Health
Global Conversations: Climate Change Multiplies Health Risks, A Call to Action on Extreme Weather Effects
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.
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.”
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.”
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.
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.
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.
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.
“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.
On 27th November 2025 the Makerere University Infectious Diseases Institute (IDI) unveiled the second cohort of fellows—marking a significant step forward in strengthening global health security across the region. The cohort brings together five exceptional emerging scientists whose research areas reflect the continent’s most urgent health priorities. They include Mr. Dickson Aruhomukama in Antimicrobial Resistance (AMR); Dr. Rodgers Ayebare in Case Management, Infection Prevention and Control; Mr. Julius Okwir in Epidemic Intelligence and Community Health; Dr. Robert Zavuga in Vaccines and Medical Counter Measures; and Ms. Phionah Tushabe in Planetary Health, Water, Sanitation and Hygiene (WASH). Their selection marks a new chapter in nurturing homegrown expertise capable of safeguarding Africa’s health systems for generations to come.
The Acting Vice Chancellor, Prof. Sarah Ssali while presiding over the event emphasized the significance of launching the Sewankambo Training Program for Global Health Security as a milestone not only for IDI but for Makerere University and the continent at large. She highlighted the urgency of strengthening Africa’s capacity to predict, prevent, and respond to emerging epidemics, noting the rapid rise in zoonotic disease outbreaks and the persistent weaknesses exposed by crises like Ebola and COVID-19. She celebrated the legacy of Prof. Nelson Sewankambo and the scholars shaped by his leadership, stressing that the program embodies the university’s commitment to producing transformative health leaders grounded in multidisciplinary expertise and One Health principles.
She also called for stronger collaboration across colleges—particularly with the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB)’s Center for Biosecurity and the College of Health Sciences (CHS) to ensure that scarce scientific resources are fully utilized and that future health professionals are prepared for an evolving global landscape. In closing, she reaffirmed Makerere University’s dedication to advancing research excellence, nurturing responsible stewardship, and upholding the values that define the Sewankambo legacy.
The Academic Registrar Prof. Buyinza Mukadasi also conveyed his heartfelt congratulations to IDI and Prof. Nelson Sewankambo upon this remarkable milestone. He reflected on his recent engagements with the Institute—most notably the launch of the African Centre of Excellence in Bioinformatics—and expressed his admiration for the world-class research emerging from IDI, including publications in leading journals such as The Lancet and Nature. He noted that Makerere takes great pride in IDI’s work across multiple initiatives, from THRiVE to ongoing research collaborations, and wished the newly launched fellows a rewarding and impactful journey in research.
The Deputy Principal CHS, Prof. Richard Idro congratulated the new cohort and welcomed them into what he fondly referred to as “the cookhouse,” where future scientific leaders are shaped. Drawing from his own formative encounters with Prof. Nelson Sewankambo, he reflected on the deep mentorship culture that has defined generations of clinicians and researchers at Makerere—sharing stories of being challenged, supported, and pushed toward excellence. He reminded the fellows that their research will influence health policy and clinical practice far beyond individual patients, carrying long-term implications for national and global health.
Prof. Idro also acknowledged the critical challenges facing clinical disciplines, especially the constraints of promotion pathways that disadvantage highly skilled specialists without PhDs. He appealed for reforms to safeguard the future of key fields like anesthesia and surgery. Closing his remarks, he celebrated the College’s 100-year legacy, expressed gratitude for the university’s continued support, and invited alumni and partners to contribute ideas that will shape the next century of innovation, training, and service.
Dr. Charles Olaro, the Director General of Health Services, highlighted the essential role of academia in strengthening Uganda’s global health security, noting how recent outbreaks—from COVID-19 to Ebola—have revealed both the country’s progress and remaining gaps. He emphasized that programs like the Sewankambo Training Program are vital for building resilient health systems, advancing research, and shaping policies that can respond swiftly and effectively to public health threats.
Reflecting on the strong collaboration between the Ministry of Health and institutions such as Makerere University and IDI, he pointed out how research emerging from academia continually informs national policy, including work presented at recent conferences on non-communicable diseases and community health. Dr. Olaro congratulated the new cohort, reminding them that their work carries significant responsibility, as their research and leadership will influence health outcomes far beyond individual clinical care. He also underscored the need for stronger regional capacity, improved emergency response systems, and sustained mentorship to ensure that communities across Uganda—and the region—benefit from timely, coordinated outbreak preparedness.
In his address, Prof. Nelson Sewankambo commended the achievements of the first cohort and challenged the new fellows to uphold—and even surpass—the high standards already set. Reflecting on the rigorous selection process, he reminded the cohort that they were chosen because they demonstrated exceptional promise in a highly competitive field. He noted that the launch of this program comes at a particularly critical moment, as Africa CDC has just established a new Division for Health Security and Sovereignty, even as global financing for health research continues to decline. This, he said, makes the commitment to sustaining the program both bold and necessary.
Prof. Sewankambo also addressed concerns about the future of clinical scholars at Makerere, arguing that rigid promotion policies risk driving away talented specialists who are vital to the university’s mission. Emphasizing that “it is wise people who change direction when it is necessary,” he urged university leadership to protect pathways that allow clinicians to grow, serve, and undertake PhDs without being pushed out of the system. His message underscored both the responsibility carried by the new fellows and the collective duty to safeguard the future of medical education and research.
Dr. Andrew Kambugu, Executive Director (ED) of IDI, warmly welcomed all guests and reflected on the Institute’s long-standing culture of adaptation and innovation in response to Africa’s evolving health challenges. He celebrated the presence of Prof. Nelson Sewankambo—honoring his legacy as a founder, mentor, and active research collaborator—and acknowledged the strength of Cohort One as a living example of what the program can produce.
The ED emphasized that the Sewankambo Program stands on three pillars: rigorous selection, structured support with clear accountability, and strong alignment with national health priorities. He reminded the new fellows that IDI itself was born from the principle “adapt or perish,” and urged them to carry forward that spirit as they confront emerging threats like antimicrobial resistance and disease outbreaks across the continent. He also reflected on the power of mentorship, sharing personal experiences that illustrated how deeply mentorship can shape a scientific career. In closing, he expressed confidence that the five new fellows will honor the name they bear and continue building a legacy that inspires future generations.
Prof. Harriet Mayanja-Kizza reminded the newly selected fellows that while this achievement is significant, it marks only the beginning of a demanding but deeply meaningful journey. She expressed pride in the diversity of the cohort—drawn from ten African countries—and noted with delight that one of the brightest candidates emerged from the smallest country represented.
Reflecting on the evolution of impactful careers, she encouraged young people to embrace emerging fields such as bioinformatics, biotechnology, AI, molecular biology, and biostatistics, which she believes will define the future of science and global health. Prof. Mayanja spoke passionately about the diseases the fellows will tackle, highlighting the severe threat of antimicrobial resistance, the persistent burden of malaria, the dangers of resurfacing viral infections, and the transformative power of immunization. She urged the fellows to stay grounded, stay committed, and embrace the modern, data-driven tools now shaping global health research. In closing, she celebrated their potential to make a global impact and welcomed them formally into a field where their work will shape healthier futures for generations to come.
Prof. Ponsiano Ochama, one of the pioneers from the first cohort, reflected on the journey of the Sewankambo clinical scholarship from its early days in the “cookhouse” to the strong, structured program it has become. He recounted how the scholarship began as a mentorship-driven initiative aimed at nurturing future researchers and how sustained advocacy eventually removed barriers that once limited clinical scholars’ progression.
Prof. Ochama shared the impactful work he and his colleagues have since undertaken—highlighting, for example, a national study on hepatitis B mother-to-child transmission that shaped recent Ministry of Health policy. He encouraged the incoming cohort to embrace the program fully, assuring them that the “cookhouse” experience will transform them into strong, skilled scientists whose work will influence health policy and improve lives across the country.
Dr. Byonanebye Dathan, Deputy Head of the Global Health Security Department, outlined the strong rationale behind the Sewankambo Global Health Security Program, noting Africa’s rising burden of zoonotic and viral hemorrhagic fevers and the continent’s limited capacity for early detection and response. He emphasized that despite competing health priorities—HIV, TB, malaria, maternal health—there remain significant gaps in surveillance systems, workforce capacity, and research preparedness.
The program, he said, is designed to fill these gaps by strengthening research training, developing a skilled outbreak response workforce, and building a network of experts across Africa capable of generating evidence that directly informs policy and improves health systems. Dr. Dathan highlighted the rigorous selection process, the program’s alignment with WHO and national public health frameworks, and its integration of emerging technologies such as AI and machine learning. He affirmed that the fellows will receive structured mentorship, leadership development, and hands-on experience using existing data and real-world outbreak response systems—ensuring that their work leads not only to publications, but to meaningful impact across the continent.
Dr. Francis Kakooza, Acting Head of Global Health Security, traced the remarkable evolution of IDI’s Global Health Security work over the past decade, from its early CDC-funded surveillance efforts in 2015 to its expansion into biosecurity, AMR, epidemic research, policy development, and regional outbreak support. He highlighted IDI’s role in major national initiatives—including COVID-19 response, vaccination rollouts, risk management, lab accreditation, and the establishment of Regional Emergency Operations Centers—as well as its growing continental footprint through partnerships with Africa CDC, Mastercard Foundation, and Resolve to Save Lives.
Dr. Kakooza emphasized that the launch of the Prof. Nelson Sewankambo Global Health Security PhD Program is the culmination of years of investment in strengthening African research capacity and supporting fellows whose work is already shaping policy. He expressed gratitude to all partners, mentors, and leaders who contributed to the program’s development, acknowledged the rigorous selection that yielded five fellows from ten countries, and reaffirmed IDI’s commitment to nurturing a new generation of scientists equipped to protect the continent from infectious disease threats.
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