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.

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.

“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.

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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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.”

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.

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.

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%.

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.

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.”

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.

“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.”

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.

Read the full UPHIA 2025 summary results here:

UPHIA 2025 SUMMARY SHEET

Health experts from across Africa have called for stronger use of routine health data in planning, supervision and service delivery, noting that although countries are generating large amounts of health information, much of it is still not being used.

The call came during a webinar hosted by the Makerere University School of Public Health (MakSPH) in partnership with The Global Fund under the theme “From National Dashboards to District Action: Strengthening Subnational Data Use for Planning, Supervision and Service Delivery.”

The webinar brought together health information specialists, policymakers and practitioners from Uganda, Kenya, Zimbabwe and Ethiopia to share experiences and lessons on using subnational data for evidence based decision making.

Kenya’s journey from data collection to action

In her keynote address, Dr Helen Kiarie, Head of the Monitoring and Evaluation Division at Kenya’s Ministry of Health, urged health practitioners and policymakers to move beyond routine reporting and use data to improve health outcomes.

“The bottleneck is no longer collecting data. It is turning routine data into decisions and decisions into action,” Dr Kiarie said.

Drawing on Kenya’s experience, she pointed to the country’s shift from paper based reporting systems to digital platforms, noting that more than 95% of public health facilities have been digitised.

According to Dr Kiarie, Kenya has developed National Data Analytics Guidelines to support evidence based decision making across the health system. The guidelines set out a structured approach to data analysis, interpretation and dissemination so that the information generated can be used.

She said building a culture of data use requires leadership that asks for evidence, regular performance reviews, public dashboards, mentorship programmes, and the integration of data into planning and budgeting.

Community data improving maternal health

Dr Kiarie gave practical examples of how data can shape health outcomes.

In Kwale County, community health promoters used household level data to identify and follow up pregnant women, encouraging them to attend antenatal care services and deliver at health facilities.

As a result, skilled birth attendance increased from 50 per cent in 2022 to 85 per cent, while reported home deliveries fell from 808 to 248.

She also pointed to Kenya’s efforts to link digital health data with health financing systems, saying better documentation and data quality have strengthened accountability and increased reimbursements to health facilities.

She added that real time maternal and perinatal death surveillance systems are helping health authorities identify gaps in care, assign responsibility and take corrective action to prevent avoidable deaths.

“Data has moved beyond documenting losses to becoming an instrument for preventing the next avoidable death,” Dr Kiarie said.

Addressing data quality challenges

Despite major investments in digital health systems, Dr Kiarie acknowledged that data quality challenges remain.

She cited system downtimes, the parallel use of paper and digital records, limited access to some digital platforms, and resistance to change among some health workers as barriers to data quality and use.

Still, she said Kenya’s data quality has improved considerably through digitisation and continued investment in governance, analytics capacity and quality assurance.

Regional experiences and lessons

The webinar also included a panel discussion with experts from Uganda, Zimbabwe and Ethiopia, who shared experiences on strengthening data use at district and facility level.

The discussion pointed to the importance of strong leadership, timely information, digital infrastructure and feedback mechanisms that help health workers and managers make informed decisions with the data available.

Participants agreed that health information systems should do more than serve as reporting tools. They should also support decision making where services are delivered.

Moving from information to impact

Speaking during the webinar, Prof. Rhoda Wanyenze, Dean of Makerere University School of Public Health (MAKSPH), commended countries for progress in strengthening health information systems and encouraging data use.

She urged practitioners and researchers to go beyond documenting challenges and start capturing examples of how data informed decisions are improving programmes and health outcomes.

“It would be really good for us to dig deeper in terms of what decisions we have actually made and what we would not have known or done differently if we did not have the data,” she said.

In his closing remarks, Dr Wodimu Ayele of The Global Fund said the value of data lies in its ability to improve service delivery, inform decision making and strengthen accountability.

He called on countries to keep investing in data quality, analytics capacity and health information systems, while making sure evidence generated at all levels leads to measurable improvements in health outcomes.