Health
Rising to the Top: Carol Nabbanja’s Journey to Becoming the Best Graduating Student from MakSPH
Carol Esther Nabbanja, 22, is set to graduate with First Class Honours in Bachelor of Environmental Health Science (BEHS) from the Makerere School of Public Health as the best-graduating student in the school this year. She graduates in Makerere University‘s 73rd Graduation ceremony today.
With a CGPA of 4.61, she has emerged as the best-graduating student in the MakSPH this year. She graduates alongside her other 43 classmates who made it to the graduation list this year.
Born in Kitemu village, Nsangi Parish, Wakiso District, to Samuel Mawejje, and Alice Naggawa, Nabbanja is the third born of four siblings and first to come to Makerere University, the very first to be on a government scholarship, and the very first to go through Kings College Budo.
Right from her childhood, Nabbanja has always been passionate about health and clean environments, which started from her early years as a head monitor at a government-aided St. Charles Primary School, where she did her nursery to primary five and the sanitation prefect at Clevers Origin Junior School.
While at St. Charles, Naggawa, Nabbanja’s mother was not convinced that she would make a foundation for a great future. She wanted better for her daughter. Nestled in the bustling streets of Kitintale, lies Clevers Origin Junior School, a beacon of hope for many students in the area. For Naggawa, her daughter’s joining the school would mark the beginning of a new chapter in her life.
She approached the owner of the school, Christopher Mugwanya, who happened to be her brother. Despite being a private school, Mugwanya, a kind-hearted and supportive uncle, offered the Nabbanja a half-bursary based on academic merit and family relationship. “I was overjoyed and couldn’t wait to start his new journey at Clevers Origin,” says Nabbanja.
Settling into her new school, Nabbanja encountered some challenges in mathematics, but her uncle was there to help. “I had some challenges in math, but he ably supported me, he gave me food, visited me when my mother couldn’t make it, and sometimes I would stay at his place over the holidays. He was really supportive. I was able to overcome my difficulties in math and excel in my studies. In fact, my grades improved and I found a newfound passion for learning. I am grateful for the support from my uncle and I feel proud of my academic achievements so far.”
Because of her unwavering determination and hard work, the School was convinced that she would sit her Primary Leaving Examinations (PLE) in Primary Six.
“I did PLE in P.6. The centre I registered at was in Nateete and I was the only first grade there but I didn’t want those results. I decided to wait for my actual time, and when it came, I excelled. I got aggregate 5,” says Nabbanja.
She was the best-performing female academician in her cohort. This was a significant achievement, as her cohort had the best grades since the school was founded. “I was also awarded the best female academician during my time at the school. I, in fact still have the certificate. I have also always been pertinent about health, and so I took up positions like the Sanitation Prefect,” says Nabbanja.
Nabbanja also had a passion for cleanliness and health. As the Sanitation Prefect, she made sure that the school environment was clean and hygienic at all times, something that was important to her from a young age. “I always loved a clean environment and to have everything in its place, so my interest developed that early.”
Joining Kings College Budo
Given her outstanding performance, Nabbanja was offered several scholarships to join Secondary School. “I was the very first from that Clevers Origin Junior School to ever go to Kings College Budo—we were two students that performed well, a boy who got 4 and me who got 5 and joined Budo on merit. My parents were offered other offers of schools giving me scholarships but Budo was exceptional. We had to make a decision that would set for me a good standard.”
Her journey to Makerere School of Public Health was paved at Budo. She was initially worried about School fees and how her father, a taxi driver would raise money to support her education.
“On joining my S.1, my parents were worried about the high fees, and the fact that I had studied on bursaries up to this point, they were not financially ready. We were paying about Shs1.4M. My mother talked to the Deputy Head Teacher, Rebecca Kiwanuka, who told her to let me join and that things would work out in the long run. Fortunately, my parents paid fees for S. 1,” says Nabbanja.
Unsure of how the second term would go, by sheer luck, Ligomarc Advocates, a financial and corporate law firm located at Social Security House in Kampala was celebrating 10 years and the partners decided to go back to their high schools and support students who were having financial issues
“By God’s grace, after the meeting between the School administration and the law firm, Mrs. Kiwanuka, our deputy head teacher informed me that I had gotten a sponsor,” Nabbanja says.
Ligomarc Advocates did not only sponsor her education but also provided opportunities for her to work with them during school breaks.
“Ligomarc took me for the 6 years I was at Budo. They were not just sponsors but also supporters, they supported me financially, came for V.Ds [Visitation Days], and also gave me an opportunity to work with them as an office attendant during my vacations. I also assisted the administration, delivering letters here and there. They supported me beyond just academics,” she says.
Budo was a turning point in Nabbanja’s life. It exposed her to new experiences and taught her valuable life lessons that have stayed with her to this day. She thrived in her studies, maintaining an average of 94 and earning 10 out of 8 aggregates in S.4 and 16 out of 20 in S.6.
Nabbanja never lost sight of her goals and was motivated by quotes from her late headmaster, Mr. Patrick Bakamale, such as “In this era of information and technology, we need to have the power of selection,” and “Focus on roots not fruits.”
Shaping her dream
Growing up, Nabbanja had always been fascinated by journalists, with the thrill of being on TV. “I used to hear that they earn 1 million, so that excited me.” However, it was her frequent trips to the dentist that truly sparked her interest in the field of dentistry. As she watched the dentists work their magic, Nabbanja was drawn to their ability to improve people’s dental health and change their lives for the better. “As a child I had so many dental issues, even at home. When I would visit the dentist, I would see a guy in a coat, doing some good work so I realized he doesn’t even work the night shift and it made me want to become a dentist,” she added.
Despite being tempted to pursue a career in law due to the time she spent at Ligomarc Advocates, Nabbanja held firm to her dream of attending medical school and becoming a dentist. She was determined to help her siblings, and others, achieve the confident smile they deserved.
However, her dream course, Dental Surgery, eluded her by just one point. Instead, she was given the opportunity to study Environmental Health Science, a subject that would soon become her passion.
“I didn’t know much about MakSPH, actually my first few days were not that pleasant. I kept thinking about my friends who were doing my dream course even though they were on private not government sponsorship, but my mother didn’t have the money,” she says.
Ruth Mubeezi Neebye, an Assistant Lecturer in the Department of Disease Control and Environmental Health would later become Nabbanja’s mentor. According to Nabbanja, she has equally been inspired by Dr. Esther Buregyeya and Dr. David Musoke.
Throughout her time at MakSPH, Nabbanja has consistently stood out as a top performer, earning high grades and impressing her professors and peers alike. Despite her impressive academic record, she remains humble and grateful for the support she has received from her family, friends, and sponsors along the way.
Nabbanja, a sports personality
As a student at Makerere School of Public Health, Nabbanja was a standout in both academics and sports. She fell in love with swimming. As a member of the Makerere University swim team, Nabbanja excelled in competitions and brought home medals for the university. She found solace in the sport, using it as a way to relax after long days of lectures and studying. Swimming also provided her with the opportunity to travel and make new friends, as well as to work on her physical and mental health.
“Swimming gives you a lot of opportunities, so that inspired me as well. Very many people travel on University tickets, and since I love outdoor life and traveling, I looked at this as an opportunity. Swimming teaches you to read, and do other things like jogging before joining the pool. It is also an individual sport because when you don’t swim for a month, your time is cut,” says Nabbanja.
Journeying to First Class
For some students, University education is just a three-four-year period of attending lectures and socializing with peers. But for others, it’s a stepping stone to a brighter future. And that’s exactly what happened to Nabbanja, the best-graduating student from Makerere School of Public Health (MakSPH). She has not only excelled in academics but was also a talented swimmer who represented the University in various competitions.
Nabbanja’s success journey started with a clear plan and a strong determination to succeed. She believed that becoming a first-class student was not only about attending lectures but also about being self-aware and taking control of one’s own learning process. Nabbanja made a habit of reflecting on what was learned each day and relating it to real-life situations.
When asked about her experience at MakSPH, Nabbanja had nothing but praise for the staff and their professionalism. She says she never encountered any corrupt practices and appreciated the well-defined structure that made it easy to know where to go for assistance. Marks were received on time and she never felt lost or unsure of what to do next.
“The staff is also supportive, right from the reception, everyone is helpful—when inquiring about offices, or office protocol. We also get our marks on time, usually a week into the new semester. The service delivery is good and we are not tossed around.”
Nabbanja’s journey serves as a testament to the power of hard work, determination, and support from family and sponsors.
By Davidson Ndyabahika and Samantha Agasha
Makerere’s School of Public Health (MakSPH) is expanding faster than it can house itself. It now hosts more than 1,000 students, runs programmes across multiple countries, and anchors a large share of the University’s research output. Yet parts of its operation still spill into rented space, costing over $113,000 a year, because the infrastructure has not kept pace with its growth.
That constraint sits uneasily with the School’s economic weight. Health research accounts for more than half of Makerere University’s academic output, making it one of the University’s most productive engines. As Vice Chancellor Barnabas Nawangwe put it, “An educated population is a healthy population, and an educated and healthy population is a prosperous population.”
Beyond the university, health is not just a social outcome but a driver of economic performance. Healthier populations are more productive, more resilient, and less costly to sustain. Investments in public health, whether in prevention, systems, or infrastructure, raise an economy’s productive capacity, not just improve outcomes.
Institutions that generate public health knowledge and train professionals are not peripheral to growth; they are part of its foundation.
It is this logic that is shaping how Makerere’s School of Public Health is positioning itself. At its centre is a new, unfinished complex on the University’s main campus, intended to anchor the School’s next phase as a regional hub for research, training, and policy support. But like much of the system it supports, it is being built gradually, in a “build-as-you-go” approach constrained as much by funding realities as by design.
Construction of Phase II of the MakSPH complex is now at an advanced stage, with progress recorded across all sections of the site. As of March 2026, Phase 2B is nearing completion at 98%, while Phase 2A stands at 89%, and Phase 2C at 69%, each tracking close to or slightly ahead of planned targets. Current works are concentrated on interior finishes—including tiling, terrazzo installation, and external rendering—as well as preparations for lift installation, signaling a transition from structural works to final detailing. The project team is working toward a practical completion date of August 31, 2026, with timelines calibrated to align with broader resource flows and implementation considerations.
Six years ago, in February 2020, construction began on what will be the new home of the School of Public Health. The building, a permanent, purpose-built public health facility on Makerere’s main campus, will accommodate a growing student body, provide space for doctoral and postdoctoral fellows, and strengthen the University’s ability to respond to Africa’s most pressing public health challenges.
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, said the construction journey reflects the School’s “ambition, intent, and courage”—a bold step despite limited resources. He was speaking at a public lecture on health financing held at Makerere University on April 9, 2026.
But the ambition behind the project is not modest. “We are not building for today—we are building for the future,” said Professor David Serwadda, reflecting on a decision that shaped the entire construction effort. “We need to build for the next 100 years.”
That long view helps explain both the scale of the project and the risks taken to start it. When construction began, the School did not have the full funding. “We started with about a third of the required budget,” Serwadda said.
The approach was not without setbacks. A major grant from USAID, worth over a million dollars, was later withdrawn, midway through the construction, due to the closure of USAID. “We received what is called a ‘Dear John letter,’” he recalled. “At that moment, we felt the situation was a major blow, almost terminal for the project.”
But the project did not stop. It adjusted. “We said, let us continue, piecemeal,’” he said. “Finish the auditorium first, use it, and keep building the rest.”
“We have come a long way as the School of Public Health,” said Professor Rhoda Wanyenze, the Dean. “We are proud of that history, but we also recognize that it comes with responsibility.”
She argued that responsibility is no longer confined to Uganda. With ongoing collaborative work in more than 25 African countries currently, the Dean says this is “a responsibility to provide leadership in public health not only in Uganda but across the continent.”
The scale of that growth has been visible from what was once a small training unit in the Faculty of Medicine in the 1950s, which has expanded into 12 academic programmes and more than 1,000 students.
“When I came back for my public health training, we were about 40 students,” she said. “Now, we have more than 1,000.” “Public health is growing and evolving,” Wanyenze said. “And we are doing our best to develop the skills needed for this changing landscape.”
That includes new areas such as health informatics and data science, driven by the digitisation of health systems and the growing role of data in decision-making and AI. The School is already coordinating regional platforms on digital health, linking multiple countries in shared learning and practice.
But this growth has outpaced the physical systems needed to sustain it. For the University leadership, the implications extend beyond infrastructure.
“One of the most effective ways to invest in health in Uganda is to invest properly in Makerere University,” said Vice Chancellor Barnabas Nawangwe. “We must recognize Makerere as a research-led university with a special national role—not fund it like any other institution or department. Makerere is one of the government’s greatest assets. Invest in her, and the returns will exceed expectations.”
Professor Nawangwe hailed Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury, who delivered a keynote on investing in health for Uganda’s future in view of Vision 2040. “I wish to thank Dr. Ramathan Ggoobi and his team for their personal intervention in allocating resources in next year’s budget to complete the new School of Public Health building. That support is deeply appreciated,” he said.
Uganda’s progress in health outcomes is evident, but uneven. Life expectancy has risen significantly from about 50 years in 2000 to roughly 68.8 years in 2024, according to the Permanent Secretary to the Treasury, Ramathan Ggoobi. Yet the gains sit alongside persistent financial strain on households. About 4% of Ugandans still spend more than a quarter of their consumption on healthcare, pushing many into poverty as a result of illness.
For Ggoobi, this points to a structural gap that recurrent government spending alone cannot close. “We must mobilise long-term domestic capital without adding fiscal risk,” he argued, pointing to the need for more sustainable financing mechanisms. Central to this is the gradual design and rollout of a national health insurance scheme. Evidence from countries such as Rwanda, Kenya, and Ghana suggests that well-structured contributory models can expand coverage while reducing catastrophic out-of-pocket spending.
“My Ministry and the School of Public Health must be partners. … Evidence framed in fiscal terms drives policy,” said Ggoobi, stressing the need for locally grounded solutions. “What works in Ghana might not work here. We need a model that fits Uganda.”
Uganda’s current macroeconomic conditions, relatively low inflation, currency stability, and expanding private credit may provide a window to move in that direction.
Uganda’s health system is entering a new phase—one where the biggest challenge is no longer building it, but sustaining it. External funding is tightening. Domestic resources are under pressure. Demand for care is rising faster than both.
In this new reality, health is no longer just a social priority but a financing problem and a test of economic strategy.
For years, the system expanded on government investment, backed by strong external support. Infrastructure grew. Services followed. But that model is now under strain. Expectations are rising. Citizens want better care, closer to where they live, and without the financial shock that so often comes with illness.
Uganda is already investing in health. The real question is whether that investment is sustainable and whether it is delivering value.
It was against this backdrop that policymakers, academics, and practitioners gathered at Makerere University on April 9 for a public lecture and high-level dialogue on health financing. At the centre of the discussion was a keynote by Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury under the theme “Investing in Health for Uganda’s Future: Delivering Vision 2040 through Smart and Sustainable Health Financing.”
The event was organised by Makerere University School of Public Health (MakSPH) in collaboration with the Ministry of Health and the Ministry of Finance, Planning, and Economic Development.
Dr. Ggoobi does not think about health the way most people in government do. He is not persuaded by the language of welfare. When he speaks about health, he reaches for the language of growth, productivity, and national wealth. In his view, the sector is not a cost centre. It is an economic engine.
“Health is not merely a social sector issue. It is an economic transformation issue, a productivity issue, and a national competitiveness issue,” he said, arguing that no country has achieved sustained growth without investing in human capital. Globally, human capital accounts for nearly 70% of national wealth. The World Health Organization (2021) estimates that every dollar invested in health can return four to nine dollars in productivity gains.
“Investment in health is not charity. It is growth finance. So, my first message is to treat health spending as an investment, not as consumption. Every shilling must buy measurable economic and social returns,” he emphases.
His views reveal a shift in how Uganda’s Treasury thinks about health financing. Spending must justify itself. Investments must deliver returns. And inefficiency is no longer just a technical issue but a fiscal problem.
Ggoobi’s worldview is shaped by the idea that Uganda’s long-term growth ambitions under Vision 2040, which is 13 years away, to achieve what he describes as a tenfold expansion to a $500 billion economy, will be decided not just by infrastructure or industry but by the quality of its human capital.
Globally, he notes, human capital accounts for the bulk of national wealth. Health, therefore, is not peripheral to development. It is central to it.
If health is an investment, then it must generate returns. If it does not, then something in the system is not working. “Every shilling must buy measurable economic and social returns,” he said.
This is where the optimism gives way to unease. Countries that have achieved and sustained middle-income status did so through deliberate, sustained, evidence-driven investments in human capital.
Uganda is working within tight fiscal limits. The national budget for 2025/26 stands at Shs 72.38 trillion, with about Shs 5.87 trillion going to health.
Government spending on health has increased over time, rising from about Shs 2.8 trillion a few years ago to Shs 4.4 trillion today. But even with this growth, spending per person is still low, around $50 a year, less than half of what is often needed to provide basic health services.
Not all the money is used efficiently. Global estimates suggest that weak systems, poor coordination, and procurement challenges can cause up to a third of health spending to be lost.
According to Dr. Ggoobi, Uganda has made notable progress in strengthening its health system, driven by sustained public investment. Life expectancy has risen from about 50 years in 2000 to approximately 68.8 years in 2024, an increase of over 18 years. Access to services has also improved significantly, with about 91 percent of Ugandans now living within five kilometres of a health facility, while income poverty has declined from 24.5 percent in 2010 to 16 percent.
On the service delivery side, the government has introduced the malaria vaccine for children under five and rolled out electronic medical records across national and regional referral hospitals. Strategic investments have also been made, including 16 high-capacity oxygen plants, three regional blood banks, CT scan equipment in 14 of 16 regional referral hospitals, and 20 digital X-ray machines in general hospitals, with remaining gaps expected to be closed in the next budget. Together, he noted, these efforts demonstrate that sustained investment in health is yielding tangible results.
Beneath that progress, Dr. Ggoobi sees a health financing structure that is fundamentally unstable, noting that external partners still finance as much as 40–45 percent of health expenditure. Government contributes about 22 percent, household’s 31 percent, and insurance remains marginal at less than five percent. This balance, Ggoobi argues, is dangerous. It leaves the system exposed to shocks from outside while pushing risk onto those least able to bear it.
But the issue that troubles him most is government inefficiency. His priorities are to increase and protect domestic health financing, mobilise long-term capital, and improve efficiency.
“We are wasteful even with the little we have. Procurement is a major problem—many fights in government are not about mandate but about procurement. That is why we are moving all entities onto an electronic procurement system to improve transparency, reduce leakage, and ensure accountability,” said Dr. Ggoobi.
The government has enrolled 38 entities on the electronic procurement system. Full adoption is expected by mid-2026.
If you have good audits and we implement their recommendations, then we can expect positive outcomes. Number two is e-government, reducing human contact where it is not necessary. Unless you’re a doctor, you have to examine someone. Why do you have to sit in a hotel to discuss procurement? Humans must get out of discussing procurement. That’s why we are building the eGP and reviewing the procurement law. We are going back to the cabinet; we are going to remove human beings who are not necessary in the chain of procurement,” said Ggoobi.
Across the discussion, one issue drew near-unanimous agreement that prevention remains underfunded.
The Ministry of Health’s position, delivered through John Kauta, the Commissioner in charge of Health Information, Statistics, Monitoring, and Evaluation, is unequivocal that “the cheapest disease to treat is the one we prevent.”
Yet Uganda still spends more on treating illness than preventing it. Freddie Ssengooba, a Professor of Health Economics and Health Systems Management, MakSPH, highlighted malaria as a case study, both costly and preventable, while others pointed to rising non-communicable diseases driven by lifestyle factors.
This imbalance has fiscal consequences. Preventable diseases generate recurrent costs, crowding out other investments and reinforcing the cycle of inefficiency.
Mak Chancellor Hon. Dr. Crispus Kiyonga pushed the debate toward geography and access, citing that while Uganda’s health system was originally designed to follow administrative structures, the ambition to reach every village was never fully realised.
“We must plan based on what we can sustainably afford. We cannot import another country’s system. But where shall we save the majority of our people? It is in the villages. That is where children miss school due to illness. Where young girls drop out due to a lack of basic support, like pads. So, we must choose: given limited resources, what system gives the greatest impact? When the Minister of Health asks for a CT scan—something people travel to Nairobi for—that is important. But in the village, a child needs an antimalarial. The choice is between a CT scan and basic treatment. These are tough decisions,” says Dr. Kiyonga.
While the country is “highly indebted” and resources are limited, the level of care that Uganda can realistically provide to its citizens should borrow from China’s early pragmatic reforms of universal access first and quality later, according to the Chancellor.
“You cannot deliver health from a distance,” he said, arguing for a renewed focus on community-level access.
The Chancellor also strongly supported a shift from tertiary care to primary care. From Mulago National Referral and reducing its congestion to the village by investing in lower health facilities.
He urged the government ministries of Finance and Health to strongly collaborate with academic institutions to improve their work. “This dialogue should not be a one-off. It must be continuous. Makerere must engage the government with well-costed, risk-weighted proposals. We should build structured collaboration between universities and government so that research informs policy, and we reduce reliance on expensive foreign consultants. There is valuable research here,” said Dr. Kiyonga.
Taken together, the dialogue revealed a country’s health system in transition, from scarcity to expansion but not yet to performance.
As Ms. Jane Kyarisiima Mwesiga, Deputy Head of Public Service (Service Delivery), Office of the Prime Minister, framed it, the next phase must move “from expansion to performance, from inputs to outcomes, from financing to public value.”
But the path forward remains contested. Should Uganda prioritise insurance or direct public provision? Prevention or specialised care? Infrastructure or functionality?
The answers lie not in choosing but in sequencing, something Uganda has historically struggled to do.
Dr. Ian Clarke, a Physician, philanthropist, entrepreneur, and Chairman of Clarke Group Companies, speaking while representing the Private Sector during the dialogue, spoke emotionally on national health insurance, whose discussion has been ongoing for close to 20 years, but with minimal progress.
“We have had studies and proposals, but many were rightly rejected because they were not practical. You cannot design a National Health Insurance scheme that looks like private insurance. There is simply not enough money in Uganda—or anywhere—to sustain that. We still think in silos: public sector and private sector. Then we ask, how do we support the private sector? There are many ways—but as has been emphasized, we must focus on prevention and equity, especially in rural areas.”
For Ssengooba, while insurance is important and long-term, its implementation needs to be phased. He called for more investments in the health sector as the first line of insurance for citizens. He also called on the government to partner with institutions such as the National Social Security Fund (NSSF), which already have systems, capacity, and reach in place to support health investments. “If we leverage institutions like NSSF—for collection, for pooling resources—we can make progress. During COVID, they demonstrated that they can support national priorities. So, we should think about how to leverage what already exists,” he says.
Stephen Omojong of the National Social Security Fund highlighted an untapped opportunity. The Fund currently manages about Shs 30 trillion in assets, with millions of contributors.
This pool, he argued, could support health financing either through insurance-linked products or long-term investment vehicles. His example of a voluntary savings scheme now has 68,000 participants and Shs. 114 billion mobilised in a year, suggesting that behavioural barriers may be less rigid than often assumed.
Makerere University Vice Chancellor, Professor Barnabas Nawangwe, framed the dialogue as more than an academic exercise, describing it as a call to action. He urged the government to tap into the University’s research capacity to inform strategic investments, noting that “health research constitutes more than 50% of all research at Makerere University,” with institutions like the School of Public Health and the Infectious Diseases Institute playing a central role.
He referred to their national impact—from supporting over 20% of Uganda’s HIV patients to operating in more than 90 districts—and emphasised that Makerere brings in over one trillion shillings annually in research income. “When you fund Makerere University,” he said, “you should understand that we are not a net consumer—we are a net producer for the country.”
Taken together, the dialogue revealed a system in transition from expansion to performance, from spending to results. Uganda is no longer short of ideas, nor entirely short of resources. The real test is execution.
Whether the country can turn health spending into measurable outcomes will determine not just the future of its health system but the credibility of its economic ambitions.
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