of the study resources into making customised and re-usable masks for some of the older children,” explains Dr. Gloria Seruwagi.
Behavioural change messages needed
The REFLECT study team observed during the study that there was a great and urgent need for engaging leadership at all levels as well as developing Behavioral change messages to positively influence behavior.
During the dissemination exercise, the REFLECT Study Team donated masks to support the refugees “walk the compliance talk” in the fight against COVID-19.
The study team physically sensitised and demonstrated to the refugees on proper wearing of masks. They strongly discouraged the improper use of masks including “chin” masking, partial masking, inconsistent masking, sharing of masks as well as wearing ill-fitting masks.
On the whole, researchers applauded government and development partners’ efforts on undertaking a largely successful awareness campaign around COVID-19.
They note however that this awareness has not translated into positive change, emphasising the need for more effort towards behavioural change, building on from the COVID awareness campaign.
The research team recommends thus;
- Government and all stakeholders should focus on addressing the drivers of non-compliance and enforcement fatigue. These drivers include:
- Reviewing the feasibility of interventions: Guidelines like physical distancing are not feasible in crowded refugee settings and need to be revisited. For crowded settings emphasis needs to be put on some guidelines and not others, for example handwashing and consistently wearing fitting face masks instead of physical distancing or sanitizing.
- Debunk myths and negative perceptions: Majority of the community has not fully bought into the seriousness of COVID-19 and think it is not only a joke but is also a political and monetary ploy advanced by politicians, some scientists, supremacists or population control enthusiasts. These myths need to be debunked and instead replaced with factual information about COVID-19.
- More profiling of COVID-19 trends and cases should be undertaken for behavioural change impact. This is because more than 90% of study participants had not seen a single COVID case. However, stigma and other potentially related dilemmas should be carefully managed.
- Leaders, implementers and enforcers of COVID-19 guidelines should be consistent and “walk the talk”. This is especially needed now with the political campaign season where masses are gathering and politicians are not leading by example.
- The issue of livelihoods and food security must be resolved as a key bottleneck to compliance.
- Culture: Local leaders, cultural leaders and grassroots organisations should be recognised and engaged more in behavioural change campaigns – for instance to engage their communities identify alternative social norms for greetings, for showing love and kindness etc., without put their lives at risk.
- The timeliness and critical role of the recently launched 2020 Community Health Engagement Strategy (CES) should be leveraged whereby:
- Local health system capacity is strengthened to effectively take up the implementation and enforcement of SOPs for COVID-19 prevention.
- Community health systems and other enforcement structures are equipped with knowledge, skills, supplies and adequate infrastructure.
- Key sociodemographic factors and COVID-19 risk should guide tailored impact messaging and other interventions.
- Children, adolescents and youth should be effectively targeted in COVID-19 interventions. They need awareness, products (e.g. fitting face masks), visibility, voice and protection from the effects of COVID-19 including being witnesses and victims of different forms of violence.
- The awareness message found high among adults should be reinforced and consolidated – equitably this time.
“We believe that these are low-cost interventions but which will bring about high impact in a very short time and reverse not only the trend of COVID-19 transmission but also its negative effects across the health socioeconomic spectrum” Dr Seruwagi said.
Kyegegwa Authorities Speak Out
Jethro Aldrine, the Kyegegwa District Assistant Resident District Commissioner said government was committed to inclusive dissemination of information on MOH SOPs in order to mitigate the spread of the pandemic.
“As the COVID-19 district task force, we move from door to door to sensitize people on COVID-19 including children,” he disclosed.
He also noted that government was also sensitising the masses through radio stations to create awareness that COVID-19 is real and needs to be prevented. He thanked the REFLECT Project for carrying out the study that will help the district fight the current pandemic.
At a radio talk show conducted jointly with the study team, district officials and refugee community leaders, Mr Thomas Mugweri the Surveillance Officer in the District Health Office of Kyegegwa District Local Government also thanked the REFLECT Study Team for giving it new direction.
“While we as a district have been massively sensitizing on awareness, now we know that people are not using the message they know about COVID. We are now going to start using all our behavioural change techniques to make sure that we bring out the desired behavioural change,” observed Mugweri
He urged the politicians to stop recklessly endangering the masses by calling them to campaign rallies and instead called upon them to donate masks and lead by example through observing COVID SOPs during their campaigns.
Youth Voices on COVID-19 in Refugee Settings
As part of increasing the visibility and voice of young people in COVID-19, the REFLECT Study organised an engagement session with children, adolescents and youth during the dissemination. The engagement sessions were led by Francis Kinuthia Kariuki and Grace Ssekasala of Centre for Health and Social Economic Improvement (CHASE-i) who were supported by Catherine Nakidde Lubowa and Dr Gloria Seruwagi the study PI.
During this exercise, the REFLECT Team discussed Coronavirus and it emerged that a number of issues are affecting the children and youth which needed to be addressed alongside COVID-19 prevention. Most critical, children and adolescents reported defilement, rape – leading to teenage pregnancies and a lot of other SRH challenges that affected their sexual health.
Many confessed they lacked information on menstruation hygiene products which citing that some of their families could not afford. Others decried inaccessibility of contraception despite being sexually active and access to youth-friendly counselling on SRH matters affecting them.
Both male and female youths agreed that the high level of teenage pregnancies has been attributed to high poverty levels and being out of school. ‘’Sex is being used as a tool for economic gain and survival. This is not limited to the girl child only – two cases were reported where boys are being married by older women who lure them with money and soft life’’ explained Mr. Francis Kinuthia from his engagement with adolescent boys and youth.
Mental health issues were reported to be affecting adolescents largely boys who expressed worry about their future especially, now, that schools had been closed, and they are in a foreign country.
Increasing crime rates were also reported and, following unemployment plus school closure, majority youths especially males have now resorted to drugs and substance abuse.
In regard to COVID-19 the adolescents in general reported that they had experienced the negative effect of the pandemic in their lives such as reduction on monthly hand-outs, harassment by police and enforcers of COVID -19 guidelines, increased domestic violence, SGBV, teenage pregnancy, increased levels of drug and substance abuse, poor mental health and high cost of living among others.
Asked what could be done to solve some the challenges they were facing; youth recommended the following;
- Establishment of skill development centres to empower them and make them less dependent on hand-outs
- Creation of employment opportunities by authorities
- Identification, support and nurturing talent among them refugees and youths
- Constant supply of sanitary towels/pads and other SRH products including contraception
- Health education on contraception methods and having in place youth-friendly services at health facilities
- Continuous awareness campaign on COVID-19 which involve youth and punitive policies or by-laws to severely punish the perpetrators of teenage pregnancies, rape and child marriages.
The dissemination attracted members of the academia from Makerere, Gulu and other universities, central and district Government representatives, Refugee Representatives including their leadership from OPM, Refugee Welfare Committees (RWC), Village Health Teams (VHT), Youth, Women and Sub-County representatives, local politicians, Development and Implementing Partners like Save the Children, Red Cross Society, UNHCR, Nsamizi Institute for Social Development and the Private Sector.
Research Team
The REFLECT Study is funded by Elrha/R2HC (Research for Health in Humanitarian Crises) supported by UKAID, Wellcome and National Institute for Health Research (NIHR). The Study Team is led by Dr. Gloria Seruwagi.
The full team has Prof. Stephen Lawoko of Gulu University, Dr. Denis Muhangi, Dr. Eric Awich Ochen, Dr. Betty Okot all from Makerere University, Andrew Masaba of Lutheran World Federation (LWF), Dunstan Ddamulira from Agency for Cooperation and Research in Development (ACORD and John Mary Ssekate from the National Association of Social Workers of Uganda (NASWU) Others are Brian Luswata and Joshua Kayiwa all from the Ministry of Health and Catherine Nakidde Lubowa, the Project Coordinator.
Article originally posted on MakSPH
Kampala, 11 November 2025 —Makerere University School of Public Health (MakSPH), the Ministry of Health (MoH) and Joint Medical Stores (JMS) have launched a project to boost Uganda’s health supply chain. Backed by the Gates Foundation, it aims to improve emergency deliveries and use data to ensure lasting resilience.
The intervention began on Thursday, 6 November, with the flag-off of emergency distribution of medicines and health supplies at JMS in Nsambya. Under a sub-award from MakSPH, JMS is leading warehousing, distribution, redistribution of essential commodities, reverse logistics, and technical support to health facilities, including digital training for over 1,100 facilities in the Integrated Online Ordering System. The operation aims to deliver USAID-supplied medicines that had remained in storage since donor support was suspended earlier this year, preventing expiry and restoring last-mile delivery across the country.
Building on this, MakSPH convened a stakeholder consultative workshop on Monday, 10 November, at Kabira Country Club to guide the research component of the initiative. Officials from the Ministry of Health, development partners, and health logistics experts reviewed the scope of a new study on strategic analytics to strengthen a sustainable and resilient health supply chain. The consultation focused on refining research questions to ensure alignment with national priorities and stakeholder needs.
Dr. Suzanne Kiwanuka, Associate Professor and Head of the Department of Health Policy, Planning, and Management (HPPM), stressed the need for practical, evidence-based collaboration.
“Our commitment is to make sure that whatever evidence we generate is useful. We want perspectives on governance, implementation, and the frontline, because when the supply chain isn’t functioning, a lot goes wrong,” said Prof. Kiwanuka.
The Ministry of Health has welcomed ongoing support from partners to stabilise the supply chain.
“I want to draw attention back to our 10-year health supply chain roadmap. Despite disruptions, we made important milestones in the first five years, and with support from Makerere University School of Public Health and the Gates Foundation, we are now focused on understanding challenges and building a resilient, sustainable supply chain,” said Dr. Ajulong Martha Grace, Assistant Commissioner, Pharmaceutical Supply Chain and Logistics.
Over the past decade, Uganda’s health supply chain has made steady progress under the 10-Year Roadmap for Health Supply Chain Self-Reliance (2021/22–2031/32), which sets out a vision for a self-reliant, efficient, and transparent system that ensures uninterrupted access to essential medicines. Efforts have focused on increasing financing, digitising logistics, strengthening local manufacturing, and expanding infrastructure.
Despite these gains, the system remains vulnerable. Limited financing, capacity gaps at subnational levels, and poor commodity reporting have contributed to stockouts and wastage. Heavy reliance on donor support, compounded with back-to-back shocks, has left Uganda’s health system exposed to shocks, such as the recent suspension of USAID support, which disrupted last-mile delivery to over 530 private not-for-profit health facilities.
Commodities worth more than UGX 79 billion have remained in storage, risking expiry and could potentially reverse service delivery gains. The Gates Foundation’s support comes at a critical moment to stabilise last-mile distribution while generating analytics to address deeper structural challenges.
“Before these financial disruptions, our public sector supply chain was already under intense pressure to meet rising last-mile demands. The current challenges are a critical opportunity to address long-standing bottlenecks, improve delivery of essential medicines, strengthen real-time monitoring, and build a more sustainable health system in Uganda,” said Timothy Musila, a Health Policy, Planning and Financing Specialist.
MakSPH, in partnership with the Ministry of Health, will carry out Strategic Systems Analytics to strengthen Uganda’s supply chain. The research will examine financing gaps, fiscal space, operational inefficiencies, and performance at the subnational and last-mile levels. This co-created evidence generation will also identify opportunities for sustainable financing and efficiency gains to reduce reliance on external aid and to guide reforms that ensure that essential medicines and products remain accessible to all Ugandans.
This work is spearheaded by Professor Rhoda Wanyenze, as the Principal Investigator, and Associate Professor Suzanne Kiwanuka, the Co-Principal Investigator/Research Technical Lead on the Makerere University side. Dr. Charles Olaro, Director General of Health Services at the Ministry of Health, is the focal person on a five-member steering committee overseeing the implementation. The team includes Pamela Achii, Procurement and Supply Chain Management Specialist at the Ministry, and Mr. Timothy Musila.
Health
JASH2025 wraps with the 23rd Matthew Lukwiya Memorial Lecture and Kampala Declaration Statement
The 19th Joint Annual Scientific Health Conference (JASH) and Inaugural National Annual Communicable and Non-Communicable Conference (NACNDC) held at Speke Resort Munyonyo ended on Friday 7th November, 2025 with the 23rd Matthew Lukwiya Memorial Lecture and a Kampala Declaration Statement.
The joint conference that began on 3rd November, 2025 themed, ‘Unified Action Against Communicable and Non-Communicable Diseases’ was organised by Makerere University College of Health Sciences (MakCHS), Makerere University School of Public Health (MakSPH) and Ministry of Health (MoH). The meeting brought together representatives from Central Government, Ministry of Health, academia, civil society, local governments, private sector, development partners, professional associations, local governments and communities.
Kampala Declaration Statement
Dr. David Musoke, Assoc. Professor at MakSPH who was Co-Chair of the Organising Committee delivered the Kampala Declaration which defined the priorities/commitments of the delegates from the dialogue at the conference.
The declaration highlighted the background of setting the priorities as thus: 1. Uganda’s dual disease burden from communicable diseases (CDs) alongside the growing rise of non-communicable diseases (NCDs). 2. The biological, social and clinical intersections between CDs and NCDs, which compete for limited resources. 3. Threats posed by antimicrobial resistance (AMR), climate-sensitive diseases, zoonotic spillovers, and emergency outbreaks such as Ebola, COVID-19, and Marburg. 4. Uganda’s commitment to Universal Health Coverage (UHC), the Africa CDC’s New Public Health Order, the Sustainable Development Goals (SDGs), the International Health Regulations (IHR), the International Covenant on Economic, Social and Cultural Rights, and the Global Health Security Agenda (GHSA). 5. The integration of health services at facility level continues to face challenges due to high patient-to-health worker ratios and inadequate infrastructure, which impede the delivery of comprehensive, timely, and quality healthcare services;
Emphasizing the need to involve all stakeholders—including from education, agriculture, environment, engineering, urban planning, gender, as well as community and religious leaders, and others—in the fight against communicable and non-communicable diseases; 6. The persistent challenges in access to healthcare across the country due to delays in diagnosis and treatment-seeking, and emphasizing the urgent need to strengthen early detection, ensure timely access to quality healthcare, and enhance community awareness about prompt medical attention; 7. Protection and promotion of human rights are fundamental to ensuring health, dignity, and well-being for all citizens, as these rights form the foundation of equitable access to quality healthcare services; 8. The global threat of antimicrobial resistance (AMR), now causing an estimated 700,000 deaths annually, and recognizing its strong link to self-medication, poor diagnostic capacity, and weak public health interventions; 9. Health policies and investments have focused more on curative than preventive care, underscoring the need to reinstate a strong prevention-oriented approach; 10. Many Ugandans remain inadequately informed about health issues affecting them and their role in promoting health within their communities; 11. Rapid industrialization, urbanization, and lifestyle changes are significantly contributing to the rising burden of NCDs;
The Kampala Declaration was presented as a shared call to action, a platform for sustained collaboration, and a blueprint for strengthening integrated and equitable health systems. The declaration is premised on the following priorities:
- Multisectoral Collaboration and One Health Approach: Affirmation of the requirement for involvement of the whole-of-society and whole-of-government approach to accelerate disease prevention, health promotion, and self-care through evidence-based awareness.
- Integrated, People-Centered Disease Prevention and Care: The urgent need to focus on people, not diseases, using a life-course approach and strengthening integrated service delivery across CDs and NCDs at all levels.
- Strengthened Data, Research, and Policy Translation: Recognition of the importance of timely, interoperable, and disaggregated data to inform policy, financing, and implementation decisions. In addition, commit to collaboration between academic institutions, policymakers, CSOs, and community influencers to bridge the gap between research and practice.
- Financing: Commit to advocate for increased domestic financing to progressively reduce dependence on external aid, ensuring predictable and sustainable resources for integrated disease prevention and care. Promote efficiency and accountability in health spending by strengthening budget tracking, performance-based financing, and public financial management systems. Support innovative financing mechanisms, including public-private partnerships, social health insurance, and community-based financing schemes to expand coverage and affordability.
Specific calls were directed to the various stakeholders respective to their mandates and roles.
Government of Uganda and the Ministry of Health: To accelerate implementation of integrated strategic plans for CDs, NCDs, and epidemic preparedness under a unified health systems approach; Institutionalize NACNDC–JASH as the official Annual Integrated National Health platform for disease dialogue and innovation, co-led by the Ministry of Health and academia; Mobilize domestic and international financing to strengthen primary healthcare, laboratory networks, and community systems; Enforce laws and policies aimed at preventing and controlling substance abuse nationwide.
Academia: Generate policy-relevant evidence and drive innovation in diagnostics, surveillance, and culturally appropriate care; Establish multidisciplinary working groups to connect research, clinical practice, and policy; Train health professionals in integrated, competency-based, and future-ready approaches; Create innovation hubs and partnerships linking academia, communities, and industry to co-develop scalable, people-centred solutions; Leverage technology and innovation to effectively address CDs and NCDs; and Prioritize locally led research focused on Uganda’s health realities, including NCDs, CDs, mental health, and climate-linked risks.
Development Partners and Donors: Align technical and financial support with Uganda’s integrated disease control priorities; Support the development of a national research agenda driven by local health needs; Strengthen health system resilience, digital transformation, and community-led interventions; and promote regional knowledge sharing, South-South collaboration, and local manufacturing of diagnostics and medicines.
Private Sector and Civil Society: Engage in public-private partnerships to expand access to diagnostics, care, and innovation; Champion community-responsive models for disease prevention; rehabilitation, and continuity of care; Strengthen advocacy, accountability, and public education through multimedia and grassroots platforms; Raise public awareness on mental health, sickle cell disease, asthma, and diabetes, integrating these services into primary care and reducing stigma and discrimination.
In view of the background, priorities and expected action from the stakeholders as highlighted above, the declaration also endorsed the development and dissemination of: a National Integrated Disease Control Strategy, informed by best practices and policy dialogues from this conference; a Multisectoral Action Framework guiding collaboration among health, education, agriculture, environment, and finance sectors; A Monitoring Mechanism to track implementation and institutionalize annual
reporting on disease integration; and the continuation of joint annual NACNDC and JASH conferences to sustain momentum.
Setting the Pace
Through the conference, keynote speakers delivered addresses which set pace for the dialogue by participants at the conference.
Dr. Queen Dube, Lead – Newborn Programme Implementation, Policies and Standards at the World Health Organisation (WHO), Geneva and Co-Chair of Every Woman, Every Newborn (EWENE) Country Implementation Group highlighted the reasons for rising disease burden of NCDs across sub-Saharan Africa including industrialization and urbanization; shifting dietary patterns; improved means of transport and communication which converts to less movement.
Dr. Dube noted that, the poorer one is, the higher the risk of one dying due to an illness either through communicable or non-communicable diseases. She stressed the importance for a unified action against diseases as opposed to fragmentations or silos by different working groups of various diseases. Duplication of efforts spreads thin the available resources, yet more efficiency and effectiveness could be enjoyed, she added.
Her call for action was, ‘health is interconnected, our response must be to; collaboration saves lives; and together, we can build a healthier, more resilent world’.
Delivering his keynote speech on the final day of the conference, Prof. Francis Omaswa, Founder and Director – African Centre for Global Health and Social Transformation (ACHEST) reminded the delegates that, ‘it is up-to us to achieve our goals provided we commit to do what is expected of us in the best possible way’.
He questioned why Africa continues to lag behind in the global health indices considering the professionals present on the continent. ‘Inclusiveness, equity and working together is the way forward’, he advised.
Prof. Omaswa reminded the delegates that Uganda in particular achieved in areas like HIV/AIDS control, therefore the means we used then must be employed in fighting communicable and non-communicable diseases. He heighted that, some of the means included leadership at all levels, working together, for monitoring and reporting, engagement of youth through the means they respond to among others.
‘Let no one go to sleep, each one of us is a leader at our levels of responsibility and we must make sure that there is coordination and supportive supervision within the health system’, Prof. Omaswa reiterated.
In his keynote speech, Dr. David Serwadda, a Professor in the Department of Disease Control and Environmental Health at MakSPH reminded researchers and academia the importance of their work to disease prevention and control. He stressed that the link between research and implementation is critical for a unified action, and there bridging the gap must be intentional.
23rd Dr. Matthew Lukwiya Memorial Lecture
Dr. Matthew Lukwiya is remembered for his leadership and selflessness as a Ugandan physician at the forefront during the Ebola virus disease outbreak in Uganda in 2000 until de succumbed to the disease. He was the supervisor at St. Mary’s Hospital Lacor, outside Gulu City, Uganda; Gulu district was an epicentre of the disease at the time.
As has been the case at the previous JASH conferences, the 23rd edition of the Matthew Lukwiya Memorial Lecture was held on the final day of the conference, themed, “Identified Critical Gaps in the Response to Outbreaks”.
The session convened leading scientists, policymakers, community and health professionals to reflect on lessons learnt from past epidemics and chart strategies for stronger preparedness, response and resilience across the health system.
The Way forward
At the end of the meeting, delegates were advised that information from the meeting will be shared through a link on the MakSPH website and abstracts will be published as well.
Prof. Rhoda Wanyenze, Dean-MakSPH who also represented Prof. Bruce Kirenga, Principal-MakCHS thanked all participants for attending the dual conference and willingness to share information in support of integrating to improve Uganda’ Health System. She also thanked the organising committee and partners for the support leading to a successful conference.
‘What is it that touched you at this conference, what are the takeaways and I implore you to reflect on the discussions and create a change. This is not business as usual and let us make change.’, the Dean said.
Prof. Wanyenze handed the baton to the School of Medicine who will work with the MoH in organising the conference in 2026.
Closing by the Permanent Secretary
The conference was officially closed by Dr. Diana Atwine, Permanent Secretary-MoH. She highlighted five points for all of us to remember as takeaway from the dialogue.
- All of us should innovate solutions for the challenges before us including innovative leadership. Uganda’s population growth remains high and the resources are not growing at same rate therefore challenges will continue to arise therefore innovation is necessary.
- Inculcate a culture and mindset change and remember health change begins with each of us.
- Integrate not verticalization because it is the right thing to do, leads to efficiency and gives results.
- As government continues to explore means of resource mobilisation, smart investments in high impact activities and priorities are critical.
- Call upon all of us, to implement the resolutions reached.
She thanked all stakeholders for the contributions made towards success of the conference.
The two-day 2nd Artificial Intelligence (AI) in Health Africa Conference that kicked off today in the Main Hall, Makerere University has been described as not being about technology but about people – the vulnerable communities bearing the burden of infectious diseases and other health challenges – and the promise AI holds as a panacea. Officially opened by Hon. Dr. Monica Musenero, Minister of Science, Technology and Innovation the conference will be held under the theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”.
Africa Must Enter the ‘Evil Forest’
In her now characteristic style of speaking from the heart, Hon. Dr. Musenero observed that Africa has from the first industrial revolution to the current fourth and impending fifth industrial revolutions experienced emotions ranging from non-recognition, rejection and skepticism to the current consumption with awe. This current emotion, though receptive unlike previous ones, continues to position Africa at a disadvantage economically, she noted.
“We are positioning ourselves to disadvantage in skill; we have positioned ourselves at the consumption end and we’ve stood in awe of this technology,” she observed, using the example of the amount of admiration a user who whips out the latest iPhone 17 attracts from those around them. “We respect you for your iPhone 17, but I would be happier if you were able to design and manufacture iPhone 5” intimated Hon. Dr. Musenero.
The Minister urged fellow scientists to wake up to the realization that the future of Africa lies in their hands. “We can no longer be passive participants, we can no longer reside on the shallow end of science; we must be willing, as I said when I was here last week, to enter the ‘evil forest’”.
The ‘evil forest’ is Hon. Dr. Musenero’s analogy of Africa’s perception of current technology ecosystem drawing parallels with scenes often dramatized by Nigerian Movies. She notes that though depicted in these movies as scary and potentially dangerous, the ‘evil forest’ is loaded with hidden treasures, necessitating resilience and wisdom for one to navigate the pitfalls until they discover the treasure trove. Upon discovery, the value of this treasure has the potential to turn around the fortunes of the family, community or entire kingdom. Entering the ‘evil forest’ therefore, is her way of encouraging scientists to go beyond adapting imported technology for local use to understanding how it works enough to develop homegrown solutions.
Building AI Capacity through Synergy
Representing the Vice Chancellor, Prof. Barnabas Nawangwe, the Academic Registrar, Prof. Buyinza Mukadasi concurred with Hon. Dr. Musenero that Uganda needs to accelerate investment capacity in AI, if it is to be used as tool to manage health challenges. He nevertheless underlined the steps Makerere has undertaken to close the gaps by hosting units such as the Infectious Diseases Institute (IDI), AI and Health Lab, Innovation Pod, while working with various partners.
“We want to renew our commitment that we shall continue to translate our research findings into service delivery and products that improve the livelihoods of our people,” pledged Prof. Buyinza, who also noted that this will be undertaken within institutional ethical guidelines and policies, bolstered by good practices and recommendations arising from the conference.
Taking cognizance of contributions of various partners to strides made so far, the Permanent Secretary Ministry of ICT and National Guidance, Dr. Aminah Zawedde who was represented by Mr. Ambrose Ruyooka, the Ministry’s Head of Department of Research and Development, thanked the Makerere University AI Health Lab, IDI, Health AI for All Network, the Research and Innovation Fund, the African Population and Health Research Centre, and the Mastercard Foundation for convening the second edition of the conference.
“This year’s theme aligns perfectly with Uganda’s digital transformation vision. It reminds us that while innovation is powerful, true progress lies in ensuring it is equitable, ethical, locally relevant, and accessible to all” read Dr. Zawedde’s remarks.
She noted that when used responsibly, AI empowers healthcare workers to do more with greater precision and efficiency while extending services to under-served communities, essentially amplifying their impact whilst preserving the essential human touch that defines care. Dr. Zawedde reiterated the Government of Uganda’s commitment to positioning AI as a catalyst for national development and improved service delivery through the national AI governance framework. “By the end of 2025, we expect to reach a decision on whether to adopt a comprehensive AI policy or a flexible, sector-led regulatory approach.”
Referring to projects already underway at the College of Computing and Information Sciences (CoCIS), the Principal, Prof. Tonny Oyana underscored the great promise AI holds for not only improving affordability but also diagnosis of disease. He nevertheless called for targeted investment in data centres so as to build the required capacity to process the large amount of data that AI thrives on.
The Executive Director IDI and conference Co-Chair, Dr. Andrew Kambugu described the conference timing as “impeccable”. Citing a recently convened conference on Communicable and Non-Communicable Diseases that discussed Universal Health Coverage, he shared “there are people in this country who are one step away from disaster because of health.”
He therefore paid tribute to his conference Co-Chair, Dr. Rose Nakasi, whose AI-automation work with the light microscope, one of game-changing inventions in human medicine to-date, has improved precision, accuracy and efficiency in diagnosis of malaria, tuberculosis and cancer in healthcare facilities. Dr. Kambugu therefore urged his audience to always be eager to learn about the capabilities game changing tools such as AlphaFold.
“Our African Centre of Excellence in Bioinformatics & Data Intensive Science (ACE) in collaboration with CoCIS has been one of the first trainers of AlphaFold in Africa” remarked Dr. Kambugu. He added that the to ensure inclusive training ACE has attracted funding to support the She Data Science (SHEDS) project, an initiative that offers MSc and PhD fellowships to Ugandan women in the fields of data science and bioinformatics, with a strong emphasis on health data.
How Ocular is shaping healthcare
Conference Co-Chair and Principal Investigator of Ocular, Dr. Rose Nakasi noted that their project that aims at empowering healthcare professionals with AI-powered microscopy was motivated by the fact that wrong diagnoses have a cascading effect on prescription, treatment, recommendation and surveillance services. “Where health practitioners have been taking 30 minutes or more to diagnose malaria, and days to diagnose cancers, we are slashing down that time to literally 5 seconds to diagnose and make a recommendation.” She added.
Dr. Nakasi added that beyond diagnosis, the Ocular project is supporting the Ministry of Health with more precise surveillance and monitoring of diseases by quicker augmentation of information for faster roll-out of interventions as opposed to current weekly or monthly reporting period required by the Digital Health Information System (DHIS 2).
“The beauty about AI is that it has the capability not to just learn with one dataset but also provide insights on different pieces of data – for diseases such as malaria where climate has an effect, we want to integrate climate datasets and seasonality aspects so that interventions by Government are timely and targeted to specific locations.”
Beyond the plenary sessions, the 2nd AI in Health Africa Conference will feature abstract presentations, a Makerere AI Health Lab Showcase, Breakout Sessions, Workshops, Masterclasses and a hackathon for prototypes developed during the conference. Please see downloads for a detailed concept and programme.
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