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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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MakSPH, MOH and JMS Lead National Efforts to Build a Resilient Health Supply Chain

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Participants in the stakeholder consultative workshop convened by MakSPH to guide the research component of the initiative on Monday, 10 November, at Kabira Country Club. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.

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.

Dr. Suzanne Kiwanuka, Associate Professor and Head of the Department of Health Policy, Planning, and Management (HPPM), speaking at the inaugural consultative meeting with stakeholders at Kabira Country Club on Monday, November 10, 2025. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.
Dr. Suzanne Kiwanuka, Associate Professor and Head of the Department of Health Policy, Planning, and Management (HPPM), speaking at the inaugural consultative meeting with stakeholders at Kabira Country Club on Monday, November 10, 2025.

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.

Dr. Ajulong Martha Grace, Assistant Commissioner, Pharmaceutical Supply Chain and Logistics submitting during the meeting. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.
Dr. Ajulong Martha Grace, Assistant Commissioner, Pharmaceutical Supply Chain and Logistics submitting during the meeting.

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.

Official flag off, Dr. Bildard Baguma, Executive Director of Joint Medical Store, Ms. Pamela Achii, Procurement and Supply Chain Management Specialist at Ministry of Health and Prof. Rhoda Wanyenze, the Dean, Makerere University School of Public Health and Principal Investigator of the Project at JMS offices in Nsambya last week. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.
Official flag off, Dr. Bildard Baguma, Executive Director of Joint Medical Store, Ms. Pamela Achii, Procurement and Supply Chain Management Specialist at Ministry of Health and Prof. Rhoda Wanyenze, the Dean, Makerere University School of Public Health and Principal Investigator of the Project at JMS offices in Nsambya last week.

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.

Timothy Musila, a Health Policy, Planning and Financing Specialist speaking at the consultative meeting. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.
Timothy Musila, a Health Policy, Planning and Financing Specialist speaking at the consultative meeting.

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.

L-R: The project team, Timothy Musila, a Health Policy, Planning and Financing Specialist, Pamela Achii, Procurement and Supply Chain Management Specialist at the Ministry, and Dr. Suzanne Kiwanuka share notes shortly after the consultative meeting at Kabira Country Club, Kampala. Makerere University School of Public Health (MakSPH), Ministry of Health (MoH) and Joint Medical Stores (JMS) launched of project to boost Uganda’s health supply chain backed by the Gates Foundation to improve emergency deliveries and use data to ensure lasting resilience, flag off-6th November 2025, stakeholder consultative workshop-10th November 2025, Kampala Uganda, East Africa.
L-R: The project team, Timothy Musila, a Health Policy, Planning and Financing Specialist, Pamela Achii, Procurement and Supply Chain Management Specialist at the Ministry, and Dr. Suzanne Kiwanuka share notes shortly after the consultative meeting at Kabira Country Club, Kampala.

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.

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Davidson Ndyabahika

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JASH2025 wraps with the 23rd Matthew Lukwiya Memorial Lecture and Kampala Declaration Statement

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Panelists moderated by ED IDI-Dr. Andrew Kambugu (Left) reflect on Dr. Lukwiya's legacy during the 23rd Matthew Lukwiya Memorial Lecture on 7th November 2025. Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, 23rd Matthew Lukwiya Memorial Lecture, Kampala Declaration Statement and Closing Ceremony 5th November 2025, Victoria Hall, Speke Resort Munyonyo, Kampala Uganda, East Africa.

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’.

Prof. Francis Omaswa delivers the keynote address. Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, 23rd Matthew Lukwiya Memorial Lecture, Kampala Declaration Statement and Closing Ceremony 5th November 2025, Victoria Hall, Speke Resort Munyonyo, Kampala Uganda, East Africa.
Prof. Francis Omaswa delivers the keynote address.

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.

Prof. Francis Omaswa (2nd Right) with panelists that discussed his keynote address. Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, 23rd Matthew Lukwiya Memorial Lecture, Kampala Declaration Statement and Closing Ceremony 5th November 2025, Victoria Hall, Speke Resort Munyonyo, Kampala Uganda, East Africa.
Prof. Francis Omaswa (2nd Right) with panelists that discussed his keynote address.

‘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.

Prof. David Serwadda delivers his keynote address on "Health Systems Resilience Amidst Global Funding Cuts: What African Countries Must Do". Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, 6th November 2025, Victoria Hall, Speke Resort Munyonyo, Kampala Uganda, East Africa.
Prof. David Serwadda delivers his keynote address on “Health Systems Resilience Amidst Global Funding Cuts: What African Countries Must Do”.

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

PS-MoH, Dr. Diana Atwine. Ministry of Health (MoH), Makerere University School of Public Health (MakSPH), Makerere University College of Health Science (MakCHS) and other partners jointly hosting the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Annual Scientific Health (JASH) Conference 2025, 23rd Matthew Lukwiya Memorial Lecture, Kampala Declaration Statement and Closing Ceremony 5th November 2025, Victoria Hall, Speke Resort Munyonyo, Kampala Uganda, East Africa.
PS-MoH, Dr. Diana Atwine.

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.

Zaam Ssali

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2nd AI in Health Africa Conference, Not about Tech but the Vulnerable

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Hon. Dr. Monica Musenero (3rd Right) flanked by Left to Right: Mr. Ambrose Ruyooka, Dr. Rose Nakasi, Dr. Stella Kivila, Prof. Buyinza Mukadasi and Dr. Andrew Kambugu at the Conference Opening Ceremony on 6th November 2025. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.

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.

Hon. Dr. Monica Musenero delivers her keynote address. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Hon. Dr. Monica Musenero delivers her keynote address.

“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’”.

Hon. Dr. Monica Musenero (Centre) with exhibitors after the official opening ceremony. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Hon. Dr. Monica Musenero (Centre) with exhibitors after the official opening ceremony.

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.

Prof. Buyinza Mukadasi. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Prof. Buyinza Mukadasi.

“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.

Mr. Ambrose Ruyooka. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Mr. Ambrose Ruyooka.

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.

Prof. Tonny Oyana. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Prof. Tonny Oyana.

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.

Dr. Andrew Kambugu. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Dr. Andrew Kambugu.

“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.

Prof. Buyinza Mukadasi (Right) receives a SHEDS gift pack from Dr. Andrew Kambugu (Left). 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Prof. Buyinza Mukadasi (Right) receives a SHEDS gift pack from Dr. Andrew Kambugu (Left).

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).

Dr. Rose Nakasi. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
Dr. Rose Nakasi.

“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.”

The Ocular project exhibition setup. 2nd Artificial Intelligence (AI) in Health Africa Conference under theme “Setting AI for Sustainable and Inclusive Health Systems in Africa”, Opening Ceremony 6th November 2025, Main Hall, Makerere University, Kampala Uganda, East Africa.
The Ocular project exhibition setup.

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.

Mark Wamai

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