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COVID-19: Handwashing Adherence Drops by 93% in Kampala Hotspots

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By Joseph Odoi

As Uganda continues to fight tirelessly to control the spread of COVID-19, results from a field-based survey in Kampala’s informal settlements have indicated that citizens have abandoned hand hygiene, a key pillar in stopping the spread of a virus.

To beat the virus today and ensure better health outcomes beyond the pandemic, hand hygiene, especially through handwashing with soap have been emphasized as a top priority.

But results of a study titled: Adherence, Lived Experiences and Resilient Transformation among “slum dwellers” (ALERTs) in COVID-19: A study of Ki-Mombasa and Kabalagala-Kataba slums in Kampala present an urgent need to intervene in these communities in order to improve public hygiene practices such as handwashing, if the intended objectives are to be achieved.

Dr. Gloria Seruwagi, a behavioural scientist at Makerere University School of Public Health has observed that some of the set Standard Operating Procedures such as physical distancing, regular sanitizing and use of face masks are less likely to be followed and implemented due to congestion in the settlements.

Community and local government leaders at the ALERTs study Validation and Co-Design Workshop on COVID-19 in Kampala slums. 5th Left is the Project PI Dr. Gloria Seruwagi

While presenting an overview of results from the study, Dr. Seruwagi said Ugandans had gone back to their old ways and abandoned best hygiene practices such as handwashing, which is critical in the fight against COVID-19.

“Residents say they can’t afford masks and those who have them say masks make breathing uncomfortable. Sanitizing is a luxury to most people in Bwaise and Kataba communities. While the practice of handwashing was feasible and adhered to at the beginning of March, it has drastically dropped by up to 92.6%.

Dr. Seruwagi, who is also the Study Principal Investigator observed that residents of Ki-Mombasa and Kabalagala-Kataba still have a major infodemic challenge of misinformation surrounding COVID-19, also exacerbated by multiple power centres and enforcers who locals say give confusing messages and seemed to have an uncoordinated response strategy.

“The community told us that everyone seems to be a “little king” in enforcing COVID SOPs and guidelines – from the police to Division leaders, food distributors, VHTs and local village leaders. They were not working in harmony and were giving different, sometimes confusing, messages and instructions. This greatly contributed to confusion and partly resulted in community noncompliance” she said.

Dr Gloria Seruwagi, Principal Investigator of ALERTs Study, at the Validation and Co-Design event.
Dr Gloria Seruwagi, Principal Investigator of ALERTs Study, at the Validation and Co-Design event.

According to Hilda Namakula, ALERTs study Co-Investigator people living in informal settlements had vast knowledge of COVID-19 signs, symptoms and how it is spread.

For instance, in this study, up to 82% mentioned high fever as a symptom while 80.2% mentioned sore throat as a symptom.  Meanwhile 80.8% knew that sneezing and coughing were symptoms and 78% mentioned body pain.

Despite this knowledge, Namakula contends that communities have multiple – and sometimes contradictory – sources of information which affect their adherence to the preventive measures.

“In Kampala, TV takes lead as the main information source at 78%, social media 14%. Other sources include radio, family members and neighbors. In addition to multiple information sources, multiple enforcement authorities in Ki-Mombasa and Kabalagala-Kataba have contributed to confusion on which information to follow.’’ said Ms. Namakula.

In a bid to establish reasons for non-compliance to COVID-19 SOPs such as physical distancing or staying home, researchers also found that livelihoods and the need to make a living were the most common explanatory factors.

“Other reasons for non-compliance include perceptions that COVID-19 is a political ploy, declining enforcement and multiple implementers with confusing messages and warring power centres. Moreover, in their power struggles, the different actors who were enforcing SOPs were themselves not adhering for example by wearing masks” Namakula added. 

According to the study, communities reported lot of myths and misconceptions about COVID-19 as key drivers of high risk behaviour. For example; people living in Kampala’s informal settlements believe that taking alcohol reduces the risk of infection (16.8%); that sunbathing protects against COVID-19 (47.9%); and that Africans are immune by virtue of their skin Colour (46.5%).

Hilda Namakula a Co-Investigator of the ALERTs study presenting the Key Findings at the ALERTs Validation and Co-Design Event
Hilda Namakula a Co-Investigator of the ALERTs study presenting the Key Findings at the ALERTs Validation and Co-Design Event

Following the survey findings, Makerere University researchers underscored the need for sustainable community-led interventions to minimize the pandemic implications. The researchers observe that the current efforts to contain the pandemic cannot yield better results unless there is harmony and consistency in messages shared out.

The project team set out to engage health workers and community leaders of Ki-Mombasa Bwaise and Kabalagala-Kataba slum communities to jointly co-design tailored interventions on Thursday 17th December 2020. The engagement climaxed with a dialogue held at Makerere University Central Teaching Facility (CTF-1) with key stakeholders in attendance, including representatives from Makerere University, Kampala Capital City Authority (KCCA), Division and political leaders, Village Health Teams (VHTs), community, administrative leaders, religious leaders among others.

Following presentation of findings, there was consensus from all participants that it was still possible to reverse the non-adherence and high-risk behaviour.

The stakeholders identified priority areas for interventions underscoring the need for community leaders (Village Chairperson, VHTs) to be at the forefront. The co-design process comprised proposals for re-adaptation of some existing interventions or focusing more on some than others (e.g. emphasising wearing facemasks vs. social distancing); and practical ways for operationalizing the Community Engagement Strategy (CES) amidst increasing community transmission; designing a community behavioural change communication component; as well as undertaking joint rigorous resource mobilisation at the next phase to implement some of the proposed interventions.

Mr. Henry Bwire, an official from Kawempe Division, gives input in the co-design process
Mr. Henry Bwire, an official from Kawempe Division, gives input in the co-design process

Government of Uganda through the Ministry of Health launched the National Community Engagement Strategy (CES) for COVID-19 Response in October 2020. This strategy arose from the need to stem the wide spread community transmission amidst low levels of compliance to the COVID-19 SOPs.

This strategy puts responsibility to community individuals, local leaders, households and communities to take charge and ensure optimal compliance. The CES also spells out the key role of VHTs, other local leaders the roles of the proposed village health Taskforce (VTF) and expected outcomes.

Catherine Nakidde, Co-Investigator on the ALERTs Study, presenting on the National Community Engagement Strategy (CES)
Catherine Nakidde, Co-Investigator on the ALERTs Study, presenting on the National Community Engagement Strategy (CES)

This study is funded by the Government of Uganda, through the Makerere University Research and Innovation Fund (MakRIF). The ALERTs study is dual-pronged and phased in implementation that combines an innovative citizen science approach with a participatory project co-design phase.

Ms. Carol Kamugira, a Mak-RIF representative applauded the research team for being innovative and bringing community members to devise community-led sustainable solutions in the fight against the coronavirus.

“It is the first time I have seen this kind of arrangement, bringing real community members to co-design interventions here at the university. Such interventions will be successful because they came from the people concerned and who will monitor the process. As the RIF we are very proud of Dr Seruwagi and her team and that is why we are here to support such meaningful studies. The government gave us resources, we advertised and received many research proposals. The proposal for this research was among those selected for funding because it was strong and very innovative,” Ms. Kamugira said.

She hailed the Uganda Government for the support rendered towards research and other training needs at Makerere University.

Ms. Carol Kamugira, the Mak-RIF Engagement Officer, gives her remarks at the event
Ms. Carol Kamugira, the Mak-RIF Engagement Officer, gives her remarks at the event

Other Key Findings


• The living arrangements in the informal settlements affect people’s adherence to SOPs like social distancing –emphasis should be on encouraging them to adhere to the other more plausible measures like hand washing or wearing masks.

• The participants reported doing the following often: the washing of hands with water (38.3%); washing hands with water and soap (33%); covering the mouth while sneezing/coughing (28.5%); using a mask while in a public place (32.2%); consumption of fruits (25.8%); regular drinking of water (35.5%).

• A big proportion of the study participants knew that chronic illness increases the risk of death from COVID-19 (81%); and that those infected with the disease should be isolated (93%).

• While children living in informal settlements were aware of COVID-19, they are generally not adhering to the SOPs because it is believed that their age group is not at risk.

• COVID-19 has increased levels of violence, including violence against children and SGBV. It has also significantly contributed to increased cases of defilement, early marriages, teenage pregnancy and pimping children for transactional sex. For example, forced sex among the respondents during lockdown was reported at 2% and slapping 4%.

• The study also revealed that some men are survivors of violence whose condition has been worsened by COVID through not having an income source and depending on their wives who job is commercial sex work (CSW). Other men are clients of CSWs who target them claiming nonpayment; or their husbands who don’t want clients sleeping with their partner.

• Study findings also highlight some adults, including parents, local leaders and law enforcement officers as being more collusive than supportive in cases involving violence against children.

• Local duty bearers and key stakeholders in child protection such as social workers and police officers need more support to effectively undertake their roles in child protection and wellbeing.

• Schools remain both a cognitive and physical safe space for children. The closure of schools presented heightened vulnerability for children as they became more exposed, over prolonged periods of time, to multiple rights violation including lack of food and all forms of violence. Nearly all children in study sites are not benefitting much from the Education Continuity Programme and most caregivers were not in position to support learning during school closure. Children wanted to return to school and worried about an uncertain future.

• There is also evidence of belief of the politicization of COVID-19 for example the impression that the related measures are intended to curtail the activities of the opposition politicians.

• Slum communities reported limited knowledge and access to COVID-19 testing services in their communities or within Kampala as a whole.

Recommendations:

The researchers recommend that, building on from its massively successful awareness campaign on COVID-19, government should now work on addressing the barriers of non-compliance; emphasising personal responsibility and the community’s own contribution in the fight against COVID-19.

Moving forward, the researchers recommend that:

1. Government and all stakeholders should focus on addressing the drivers of non-compliance and enforcement fatigue. These drivers include:

  • The feasibility of interventions: Guidelines like physical distancing are not feasible in crowded informal or slum settings and need to be revisited. Emphasis should be placed on feasible ones like hand washing and masking.
  • Myths and negative perceptions: Majority of the community has not fully bought into the seriousness ofCOVID-19 and think it is not only a joke but is also a political and monetary ploy advanced by politicians, some scientists and supremacists or population control enthusiasts. These myths need to be addressed.
  • Shielding community from the reality of COVID as cases are managed out of the community. More profiling of COVID-19 trends and cases should be undertaken for behavioural change impact. 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”.

2. The issue of livelihoods and food security must be resolved as a key bottleneck to compliance.

3. Innovative multi-sectoral and tailored approaches should be adopted to address COVID-19 effects, including violence against children, men and women.

4. Children and adolescents should be effectively targeted in COVID-19 interventions. They need awareness, products (e.g. fitting face masks), voice and protection from the effects of COVID-19 including being witnesses and victims of different forms of violence.

5.  Local and community leader 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 putting their lives at risk.

6. The timeliness and critical role of the recently launched Community Engagement Strategy should be leveraged. Local health system capacity should be strengthened and equipped to effectively take up the implementation and enforcement of SOPs for COVID-19 prevention. Equip community health systems and other enforcement structures with the knowledge, required supplies and supportive infrastructure.

Mak Researchers-Slum Communities Designing interventions

In this dissemination, Makerere University researchers and slum community leaders and journalists   engaged in co- designing behavioural change interventions to address COVID-19. The results of these sessions will form the final part of the ALERTs study objectives and will be presented in its final reporting. However, some of the suggested “quick” solutions from the groups include:

  • Involvement of women in sensitization drives around COVID-19
  • Preventive treatment of suspected cases
  • Skilling of Youth at Village Level
  • Health Education
  • Incorporating church leaders in the fight against COVID-19
  • Politicians should incorporate COVID-19 Messages in their campaigns
  • There is need for VHT support to counter community Spread
  • Cultural leaders should join the sensitization
  • Incorporate Youth Leaders in awareness
  • Have local leaders and Police enforcing directives
  • Incorporate NGOs in the fight against COVID-19
  • Employ musicians in COVID-19 since they have a huge following
  • There is need to incorporate drama and plays with key messages highlighting COVID-19 dangers and how to fight it.

More about the Study

The ALERTS Study was conducted by researchers from Makerere University and   Gulu University with funding by Government of Uganda through the Makerere University Research Innovation Fund (MakRIF).

The total number of study participants was 807 in two slum communities of Kampala i.e. Kataba-Kabalagala-Kataba in Makindye and Ki-Mombasa Bwaise in Kawempe Division.

The Study Team:

1. Dr. Gloria Seruwagi – PI, Makerere University

2. Prof. Stephen Lawoko – Co-Investigator, Gulu University

3. Catherine Nakidde Lubowa – Co-Investigator, CHASE-i

4. Hilda Namakula – Co-Investigator, CHASE-i

5. Dr. Eric Lugada – Co-Investigator, CHASE-i

6. Daniel Magumba – Coordinator, Makerere University

7. Flavia Nakacwa – Administrator, Department of Social Work and Social Administration, Makerere University

Article originally posted on MakSPH

Mark Wamai

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Makerere Public Health Showcases EU Funded Research

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Makerere University’s School of Public Health (MakSPH) showcased research, training and international partnerships supported through European Union funding during the EU Uganda Research and Study Fair 2026 held at Makerere University.

The fair brought together students, researchers, academics, government representatives and development partners to explore opportunities in education, research, innovation and international collaboration, while celebrating 50 years of partnership between Uganda and the European Union.

Through its exhibition, MakSPH highlighted research and capacity building initiatives addressing public health challenges including infectious diseases, non communicable diseases, health systems, climate change and pandemic preparedness.

18 EU funded projects supported at MakSPH

Prof. Rhoda Wanyenze, Dean of Students, School of Public Health, said the School has benefited from 18 EU funded projects over the past five years, supporting research and training across several areas of public health.

Prof. Rhoda Wanyenze explains MakSPH research projects to Acting Minister of Education and Sports Dr John Chrysostom Muyingo during a tour of exhibition stands at the EU Uganda Research and Study Fair.

She said the projects have contributed to the training of PhD researchers and the development of research addressing infectious diseases and prevention, non communicable diseases, health systems, climate change and health.

Prof. Wanyenze also highlighted a new five year programme which started in 2021 that is aiming at strengthening capacity for research on pandemic preparedness and response, including outbreaks such as Ebola.

Stella Kakeeto interacts with students during the EU Uganda Research and Study Fair

Another programme being undertaken with the Ministry of Health and Karolinska Institute focuses on improving maternal health while also addressing adolescent pregnancy and the health of mothers and children.

She described partnerships as critical to advancing science and innovation, noting that collaboration allows researchers in Africa and Europe to share knowledge and strengthen the impact of research on communities.

Research partnerships strengthen innovation

Prof. Robert Wamala, Director of the Directorate of Research, Innovation and Partnerships at Makerere University, said the exhibition provided an opportunity to showcase EU funded projects across the University.

He noted that the School of Public Health alone has more than 18 such projects, while other colleges also have several EU supported initiatives.

Prof. Julius Okuni

One of the projects showcased was PREPARE TID, a partnership aimed at developing rapid diagnostic technologies for emerging and re emerging infectious diseases.

Prof. Julius Okuni, Associate Professor of Veterinary Pathobiology and Molecular Diagnostics at Makerere University, said the project brings together universities, industries and other organisations from Africa and Europe.

The project is working to develop technologies that can quickly identify pathogens responsible for outbreaks such as Ebola, Rift Valley fever and Crimean Congo haemorrhagic fever.

According to Prof. Okuni, Makerere is involved in field and laboratory work to test and refine the technologies before they can be delivered to end users.

Fair provides platform for research visibility

For researchers at MakSPH, the fair also provided an opportunity to increase the visibility of ongoing research and create new connections with researchers, policymakers and potential funders.

Dr. Raymond Tweheyo, Honorary Lecturer and Senior Research Fellow in the Department of Health Policy, Planning and Management, said such exhibitions allow researchers to share their work and identify others working on related challenges.

Dr. Raymond Tweheyo and Assoc. Prof. Angelina Kakooza Mwesigye at the exhibition

He cited the CONNECT for Health project, which focuses on transforming non-communicable disease care in Uganda through collaboration with partners across several countries.

Dr. Tweheyo said exhibitions can help researchers connect with policymakers, civil society organisations and other partners who can contribute to translating research into practical solutions.

Assoc. Prof. Angelina Kakooza Mwesigye, Associate Professor and Child Neurologist at Makerere University College of Health Sciences, also emphasised the importance of exposing young people to international research opportunities.

She said the long standing Uganda Europe partnership provides opportunities for the next generation of researchers to learn, build networks and prepare for future research collaborations.

The School of Public Health’s participation highlighted the role of international partnerships in strengthening research capacity, supporting innovation and developing evidence based responses to Uganda’s public health challenges.

Allan Ainematsiko

Bachelors of Journalism and Communication

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Uganda’s Outbreak Experience Points to Strong Response Systems but Persistent Detection Gaps

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MakSPH Dean Prof. Rhoda Wanyenze, Dr. Steven Kabwama, district health officials and partners at the EPiC validation workshop on Uganda’s Ebola and Marburg outbreak responses, 6 October 2026. Makerere University School of Public Health and FHI 360 country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks, 6th October 2026, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.

Uganda has strengthened its ability to respond rapidly to Ebola and Marburg outbreaks once cases are confirmed, but delays in frontline detection, health worker exposure, emergency financing bottlenecks and incomplete implementation of lessons from previous outbreaks continue to undermine preparedness, a study has found.

The findings were presented today, October 6, 2026, during a country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks. The study was undertaken by Makerere University School of Public Health and FHI 360.

Presented by Dr. Steven Kabwama, the synthesis examined Uganda’s experience with recurrent Ebola virus disease (EVD) and Marburg virus disease (MVD) outbreaks between 2000 and 2026, drawing particularly on After-Action Reviews from the 2017 Marburg outbreak and the 2019, 2022 and 2025 Ebola outbreaks. The work seeks to consolidate recurring strengths, weaknesses, innovations and lessons that had previously been documented separately.

Dr. Steven Kabwama presents findings on strengths and detection gaps in Uganda’s Ebola and Marburg outbreak responses at the EPiC validation workshop, 6 October 2026. Makerere University School of Public Health and FHI 360 country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks, 6th October 2026, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Dr. Steven Kabwama presents findings on strengths and detection gaps in Uganda’s Ebola and Marburg outbreak responses at the EPiC validation workshop, 6 October 2026.

Uganda has recorded 12 filovirus outbreaks over the 26-year period, including nine Ebola and three Marburg outbreaks, according to the research team. Among the four outbreaks examined closely were the 2017 Marburg outbreak in Kween and Kapchorwa, the cross-border Ebola outbreak in Kasese in 2019, the multi-district Sudan Ebola virus outbreak in 2022, and the 2025 outbreak whose index case was a health worker.

Strong systems after confirmation

Across the outbreaks reviewed, the synthesis found that Uganda has developed significant capacity to mobilise after laboratory confirmation. National and district task forces and technical response structures are activated quickly, supported by strong laboratory capacity, established coordination mechanisms and increasingly sophisticated surveillance systems.

The country has also built laboratory capacity around the Uganda Virus Research Institute, mobile laboratories, genomic sequencing, sample referral systems and the Results Dispatch System. Digital surveillance tools, Village Health Teams, survivor champions and established national and district coordination structures have further strengthened response capacity.

Detection remains a weak point

However, the findings point to a critical problem before confirmation: recognising a possible outbreak early enough.

For outbreaks originating within Uganda, the synthesis found that the period between a patient’s first presentation and confirmation ranged from nine to 27 days. This the study found is linked to low clinical suspicion and weaknesses in screening. Other recurring challenges included delayed access to emergency financing, infections among health workers, disruptions to essential health services, community mistrust and stigma, and limited follow-through on recommendations from previous After-Action Reviews.

Opening the workshop, the Dean, Prof. Rhoda Wanyenze, said understanding these delays requires going beyond identifying broad weaknesses to examining where response systems fail in practice.

“We can identify a broad challenge such as delayed detection from the literature, but your experience on the ground can help us understand the specific factors that create that challenge,” Prof. Wanyenze said while addressing district health officials from across the country.

MakSPH Dean Prof. Rhoda Wanyenze (right) speaks with Dr. Andrew Ocero of FHI 360 during the EPiC validation workshop on Uganda’s Ebola and Marburg outbreak responses, 6 October 2026. Makerere University School of Public Health and FHI 360 country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks, 6th October 2026, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
MakSPH Dean Prof. Rhoda Wanyenze (right) speaks with Dr. Andrew Ocero of FHI 360 during the EPiC validation workshop on Uganda’s Ebola and Marburg outbreak responses, 6 October 2026.

“When we begin looking for solutions, we need to be able to target the actual problems rather than simply identifying broad challenges.”

The workshop brought together partners and colleagues from districts, including people directly involved in outbreak response, to validate the synthesis against frontline experience. Prof. Wanyenze noted that published literature, scientific papers and response reports cannot capture every operational reality, making practitioner experience essential to understanding where delays occur and what interventions have worked. Remarks validation workshop

Turning outbreak experience into continuous readiness

Among the priority actions proposed are stronger screening and alert systems for earlier detection; ring-fenced emergency financing and more reliable responder payment systems; routine infection prevention and control training; stronger occupational protection for health workers; continued investment in laboratories and genomic sequencing; and preparedness extending beyond districts traditionally considered outbreak hotspots. The study also recommends stronger community engagement and a formal mechanism to track and finance implementation of recommendations from After-Action Reviews.

Participants contribute to discussions on Uganda’s Ebola and Marburg outbreak responses during the EPiC validation workshop, 6 October 2026. Makerere University School of Public Health and FHI 360 country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks, 6th October 2026, MakSPH Auditorium, Makerere University, Kampala Uganda, East Africa.
Participants contribute to discussions on Uganda’s Ebola and Marburg outbreak responses during the EPiC validation workshop, 6 October 2026.

Dr. Andrew Acero, Director of the EPiC project at FHI 360’s Uganda Office said the central challenge is ensuring that experience accumulated during successive outbreaks translates into lasting institutional capacity.

“The real value lies in ensuring that what we learn changes what we do. Our findings should inform policy, shape guidelines and training, strengthen systems and ultimately improve practice.”

He noted that preparedness cannot begin only after an emergency has been declared, but must be built through sustained relationships, systems and capacity before outbreaks occur. Remarks validation workshop

The EPiC project is led by FHI 360 with core partners including Right to Care, Palladium and Population Services International.

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Betty Kyakuwa
Betty Kyakuwa

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Uganda’s HIV Treatment Gains Bring the Youth Gap into Focus

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Stakeholders pose for a group photo at the UPHIA preliminary results release on 1st October 2026. Released of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.

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.”

Minister of Health Hon. Dr. Chris Baryomunsi urges earlier HIV testing and stronger treatment adherence among young people at the UPHIA 2025 preliminary results release, Uganda Media Centre, 1 October 2026. Released of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
Minister of Health Hon. Dr. Chris Baryomunsi urges earlier HIV testing and stronger treatment adherence among young people at the UPHIA 2025 preliminary results release, Uganda Media Centre, 1 October 2026.

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.

UPHIA field staff sensitise community members about the survey ahead of data collection in July 2025. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
UPHIA field staff sensitise community members about the survey ahead of data collection in July 2025.

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.

A UPHIA field worker collects a blood sample from a survey participant in July 2025. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
A UPHIA field worker collects a blood sample from a survey participant in July 2025.

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%.

UPHIA 2025 findings show HIV prevalence by age, sex and region among people aged 15 and above, with the highest estimates among middle-aged adults and in the South Western region. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
UPHIA 2025 findings show HIV prevalence by age, sex and region among people aged 15 and above, with the highest estimates among middle-aged adults and in the South Western region.

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.

Then Minister of Health Hon. Dr. Jane Ruth Aceng flagged off UPHIA 2025 field teams in Kampala on 29 May 2025 to generate evidence guiding Uganda’s HIV response towards ending AIDS as a public health threat by 2030. The Ministry of Health-led survey is implemented with technical support from MakSPH and partners. Makerere University School of Public Health (MakSPH) reflection on long and productive partnership with the people and Government of the United States, spanning more than 35 years. Kampala Uganda, East Africa.
Then Minister of Health Hon. Dr. Jane Ruth Aceng flagged off UPHIA 2025 field teams in Kampala on 29 May 2025 to generate evidence guiding Uganda’s HIV response towards ending AIDS as a public health threat by 2030.

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.”

Ministry of Health Permanent Secretary Dr. Diana Atwine explains how UPHIA findings will guide the Ministry’s planning at the preliminary results release, Uganda Media Centre, 1 October 2026. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
Ministry of Health Permanent Secretary Dr. Diana Atwine explains how UPHIA findings will guide the Ministry’s planning at the preliminary results release, Uganda Media Centre, 1 October 2026.

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.

U.S. Embassy Chargé d’Affaires Mikael (Mika) Cleverley highlights Ugandan leadership and U.S. support for UPHIA 2025 at the preliminary results release, Uganda Media Centre, 1 October 2026. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
U.S. Embassy Chargé d’Affaires Mikael (Mika) Cleverley highlights Ugandan leadership and U.S. support for UPHIA 2025 at the preliminary results release, Uganda Media Centre, 1 October 2026.

“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.”

MakSPH Dean Prof. Rhoda Wanyenze speaks during the UPHIA 2025 launch in Kampala, highlighting MakSPH’s contribution to Uganda’s public health response through research, evidence and technical guidance. Makerere University School of Public Health (MakSPH) reflection on long and productive partnership with the people and Government of the United States, spanning more than 35 years. Kampala Uganda, East Africa.
MakSPH Dean and UPHIA 2025 Principal Investigator Prof. Rhoda Wanyenze highlights Uganda’s capacity to lead national surveys at the survey launch on 29 May 2025.

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.

MakSPH researchers, including UPHIA 2025 Activity Lead Prof. Frederick Makumbi and Project Director Dr. Sam Biraro, converse at the preliminary results release, Uganda Media Centre, 1 October 2026. Release of preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators, Ministry of Health-overall leadership, Makerere University School of Public Health (MakSPH)-prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. Funded by PEPFAR through the U.S. CDC, 1st October 2026, Uganda Media Centre, Kampala Uganda, East Africa.
MakSPH researchers, including UPHIA 2025 Activity Lead Prof. Frederick Makumbi and Project Director Dr. Sam Biraro, converse at the preliminary results release, Uganda Media Centre, 1 October 2026.

Read the full UPHIA 2025 summary results here:

UPHIA 2025 SUMMARY SHEET

John Okeya

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