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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

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MakSPH Environmental Health Graduates Trained to Prevent Disease at Its Source

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Bushirah Nakulima a Bachelor of Environmental Health Science (BEHS) student who will be graduating with a CGPA of 4.58 on February 25, 2026 looks at a transcript. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.

In most health systems, attention turns to illness after it appears in clinics and hospitals. Environmental Health works earlier, often invisibly, by preventing disease before treatment becomes necessary. At Makerere University School of Public Health (MakSPH), this preventive philosophy shapes the training of students learning to manage health risks at their source, through sanitation systems, safer environments, community engagement, and evidence-based public health action.

This year, as MakSPH presents 29 graduands approved by the Makerere University Senate for the award of the Bachelor of Environmental Health Science (BEHS) degree, four outstanding students graduate with first-class honours. Their journeys, shaped by different personal histories and professional ambitions, provide a clear view of how the School prepares practitioners whose work begins long before patients reach health facilities. Through academic training, field practice, research exposure, and leadership experience, the programme equips graduates to address the environmental and social conditions that determine health outcomes across communities.

The BEHS 2022 class. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
The BEHS 2022 class.

Environmental health occupies a distinctive position within public health practice. Rather than focusing primarily on diagnosis or treatment, practitioners work at the intersection of science, policy, and society, addressing risks linked to water and sanitation, food safety, occupational health, climate change, and urbanisation. The discipline demands technical competence alongside communication, systems thinking, and community engagement, capabilities that increasingly define modern public health leadership.

The journeys of Nakulima Bushirah, graduating with a CGPA of 4.58 on February 25, 2026, Mujurani Alphersiiru with 4.44, and Cherop Eric with 4.41, alongside Phillip Acaye, the cohort’s overall best student with a CGPA of 4.63, demonstrate how MakSPH shapes students from varied beginnings into professionals grounded in prevention. Their paths reveal a shared formation that links classroom learning with real-world health challenges and prepares graduates to prevent disease before it occurs.

Bushirah Nakulima’s Turn Toward Prevention

Bushirah Nakulima, February 2026. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Bushirah Nakulima, February 2026.

For Bushirah Nakulima, environmental health began during a period of uncertainty. The COVID-19 pandemic repeatedly disrupted her Bachelor of Pharmacy studies at Kampala International University, prompting reflection about the kind of health professional she wanted to become. A conversation with a family friend working in preventive health introduced an alternative path, one focused not on treating illness after onset but on preventing it altogether.

“When I applied to Makerere University in 2022, I was considering two career paths,” she recalled. “I prayed to Allah to guide me toward the best one. When I was admitted to the Bachelor of Environmental Health Science, I accepted it wholeheartedly, and I came to appreciate it even more as I studied.”

Her academic foundation had already demonstrated consistency. She progressed from Melody Junior School in Nansana, where she obtained aggregate eight in 2010, to Shuhada’e Islamic School in Nyamitanga, completing O-Level with 25 aggregates in 2016 and A-Level with 10 points in 2018. Pharmacy initially appeared the logical continuation, yet environmental health offered something broader in scale and impact.

“Environmental Health offered an opportunity to prevent illness and suffering before it occurs,” she explained. “It allows a single intervention, such as WASH or health education, to protect many people at once, and it provides flexibility to work across diverse environments. It offered freedom to operate in various settings, which truly connects with my personality since I love exploration.”

At MakSPH, classroom concepts quickly translated into practice. During her internship at Mukono Municipal Council, she conducted school health education sessions, participated in inspections of markets and abattoirs, and engaged communities facing sanitation challenges. Field exposure deepened her understanding of how environmental conditions directly shape disease patterns, reinforcing prevention as both a scientific and social responsibility.

Leadership further expanded her training. Serving as the 90th Female Guild Representative Councillor (GRC), she represented the School of Public Health in the Student Guild structure, facilitating engagement between students and School leadership on academic and welfare matters. The role strengthened her capacity for representation, negotiation, and collaborative problem-solving, skills central to public health practice, where advocacy and systems engagement are inseparable from technical expertise.

Graduating with a CGPA of 4.58, Bushirah’s research examined roadside vendors’ exposure to air pollution in Kampala, reflecting growing concern about occupational and urban environmental risks. She now plans to pursue advanced training in public health, building on MakSPH’s emphasis on evidence-driven and community-centred practice.

Cherop Eric’s Return to the Classroom

Eric Cherop, February 2026. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Eric Cherop, February 2026.

Eric Cherop’s journey into environmental health began not in lecture halls but in community service. Raised in Kapchorwa District, he was shaped by economic hardship and resilience, experiences that informed his commitment to community well-being.

He completed his Primary Leaving Examinations at Chema Primary School, a Universal Primary Education institution, attaining 24 aggregates in 2008. He later joined Sipi Secondary School, where he obtained 37 aggregates at Uganda Certificate of Education in 2012 and continued at the same school for A-Level, earning 8 points at Uganda Advanced Certificate of Education in 2014.

After earning a Diploma in environmental health sciences from Mbale School of Hygiene between 2015 and 2017, he entered public service as an Environmental Health Officer and Community Field Facilitator with Kapchorwa District Local Government. His work included sanitation campaigns, climate resilience initiatives, nutrition education, and household behaviour change programmes. Over time, field experience revealed the limits of practice without deeper theoretical grounding.

“I wanted to understand not only what works in communities, but why it works,” he explains. Enrolling in the BEHS programme at MakSPH in 2022 allowed him to connect practical experience with analytical training. Coursework strengthened competencies in environmental risk assessment, participatory engagement, and data-driven planning. Mentorship reshaped how he interpreted evidence.

“My lecturers helped me move beyond seeing data as numbers,” he said. “I learned to see it as evidence that guides decisions and improves accountability.” Graduating with a CGPA of 4.41, Eric now aims to advance evidence-driven leadership at the intersection of climate change, nutrition, and environmental health, ensuring interventions remain grounded in community realities.

Mujurani Alphersiiru’s Path into Environmental Health

Mujurani Alphersiiru, February 2026. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Mujurani Alphersiiru, February 2026.

For Mujurani Alphersiiru, Environmental Health arrived at an unexpected moment, when his academic future appeared uncertain. Financial pressures had begun to threaten the continuation of his Bachelor of Nursing Science studies at Kampala International University Western Campus, raising the real possibility that his university education might end prematurely. The turning point came when the government district quota admission list was released, offering him placement at Makerere University under Bunyangabu District and opening an alternative academic pathway he had not previously considered.

At the time, environmental health was unfamiliar to him. “I didn’t know what environmental health was,” he recalls. “But I celebrated because I had reached my dream university.” Orientation sessions and early coursework gradually reframed that uncertainty, revealing a discipline grounded in prevention, systems thinking, and public health policy. What began as an unexpected opportunity soon developed into a clear professional direction.

Serving as class president and 90th Male GRC for the School with Nakulima Bushirah, Mujurani organised student activities, mobilised community outreach initiatives, and advocated for improved learning environments. Balancing leadership responsibilities with academic performance required deliberate discipline and time management.

His educational foundation began at St. Augustine Butiiti Demonstration Primary School in Kyenjojo, where he scored 12 aggregates in 2014. He later attended Pride Secondary School in Mityana, attaining 25 aggregates at O-Level in 2018, before proceeding to Kibiito Secondary School in Bunyangabu, where he obtained 13 points at A-Level in 2021, performance that earned him government sponsorship for university education. At MakSPH, faculty mentorship further strengthened both his academic rigour and commitment to public service.

“Government sponsorship meant responsibility,” Mujurani said. “I had to plan my time carefully while remaining active in school programmes.” Graduating with a CGPA of 4.44, his interests now centre on governance and accountability within health systems, particularly strengthening the implementation of public health policies.

Training Prevention Professionals

Taken together, the three journeys demonstrate how MakSPH’s Environmental Health training converts diverse personal backgrounds into a shared professional orientation centred on prevention. Through interdisciplinary coursework, field placements, research mentorship, and leadership opportunities, students develop competencies that extend beyond technical knowledge to include systems thinking and public engagement.

BEHS 2025 graduates. January 2025. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
BEHS 2025 graduates. January 2025.

The BEHS programme, established in 2000 within MakSPH’s Department of Disease Control and Environmental Health, remains the School’s only undergraduate degree and has trained more than 1,000 graduates who now serve across government institutions, non-governmental organisations, academia, and international health programmes. Its continued evolution reflects growing recognition that strengthening health systems requires professionals capable of addressing environmental risks before illness occurs.

The achievements of this year’s graduates, therefore, represent more than academic distinction. They reflect a model of training designed to prepare professionals whose work reduces the need for treatment by preventing disease at its source, reinforcing MakSPH’s role in shaping Uganda’s environmental health workforce.

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John Okeya

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Philliph Acaye and the Making of Uganda’s Environmental Health Workforce

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Philliph Acaye, ahead of Makerere University’s 76th Graduation Ceremony scheduled for 24-27 February 2026. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.

As Makerere University School of Public Health (MakSPH) presents 29 graduands on February 25, 2026, at Makerere University’s 76th Graduation Ceremony, for the conferment of the Bachelor of Environmental Health Science (BEHS) degree, the journey of the cohort’s best student provides a compelling window into both individual resilience and institutional impact. Philliph Acaye, graduating with a CGPA of 4.63, represents more than academic distinction. His story reflects the lived realities that shape many public health professionals in Uganda and shows how rigorous training can transform experience into leadership within health systems.

On the left, Prof. Rhoda Wanyenze, MakSPH Dean, presents Bachelor of Environmental Health Science graduands, who look on in anticipation during Makerere University’s 75th Graduation Ceremony in January 2025. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
On the left, Prof. Rhoda Wanyenze, MakSPH Dean, presents Bachelor of Environmental Health Science graduands, who look on in anticipation during Makerere University’s 75th Graduation Ceremony in January 2025.

Education Shaped by Conflict

Acaye was born on October 2, 1993, in Wangduku Village, Palenga Parish, Pajule Sub-County, Pader District in northern Uganda, a region deeply affected by the Lord’s Resistance Army (LRA) insurgency in the early 2000s, where education and security often existed in constant tension. As a child, schooling unfolded alongside displacement and uncertainty, conditions that shaped an entire generation growing up during the conflict.

“Around 2002, before we had fully moved into the IDP camps, we often ran with our parents whenever there were LRA attacks,” he recalls. “But on several occasions, they caught us unaware. During one of the attacks, they abducted me and moved with me for close to seven kilometres, from Wangduku to Pajule Trading Centre in Pader. At first, they said I was too young to be moved with. I was around nine or ten years old. Later, I understood that someone among them personally knew my father and did not want me taken, so he used my age as the reason, and they left me behind.”

Children and families walk at dusk in northern Uganda during the height of the LRA insurgency in 2004, when many travelled nightly to safer shelters to avoid abduction, a reality that shaped the childhood of a generation, including graduates like Philliph Acaye. Photo Credit: UNICEF/Chulho Hyun. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Children and families walk at dusk in northern Uganda during the height of the LRA insurgency in 2004, when many travelled nightly to safer shelters to avoid abduction, a reality that shaped the childhood of a generation, including graduates like Philliph Acaye. Photo Credit: UNICEF/Chulho Hyun.

He narrates that several relatives and neighbours, including some of his childhood friends, were not spared, among them an uncle whose whereabouts remain unknown to this day. “If they had gone with me,” Acaye reflects quietly, “I could be dead, or I might not have studied.” The remark sits deep and places his graduation in context, not simply as personal success, but as the outcome of persistence through years when conflict repeatedly disrupted education across northern Uganda.

Between 2002 and 2006, his schooling continued inside Pajule Internally Displaced Persons (IDP) Camp, where families lived in overcrowded settlements and depended largely on relief food. Learning environments were unstable, teachers travelled under risk, and lessons were frequently interrupted by insecurity. Even within the camps, attacks remained possible. Education progressed slowly, but it continued, sustained by families and teachers who insisted that schooling remained essential despite uncertainty.

When communities gradually returned home, Acaye rebuilt his academic track record step by step. He completed Primary Leaving Examinations in 2007 with an aggregate of 19 and was the best pupil at Wangduku Primary School, at a time when enrolment remained low because many families feared returning to villages. He proceeded to Pajule Senior Secondary School, completing O-Level in 2011 with 31 aggregates, and later obtained 10 points at A-Level in 2013 from Kitgum High School. 

However, his progression was shaped by consistent recovery after disruption, supported by relatives, teachers, community mentors, and educational assistance from Invisible Children, a post-LRA conflict recovery NGO led locally by Ms. Laker Jolly Okot, which supported his A-Level education.

Professional direction emerged during his training at the Mbale School of Hygiene, where he pursued a Diploma in Environmental Health Science from 2014 to 2016 and graduated with a strong CGPA of 4.4. The diploma opened immediate employment opportunities in community and humanitarian health settings back home, followed by service in local government. Today, he works as a Health Inspector in Kitgum District Local Government, implementing sanitation monitoring, infection prevention activities, and community health interventions. Practical experience strengthened his understanding of public health challenges but also revealed limits in technical depth that he felt required further training.

Training the Public Health Professional

His admission to MakSPH in 2022 through the government diploma-entry sponsorship scheme represented a deliberate academic decision rather than a career reset. He sought broader analytical skills and a stronger grounding in environmental health systems, particularly in areas of surveillance, planning, and evidence-based decision-making.

“I realised some technical aspects were not fully covered at the diploma level. I wanted to understand public health beyond implementation and learn how decisions are justified scientifically,” Acaye explained.

76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Philliph Acaye supporting COVID-19 screening at Tikao Prison Farm in Orom Sub-County, Kitgum District, in 2022, part of his frontline public health work as a Health Inspector during the pandemic response.

The sponsorship, he observed, transformed that ambition into possibility and remains central to how he understands his academic journey at Makerere University. “I am grateful to the Makerere University selection committee, the MakSPH selection committee, and the Government of Uganda for this opportunity. Opportunities like this are not guaranteed, and I recognise the trust placed in me to undertake and complete the three-year BEHS programme.”

The transition into university study was not seamless, though. His admission had come earlier than planned, and he began coursework without formal study leave while still tied to workplace obligations in Kitgum. Sustained support from district leadership, particularly Dr. Okello Henry Otto, the District Health Officer, eventually enabled him to secure study leave and concentrate fully on academic work. Now with stability came rapid academic improvement, supported by peer learning, faculty mentorship, and a strong curriculum that emphasised analytical reasoning alongside applied practice.

Acaye attributes his transformation to the programme’s academic culture rather than individual brilliance. “The programme helped me realise that what I was doing before was only a surface understanding,” he argued. “I learned to approach public health more deeply.” Exposure to research methods, he revealed, reshaped how he interpreted field experience and encouraged him to submit an abstract to an international academic conference, marking his transition from practitioner to emerging researcher.

For Mr. Abdallah Ali Halage, the MakSPH Coordinator of the BEHS programme, such outcomes reflect intentional design rather than coincidence. He noted that student success is rooted in a training philosophy that combines technical instruction with professional discipline from the moment students enter the programme. According to him, orientation focuses not only on coursework but also on expectations of conduct, independence, and responsibility. “When students join, we brief them on how seriously they must approach their academic journey,” he said. “That grounding helps shape their performance over time.”

Mr. Abdallah Ali Halage, MakSPH Coordinator of the Bachelor of Environmental Health Science programme, delivers remarks during the Heavy Metal project Dissemination Workshop at MakSPH on June 26, 2025. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Mr. Abdallah Ali Halage, MakSPH Coordinator of the Bachelor of Environmental Health Science programme, delivers remarks during the Heavy Metal project Dissemination Workshop at MakSPH on June 26, 2025.

Mr. Halage argued that while some high-performing students enter through diploma schemes, achievement ultimately depends on commitment and effort rather than background. He cited Acaye’s consistent curiosity and self-motivation as defining traits, noting that strong academic results tend to follow students who actively engage with the learning process.

“I congratulate Philliph and his colleagues upon attaining first-class honours and performing very well academically. Philliph has been hardworking and self-motivated. He has consistently shown a strong interest in his studies, and that commitment has helped him achieve this result. He has been a very good student,” Mr. Halage attested.

He added that the achievement reflects a broader culture within the programme. “Our students are disciplined and independent. Their commitment, together with support from the School management, the College and University leadership, has contributed greatly to their success.”

MakSPH Dean Prof. Rhoda Wanyenze and former Deputy Dean Prof. Elizeus Rutebemberwa join faculty and staff in welcoming incoming students during a MakSPH student orientation on 15 August 2025, reflecting the School’s strong culture of mentorship and academic support that shapes student success. 76th Graduation vMakSPH Dean Prof. Rhoda Wanyenze and former Deputy Dean Prof. Elizeus Rutebemberwa join faculty and staff in welcoming incoming students during a MakSPH student orientation on 15 August 2025, reflecting the School’s strong culture of mentorship and academic support that shapes student success. Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
MakSPH Dean Prof. Rhoda Wanyenze and former Deputy Dean Prof. Elizeus Rutebemberwa join faculty and staff in welcoming incoming students during a MakSPH student orientation on 15 August 2025, reflecting the School’s strong culture of mentorship and academic support that shapes student success.

From Individual Achievement to Institutional Impact

The broader significance of Acaye’s achievement becomes clearer when placed within the evolution of the BEHS programme itself. Established in 2000 within MakSPH’s Department of Disease Control and Environmental Health (DCEH), the programme remains the School’s sole undergraduate degree and was among the earliest environmental health bachelor’s programmes in East Africa. In more than two decades, it has produced over 1,000 graduates, expanding professional capacity beyond diploma-level training and strengthening Uganda and the region’s environmental health workforce across government, non-governmental organisations, educational institutions, and points of entry such as airports and border services.

Mr. Halage explained that the programme helped redefine career pathways within the government of Uganda’s public service structures by introducing degree-level expertise into environmental health roles. Graduates now serve as Environmental Health Officers, Senior Environmental Health Officers, and technical specialists contributing to policy implementation and service delivery across multiple sectors. The academic pathway has also expanded vertically, with postgraduate training opportunities at MakSPH currently enabling graduates to progress into research, teaching, and doctoral-level specialisation, ensuring continuity within the discipline.

Philliph Acaye conducts stream water pollution testing during field training in Kasangati in 2023, applying environmental health surveillance skills central to the Bachelor of Environmental Health Science programme at MakSPH. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Philliph Acaye conducts stream water pollution testing during field training in Kasangati in 2023, applying environmental health surveillance skills central to the Bachelor of Environmental Health Science programme at MakSPH.

A Programme Shaping Regional Practice

The reputation of Makerere University’s Bachelor of Environmental Health Science programme is also increasingly influencing regional institutions. During a strategic benchmarking visit to MakSPH on July 30, 2025, Dr. Ratib Dricile, Dean of the Faculty of Health Sciences at Muni University, described the School of Public Health as a reference point for universities seeking to strengthen environmental health training in the region.

The main reason the delegation visited Makerere University School of Public Health was that Muni University remains a young and growing institution located in north-western Uganda along the borders with the Democratic Republic of Congo and South Sudan, where porous borders contribute to frequent cross-border diseases, many of which are preventable through strong environmental health approaches, Dr. Dricile explained.

Dr. Ratib Dricile (third right), Dean of the Faculty of Health Sciences at Muni University, together with the Muni University delegation, during a benchmarking visit to MakSPH on July 30, 2025, to learn from the School’s Environmental Health training model. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Dr. Ratib Dricile (third right), Dean of the Faculty of Health Sciences at Muni University, together with the Muni University delegation, during a benchmarking visit to MakSPH on July 30, 2025, to learn from the School’s Environmental Health training model.

Makerere University, with over 100 years of institutional experience and 25 years running the Environmental Health programme, was the right place for us to benchmark, particularly in curriculum design, course content, programme structure, and implementation,” he said. “We were impressed by the work being implemented and gained more than we initially expected. By integrating these experiences, we believe the Muni University curriculum can become even stronger. The collaboration will allow us to adopt innovations built on Makerere’s long experience, and we believe that working together with Makerere University will strengthen Muni University institutionally and contribute positively to our university’s growth and ranking.”

It is within this institutional tradition, built over decades of training environmental health professionals across Uganda and the region, that Philliph Acaye’s achievement takes meaning. For him, graduating top of the class remains grounded in practical purpose rather than prestige. He views a first-class degree as an opportunity rather than an endpoint. Recalling guidance from his lecturers, he said strong academic results can open doors but must be followed by demonstrated competence. “A first class helps you get shortlisted,” he said. “After that, you must prove yourself.”

Philliph Acaye (back row) with classmates from the Bachelor of Environmental Health Science programme at MakSPH during their undergraduate training as part of the 2022 intake cohort. 76th Graduation Ceremony, Day 2, School of Public Health Bachelor of Environmental Health Science (BEHS) degree profiles, Philliph Acaye, 25th February 2026, Freedom Square, Makerere University, Kampala Uganda, East Africa.
Philliph Acaye (back row) with classmates from the Bachelor of Environmental Health Science programme at MakSPH during their undergraduate training as part of the 2022 intake cohort.

His immediate plans reflect that perspective. He is currently pursuing additional training in Health Services Management at Gulu College of Health Sciences while preparing for postgraduate study in either public health or environmental and occupational health. At the same time, he continues supporting pupils in his community and plans to mobilise resources to provide sanitary pads for girls at his former primary school, an initiative he believes will help reduce school dropout rates in rural areas.

Acaye’s journey, from disrupted schooling in an IDP camp to graduating top of MakSPH’s BEHS programme for the 2022 cohort, reflects the deeper purpose of public health education. As MakSPH presents its newest cohort for graduation this week, his story demonstrates how the programme turns lived experience into professional capacity, strengthening communities and health systems across Uganda and the region, one graduate at a time.

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John Okeya

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Makerere University School of Public Health Graduates First Cohort of Cost-Effectiveness Analysis Short Course

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Makerere University School of Public Health Graduates First Cohort of Cost-Effectiveness Analysis Short Course. Photo: ImageFX

Kampala, Uganda – The Makerere University School of Public Health (MakSPH) has marked a significant milestone with the graduation of the first-ever cohort of its Cost-Effectiveness Analysis (CEA) Short Course. The pioneering programme is designed to strengthen capacity in economic evaluation in Uganda and beyond.

The virtual graduation ceremony honored eleven (11) participants who completed the course. The cohort included professionals from academia, research institutions, government agencies, and non-state actors, reflecting the increasing demand for skills in economic evaluation across sectors.

The short course was developed and implemented by the Department of Health Policy, Planning, and Management (HPPM) in response to the increasing need for evidence-informed decision-making in a context of limited resources.

In her remarks during the ceremony, Assoc. Prof. Suzanne Kiwanuka, Head of the Department of Health Policy, Planning and Management (HPPM) at MakSPH, congratulated the inaugural cohort for completing what she described as a “critical and timely” course.

“With decreasing resources and rising demand for services driven by population growth and the emergence of high-cost technologies, decision-makers must make difficult choices,” she noted. “Cost-effectiveness analysis is no longer optional. It is central to conversations in the corridors of power.”

The CEA short course was designed to equip policymakers, researchers, and practitioners with both theoretical knowledge and practical skills in economic evaluation. Participants were introduced to key principles of health economics, costing methodologies, decision-analytic modelling, Markov modelling, sensitivity analysis, and interpretation of incremental cost-effectiveness ratios (ICERs).

According to Prof. Elizabeth Ekirapa, the course lead at MakSPH, this inaugural offering had been “a long time coming,” following years of discussions within the department about building local expertise in economic evaluation.

Delivered over 10 days through interactive online sessions, the course combined lectures, case studies, and hands-on modelling exercises using contextually relevant datasets. Participants were required to develop and present applied cost-effectiveness projects as part of their assessment, allowing them to translate theory into practice.

A certificate of completion awarded to one of the participants.
A certificate of completion awarded to one of the participants.

During the feedback session at the graduation ceremony, faculty emphasized the importance of clarity in defining study perspectives, selecting appropriate outcomes, and aligning research questions with modelling approaches.

Dr. Chrispus Mayora, one of the facilitators, highlighted the need to carefully select outcomes that directly reflect the intervention being evaluated. “When thinking about outcomes, ask yourself: Is this aligned with what I want to study? Interesting outcomes are not always the most appropriate ones,” he advised.

Participants were also encouraged to select modelling techniques such as decision trees or Markov models based on the research question and the nature of the disease or intervention under study.

Prof. Ekirapa described the graduates as “trailblazers,” noting that their feedback would shape future iterations of the course. “When you are the first cohort, you are like pioneers,” she remarked. “We are committed to improving this course to ensure it becomes a world-class programme.”

For many attendees, the graduation ceremony was a new experience, as certificates were awarded virtually an approach that participants welcomed as innovative and inclusive.

“Cost-effectiveness analysis enables us to maximise value for money,” noted Dr. Crispus Mayora of MakSPH. “It allows decision-makers to compare interventions systematically and ensure that limited resources achieve the greatest possible benefit.”

The programme aligns with Makerere University’s broader mandate to provide high-quality training that responds to national and regional development priorities. Participants who successfully complete the course receive a certificate signed by the Dean of the School of Public Health.

As the ceremony concluded, faculty encouraged continued engagement beyond the classroom. Graduates were urged to refine their project ideas and collaborate with the department in advancing research and policy discussions.

The successful completion of the first CEA short course marks an important step in building a cadre of professionals equipped to conduct rigorous economic evaluations. With plans to expand and refine the programme based on participant feedback, the HPPM department under MakSPH is positioning itself as a regional leader in health economics and policy analysis training.

Mak Editor

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