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Global Conversations: Climate Change Multiplies Health Risks, A Call to Action on Extreme Weather Effects

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By Davidson Ndyabahika, Johanna Blomgren and Julius T. Mugaga

Experts have urged urgent action to mitigate the health risks of climate change. The 2023 global conversation, on Climate Change and Health highlighted the need for transformational action in every sector to protect people’s health from climate change.

Held on September 5, 2023 the virtual seminar, organized by the Centre of Excellence for Sustainable Health (CESH), a collaboration between Makerere University and the Karolinska Institutet that aims to increase capacity and spur action to advance the agenda for sustainable health drew over 230 attendees from all over the world. It placed emphasis on mitigating the effects of extreme weather, such flooding.

A more recent research study by CESH defines Sustainable health as a multisectoral area for study, research, and practice towards improving health and well-being for all while staying within planetary boundaries.

In its 2023 report, the Intergovernmental Panel on Climate Change (IPCC) notes that global terrestrial, freshwater, and ocean ecosystems have already been affected by climate change, along with the associated losses and costs. It predicts that heavy rainfall and flooding events are expected to worsen and occur more frequently in the majority of regions of Africa, Asia, North America, and Europe by 1.5°C global warming (high confidence).

The 2023 IPCC report identifies barriers that prevent people and society from implementing climate-resilient behaviors. Financial limitations, conflicts with the SDGs, inequalities, institutional, economic, and social hurdles, as well as dispersed strategies, are a few of these. The panel equally agree that if global warming exceeds 1.5 °C and the SDGs are not adequately progressed, chances for climate-resilient development would be considerably more limited.

Now, during the seminar, the panel, by consensus agreed that climate change is critical citing that such conversations on critical factors in relation to the climate and health crisis are not only timely but necessary.

Climate change impacts the social determinants of health, which include excellent health and wellbeing, by causing decreased food output, low fishing yields, flooding, and infrastructure damage, according to Daniel Helldén, a PhD student at KI Department of Global Public Health.

“The future emission scenarios are dire. What is becoming more and more clear is that climate change is a generational issue. Children born today will continue to bear the biggest burden of climate change impact,” said Helldén.

Dr. Mugume Isaac Amooti, the Director of Weather Forecasting Services at the Uganda National Meteorological Authority (UNMA), emphasized the importance of considering both long-term averages and unprecedented weather events driven by climate change. These events are thought extreme only when they exceed past records. He noted for instance that in Uganda; “The widespread flooding brought on by heavy and frequent precipitation is what we are seeing in Uganda, particularly in the cities. However, we are witnessing heat waves and cold waves at different times of the year.”

A profile of panelist, Dr. Mugume Isaac Amooti, Director, Weather Forecasting Services, Uganda National Meteorological Authority (UNMA).
A profile of panelist, Dr. Mugume Isaac Amooti, Director, Weather Forecasting Services, Uganda National Meteorological Authority (UNMA).

Although there isn’t a clear pattern in Sweden’s precipitation, Dr. Johanna Sörensen of Lund University in Sweden said that forecasts suggest that rainfall may increase by the end of the century. Given the flooding problems that already present, this, she says is something to worry about. “Flooding is increasing not only because of climate change but also even more that we construct the cities more densely and we construct buildings and industries on lowly areas that we used not to do in the past which is of course not a good idea.”

A profile of panelist, Dr. Johanna Sörensen, Associate Senior Lecturer, Division of Water Resources Engineering, Faculty of Engineering (LTH), Lund University, Sweden.
A profile of panelist, Dr. Johanna Sörensen, Associate Senior Lecturer, Division of Water Resources Engineering, Faculty of Engineering (LTH), Lund University, Sweden.

Dr. Tamer Rabie, a lead health specialist at the World Bank Group, notes that risks are amplified by climate change, which therefore has an intensified negative impact. He points out, for instance, that in order to comprehend how climate change and changes in temperature and precipitation patterns will affect health, it is critical to view climate change as a risk multiplier.

A profile of Dr. Tamer Samah Rabie, Lead Health Specialist, World Bank's Health, Nutrition, and Population Global Practice.
A profile of Dr. Tamer Samah Rabie, Lead Health Specialist, World Bank’s Health, Nutrition, and Population Global Practice.

Dr. Tamer, also the architect of the World Bank’s global Health-Climate and Environment Program (H-CEP), underscored three pathways through which climate change impacts health: direct effects, indirect effects, and those mediated by ecosystems. Some of the direct pathways include issues like increased temperatures likely to lead to heat waves, heat-related illnesses, worsened non-communicable diseases, and increase in the risk of events like traumatic injuries.

According to Dr. Tamer, ecosystem-mediated risks include vector-borne diseases (like Malaria and Dengue), foodborne illnesses, and waterborne diseases (like Cholera). These risks are closely tied to how health outcomes are influenced by the ecosystem. Additionally, indirect health impacts encompass mental health due to population displacements, as well as malnutrition resulting from shifts in food production and overall food systems.

“We have done estimates in the World Bank that show that extreme weather events and climate change will lead to pushing nearly 132 million people into extreme poverty by 2030. If you look at the health impacts within those figures and the main drivers, we are seeing that nearly 44 million out of those 132 will be pushed into extreme poverty by 2030 if we don’t take any action today,” Dr. Tamer.

According to Dr. Tamer, the World Bank has conducted climate and health vulnerability assessments specifically looking at the cost of inaction moving into the 2030s and 2050s using information that relates to malaria, dengue, diarrhea, stunting in children, heat related illnesses, floods, among others.

“What we are seeing is that on average, countries will be losing anywhere between 1-5% of their GDP as a result of not really addressing the climate crisis, not being able to address these impacts that we are talking about, and obviously not investing enough into the health systems to be able to be more resilient,” Dr. Tamer noted during the webinar.

According to Dr. Sara Gabrielsson, an Associate Senior Lecturer in Sustainability Science at Lund University’s Centre for Sustainability Studies (LUCSUS), addressing immediate health risks involves containing flooding, which is just one aspect of climate change-related challenges like sea level rise and drought.

A profile of Dr. Sara Gabrielsson, Lecturer and Researcher, Lund University Centre for Sustainability Studies (LUCSUS).
A profile of Dr. Sara Gabrielsson, Lecturer and Researcher, Lund University Centre for Sustainability Studies (LUCSUS).

She highlights the connection between various deadly diseases like dengue, typhoid, trachoma, and cholera among others to this issue. During a crisis like flooding, treatment for these diseases she notes often takes a backseat due to the overwhelming health burdens that arise.

“There is death from drowning or direct injury from debris in these very storm surges, but then we also have the issue of just water sitting, waiting in water for longer periods, leading to lots of infections, urine-tract infections, vaginal infections, skin diseases, hypothermia, lots of those kinds of things, but also vector-borne diseases, and especially malaria, which is, of course, one big thing here,” Dr. Gabrielsson opines.

She adds that flooding brings problems like contaminated drinking water, leading to chronic diarrhea and malnutrition. Additionally, damaged sanitation facilities force people into open defecation, exposing them to harmful bacteria and further risk of chronic diarrhea.

“These immediate health risks are just the beginning. Moving into long-term risks, flooding severely impacts the availability of clean water for basic hygiene. As we’ve learned from COVID, hygiene is paramount for health. Insufficient handwashing and personal hygiene can breed disease. We need proper hygiene for preparing food, tending to babies, managing menstrual health, and more. Without it, there’s increased exposure to harmful bacteria, compounded by the use of inadequate sanitation systems, resulting in outbreaks of various diseases,” observed Gabrielsson.

Way forward

Dr. Sörensen, from a Swedish standpoint, proposes proactive steps to mitigate flooding. These include slowing down water flow, discouraging construction in flood-prone zones, and avoiding building in areas prone to heavy rain. She points out that in cities like Mumbai and Gothenburg, there has been a concerning trend of construction in flood-prone regions. Dr. Sörensen emphasizes the importance of adapting solutions for creating greener, more sustainable cities. “In China, they call it a sponge city. It’s like a sponge—you fill it up with water during rainfall and then use it later for various purposes. Utilizing vegetation and water storage helps retain water and slow down its flow in urban areas. Green spaces in cities are crucial for health, well-being, and providing shade, especially during heatwaves,” she says.

Dr. Johanna Sörensen.
Dr. Johanna Sörensen.

In Uganda, Dr. Mugume notes that the government has invested in weather monitoring infrastructure, including the three weather radars, which are strategically spread across the country to enable UNMA to monitor weather at any part of the country.

“With this technology, we can now offer more precise and timely services, ensuring our communities respond effectively. Weather and climate forecasts range from hourly to seasonal projections. Shorter forecasts tend to be more accurate, although longer ones still fall within manageable limits. For instance, our seasonal forecast accuracy in Uganda is at 90%, aligning with National Development Plan 3. We collaborate with development partners to fine-tune these forecasts.”

For Dr. Gabrielsson, preparedness is key, especially for the 2.2 billion people worldwide relying on sanitation systems, many of whom live in rapidly urbanizing areas and unplanned settlements.

Unfortunately, these systems often lack proper management, leading to health risks. In urban settings, she says, the spread of sludge from these systems can have widespread health implications. To address this, there’s a pressing need to prioritize climate-resilient sanitation systems. Historically, the sanitation sector has been under-prioritized, resulting in insufficient funding and political attention. Without a one-size-fits-all solution due to diverse living habits, cultural considerations become paramount. A gender-responsive approach is crucial, as women are primarily responsible for WASH (Water, Sanitation, and Hygiene) practices.

Dr. Sara Gabrielsson.
Dr. Sara Gabrielsson.

“It involves recognizing the unique needs of different groups, such as refugees, the elderly, disabled individuals, children, and menstruating individuals. Climate-resilient wash infrastructure requires community responsibility, government policy, and financial support. For instance, in flood-prone areas like the Amazon Basin, sanitation facilities are designed to align with local livelihoods, incorporating features like composting latrines that produce manure for farming and collecting rainwater for handwashing. This approach ensures environmental safety and sustainable practices,” she observes.

Dr. Gabrielsson emphasizes the importance of cultural acceptance in encouraging people’s dedication to upholding basic sanitation and hygiene practices, particularly in the face of flooding. “Another example I presented is a UNICEF-supported toilet in Bangladesh. It’s elevated with precast concrete rings to prevent flooding, sealed with concrete mortar for contamination prevention, and reinforced to withstand heavy rain and wind. This design was developed in close consultation with local communities, ensuring cultural acceptance and affordability. The goal is to create facilities that people actually want to use, which is why it’s crucial to integrate natural and social sciences for effective solutions.”

The World Bank has substantially supported action on climate change, including both adaptation and mitigation initiatives. Dr. Tamer says over $2.2 billion has been set aside as of today for climate-related health interventions, especially in South Asia and sub-Saharan Africa. Significant assistance has also been given to assist tiny island states in managing the effects of climate change, particularly extreme events.

In Yemen, the World Bank has sponsored efforts to put in place electronic early warning systems for real-time health data and policy response due to outbreaks of diseases including cholera and malaria. In Madagascar, the World Bank has funded work combining climate and nutrition programming.  The World Bank worked with the government of Ghana to create long-lasting vaccine delivery networks.

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Davidson Ndyabahika

Health

MakSPH METS 2024 Annual Report

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Cover image of the MakSPH METS 2024 Annual Report featuring The U.S. Ambassador to Uganda, H.E. William W. Popp, Minister of Health, Hon. Dr. Jane Ruth Aceng and other officials. Photo: METS. Makerere University School of Public Health (MakSPH), Monitoring and Evaluation Technical Support (METS) Program, Kampala Uganda, East Africa.

I am pleased to present our annual report. Throughout the past year, MakSPH-METS Program has remained steadfast in its mission to strengthen Uganda’s capacity for HIV and TB programming through strengthening robust health information systems, surveillance, and quality improvement initiatives.

MakSPH leverages its team of expertise in public health to guide program strategies, strengthen national capacity for data collection, analysis, and use. The innovations developed are solutions for health system challenges and they generate evidence that can be used to inform policy and practice.

MakSPH-METS provides technical support to MoH, RRHs, implementing partners at different health system levels.

Our collaborative approach, working closely with the Government of Uganda and various stakeholders, has enabled us to make significant strides in building sustainable health information systems and improvingthe quality of healthcare delivery. The achievements highlighted in this report reflect our commitment to strengthen health systems through development and implementation of innovative and impactful evidence- based solutions.

As we look to the future, I am confident that the METS Program will continue to play a pivotal role in strengthening Uganda’s health systems through several initiatives.

  1. Operationalising a sustainability plan through transitioning of the developed innovations to the Ministry of Health for ownership.
  2. Disease outbreak management will be strengthened through continued capacity building for emergency response and optimization of existing integrated disease surveillance systems. The field teams will facilitate seamless coordination across health system levels to build sustainable and resilient health systems capable of effectively responding to public health emergencies.
  3. Lastly, we continue to strengthen collaboration with government, enhance coordination with implementing partners and promoting integration of health services.

Our dedicated team of professionals, combined with the unwavering support from our partners and stakeholders, positions us well to address emerging health challenges and advance our nation’s public health goals. The innovative solutions and capacity-building initiatives highlighted in this report demonstrate not only our progress but also our potential for greater impact in the years ahead.

Professor Rhoda Wanyenze
Dean – School of Publc Health, Makerere University

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KeyScope Project Job Advert: Junior Research Fellow

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Part of the team at the Makerere University Biomedical Engineering Unit under the Department of Physiology, College of Health Sciences (CHS), Kampala Uganda, East Africa.

Background

Makerere University Biomedical Engineering Unit under the Department of Physiology is glad to advertise for positions under its new Project ‘KeyScope Project: The Key to Sustainable Cancer Diagnosis and Treatment in Uganda.”

Laparoscopic surgery is considered as the standard of care for cancer treatment in high-income countries. However, this technology is rarely accessible to LMICs due to the high cost of installment, lack of maintenance personnel, unreliable electricity, and shortage of consumable supplies. To address these concerns, a unique multidisciplinary collaboration between engineers, surgeons, oncologists, and business experts from Duke University, Makerere University, Uganda Cancer Institute and University of Maryland joined efforts to develop a low-cost, durable laparoscopic system (KeySuite) for use in resource- constrained environments.

Our aims are aligned to demonstrating the local capacity to manufacture, acquire local and international regulatory approval, determine clinical performance and distribute/sell the KeyScope to the local market. Specifically, we shall improve the current design and determine the local capacity to manufacture the device, establish the clinical safety and acceptability of the product, and obtain regulatory approval from local and international accredited bodies.

Position: Junior Research Fellow

Reports to: Project Coordinator

Engagement: Full time

Duration: 1 year renewable upon satisfactory performance

Duty Station: Kampala

Roles and responsibilities

As a trainee, a Junior Research Fellow will closely work with a research team to undergo training design, manufacturing and validation of the KeyScope. This is a non-degree/no-credit training opportunity that will prepare the successful candidate for advanced studies and future industry work in an upcoming medical technology sector of Uganda and Africa at large.

Specifically the Fellow will;

  1. Participate in the local construction of the KeyScope through material assessment and selection, developing a product manufacturing plan, and carrying out an impact assessment.
  2. Aid in the establishment of clinical safety and acceptability of the KeyScope through the use of a feasibility study to secure approvals, recruit patients and surgeons.
  3. Contribute to the process of attaining regulatory approval from a certified body for the KeyScope.
  4. Contribute to the development of a commercialization plan under training and mentorship of a Business Developer.
  5. Actively engage in project documentation, questionnaire and ethics protocol development, journal article writing and publication, report writing.
  6. Conduct key informant interviews, administer questionnaires, and verbatim transcription of interview recordings.
  7. Participate in data collection and analysis using digital and paper-based tools.
  8. Participate and contribute to teaching and student mentorship.
  9. Engage with the research partners and stakeholders.
  10. Any other activities as assigned by the Principal Investigator, and Project Coordinator (Immediate Supervisor) from time to time.

Qualifications:

  1. Completed a Bachelor’s Degree in Biomedical Engineering or any closely related field and at least awaiting graduation in not more than 6 months from an accredited University in Uganda.
  2. If completed, candidate must not have graduated more than 1 year ago.
  3. Academic qualifications of having attained or expecting at least expecting a second-class upper division degree.
  4. Experience in Human-Centered Design skills and Design Thinking will be highly considered.
  5. Prior experience in working with international multidisciplinary teams and organizations.
  6. Experience of previous work on laparoscopy is a plus.
  7. Evidence of prior interest for research, design, innovation and medical device manufacturing.
  8. Applicant should have a desire to work with different fabrication techniques.
  9. Ability to multitask and perform duties in learning environment with minimum supervision
  10. Excellent scientific writing skills and a good command of communication skills.

How to Apply:

All suitably qualified and interested candidates should submit a one-page cover letter, one-page writing sample, CV (maximum 3 pages) with relevant certificates, transcripts & two reference letters as a single digitally signed PDF file addressed to the Project PI and emailed to keyscopeu01@gmail.com by 17:00hours on 18th April 2025. Indicate, “KeyScope Project” in the subject line. Those awaiting graduation should send their most recent testimonials. Only shortlisted applicants will be contacted.

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Karolinska’s Department of Global Public Health Admins Visit MakSPH

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Therese Lind, Head of Administration at Karolinska Institutet (KI)’s Department of Global Public Health (3rd Right) with the delegation and staff from MakSPH during the visit on 24th March 2025. Makerere University School of Public Health (MakSPH) hosting delegation from Karolinska Institutet (KI) Department of Global Public Health led by Therese Lind, head of administration for a two-day administrative exchange, part of 25 years of a flourishing partnership, 23rd-24th March 2025, Kampala Uganda, East Africa.

Makerere University School of Public Health (MakSPH) is honored to host a distinguished delegation from Karolinska Institutet (KI) for a two-day administrative exchange, part of our 25 years of a flourishing partnership between Makerere University (Mak) and Karolinska Institutet.

Fostering Administrative Synergies

The visiting team, led by Therese Lind, head of administration at KI’s Department of Global Public Health, comprising HR specialist Sofia Öhlund-Fingal, Sonia Hammi, project manager, Kseniya Hartvigsson, communications officer CESH, and Anna Hansson, project manager, Grants Office—engaged in:

  • Discussions on research administration and financial management
  • Knowledge sharing on operational challenges and best practices
  • Exploring funding opportunities with major donors

The visit covered grants management, procurement, financial systems, and joint application strategies to enhance efficiency and academic exchanges. The team also toured key university facilities, including the historic Main Building, the state-of-the-art MakSPH auditorium, and the construction site, to witness the institution’s growth.

A Legacy of Collaboration

Since 2000, this partnership, Mak-KI, has yielded:

  • 49 PhD graduates through the Sida-supported doctoral program
  • Reciprocal exchanges benefiting 254 students and 153 faculty members
  • ⁣The Centre of Excellence for Sustainable Health, established during the pandemic

This visit reinforces our commitment to strengthening institutional capacity and driving impactful research. We extend our sincere appreciation to the KI team and look forward to continued collaboration.

Davidson Ndyabahika

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