Health
Dr. Nanyeenya Nicholus Hopes to Guide Uganda’s HIV Response with Research
Clad in a coral red and black with green panels sewed into the front facings doctorate gown with emblems and ivory tower icons, Dr. Nicholus Nanyeenya can’t help, but, smile broadly as he fastens the long oblong sleeves. At last, his journey has come to an end, and he now holds a PhD. The vibrant colours form an indelible embroidery, weaving together the distinctive identity and essence of Makerere University.
A medical doctor by training, he has not only achieved a milestone but has emerged as a leader in the fight against HIV/AIDS in Uganda. He is part of the 132 PhD graduands in the week-long #Mak74thGrad, which begins on Monday, January 29, 2024.
Dr. Nanyeenya, popular in the corridors of Makerere University School of Public Health, as, ‘His Excellency,’ having served as a PhD Forum president studied; “Viral Non-Suppression, Perceptions and Effectiveness of Intensive Adherence Counselling among People Living with HIV/AIDS on Antiretroviral Therapy with Low-Level Viraemia in Uganda.”
From MD to PhD
Dr. Nanyeenya’s passion for research began with a Master’s in Public Health (MPH) at the University of Aberdeen, UK back in 2018. Witnessing the critical role research played in health system decisions, he set his sights on a PhD at Makerere University, determined to impact HIV/AIDS policies in Uganda.
“I realized the importance of research in informing policy decisions in health systems strengthening and disease control. I noticed that at times, wrong implementation strategies were done in implementing HIV programs due to inadequate research skills, and this motivated me to start my PhD.
My goal was to generate information about HIV low-level viraemia to guide the review of the HIV guidelines in Uganda. In my PhD, I aimed to enhance my research, writing, and communication skills, to enable me to become an independent researcher and global health leader in HIV research and program implementation,” says Dr. Nanyeenya.
Previously in Uganda, individuals with a viral load (VL) below 1,000 copies/ml were considered to have effectively suppressed the virus, commended for antiretroviral adherence, and encouraged to continue treatment.
However, studies elsewhere identified a significant risk for those with low-level viraemia (≥50 to <1,000 copies/ml), including the potential for HIV drug resistance and transmission to partners, especially in discordant couples.
Despite an increase from 11 percent to 35 percent in Uganda between 2017 and 2020, using a 1,000 copies/ml threshold, no interventions were implemented to address this concerning trend.
It is this situation that motivated Dr. Nanyeenya to undertake a PhD research, to generate more information to address low-level viraemia in Uganda.
Low-Level Viraemia in HIV Patients
His study revealed a surge in individuals with low-level viraemia (LLV), posing risks of drug resistance and transmission. This alarming trend prompted a swift response, influencing the revision of Uganda’s HIV guidelines.
“From my PhD research, the number of People Living with HIV (PLHIV) with LLV in Uganda increased from 2.0% in 2016 to 8.6% in 2020. LLV was associated with being male, second line regimen and being below 18 years of age. Relative to clients with a non-detectable viral load, PLHIV with LLV had 4.1 times higher risk of developing viral non-suppression, as compared to PLHIV with a non-detectable viral load (adjusted hazard ratio was 4.1, 95% CI: 3.7 to 4.7, p < 0.001),” he notes.
According to Dr. Nanyeenya, most people living with HIV were not aware of low-level viraemia, leading to a limited understanding of its associated risks. He adds that, healthcare workers providing HIV care exhibited insufficient knowledge about LLV, resulting in a lack of formal adherence counselling for LLV management.
In the intervention study, intensive adherence counselling (IAC) demonstrated a significant impact, with the intervention arm achieving a nearly twofold increase in attaining a non-detectable viral load status of 57.4 percent compared to the non-intervention arm which was at 29.9 percent.
His findings prompted a significant policy shift, lowering the viral suppression threshold. The Ministry of Health has also implemented IAC for those with 50 to <1,000 copies/ml.
“As already highlighted, these findings have already partly guided the review of the HIV guidelines in Uganda, changing the viral load suppression threshold for plasma and dried blood spot samples respectively. Ministry of Health in Uganda has also instituted IAC as intervention to manage people living with HIV having at least 50 but less than 1,000 copies/ml,” comfortably says.
Mentorship
In his PhD journey, Dr. Nanyeenya found strength in mentorship, both from his distinguished supervisors and fellow PhD colleagues. He benefited from a multi-disciplinary team of four dedicated supervisors (Prof. Fredrick Makumbi, Prof. Noah Kiwanuka, Prof. Nakanjako Damalie, and Dr. Gertrude Nakigozi) who, armed with extensive expertise in his research field, guided him through various aspects of doctoral research. He also received valuable mentorship from Dr. Simon Peter Kibira, Dr. Susan Nabadda, Prof. Larry Chang, Dr. Kigozi Godfrey, Dr. Siu Godfrey, Dr. Fred Nalugoda, Prof. Anne Katahoire, and others.
“The most impactful aspect of my PhD journey was the land marking mentorship. This mentorship was both from my mentors who comprised of my supervisors and other experienced researchers from the field of HIV research. Peer mentorship from my fellow colleagues in the PhD Forum was also very key in enabling me to handle the entire PhD process,” he says.
The department’s head, Dr. Joan Mutyoba, also played a fundamental role, ensuring every detail of the journey was attended to.
“Dr. Joan Mutyoba, who would literally follow up on every single detail to ensure that we get the necessary assistance to progress. However, I should confess that there was still many moments of crying and distress in the three years journey, however through prayer and consultative meetings with the supervisors, fellow PhD colleagues and the head of department, most of these were overcame and that is why, I am graduating,” Dr. Nanyeenya.
Completing a PhD in a record less than 3 years
Completing his PhD in less than three years, Dr. Nanyeenya emphasizes the importance of swift action. He advises aspiring PhD candidates to persevere through challenges, knowing that the victory is worth the effort. His mantra is clear: “Once you make up your mind to start a PhD, fast track it and complete it!”
Choosing a field for a Ph.D. that aligns with one’s understanding and prior work experience is crucial. “My decision to pursue a Ph.D. in HIV low-level viraemia, a field linked to HIV viral load testing, aligns with my professional background. As an international consultant strengthening HIV systems and a programs officer at CPHL, I’ve accumulated extensive experience in this area. This expertise proved invaluable in overcoming challenges related to my research topic during my Ph.D. studies,” he says.
Looking ahead, Dr. Nanyeenya envisions becoming a global health leader, implementing evidence-based interventions to combat diseases in Uganda and beyond. His message echoes a profound truth: to control HIV and uplift Uganda, “We must love our country and fellow Ugandans.”
“I have worked as a consultant on health systems strengthening. This role has given me the opportunity to work with diverse communities in various developing countries, where I have witnessed many health challenges, characterized by many diseases of poverty and high mortality rates from rather preventable causes. My experience in the developed world has exposed me to the benefits of evidence-based interventions in promoting health and controlling diseases,” he says.
Dr. Nanyeenya Nicholus is not just graduating; he’s setting a course for a healthier, more resilient Uganda. His dedication to research, mentorship, and swift action exemplifies the transformative power of one individual committed to making a difference.
The study was funded by Rakai Health Service Program PhD Fogarty Training Scholarship, UJMT Fogarty Global Health Fellowship and Mak-BSSR program, and Makerere University Research and Innovation Fund (MakRIF).
The Makerere University College of Health Sciences (MakCHS) on July 10, 2026, welcomed senior six science students from Ngora High School and Wiggins Secondary School to an inspiring Career Fair aimed at guiding them on careers in health sciences and introducing them to the wide range of academic programmes offered by the College.
The event brought together students pursuing Physics, Chemistry, Biology (PCB) and Biology, Chemistry, Mathematics (BCM), providing them with a unique opportunity to interact with the College leadership, tour laboratories and teaching facilities, and learn first-hand about careers in medicine and other health science disciplines.
Welcoming the students, the College Principal, Prof. Bruce Kirenga, described the College of Health Sciences as one of Africa’s oldest and most distinguished medical schools, with a legacy spanning more than a century.
“We started in 1924, making us one of the oldest medical schools on the continent. You have made the right decision to visit Makerere, and we are delighted to welcome you,” he said.
Prof. Kirenga commended the school administrators and teachers for organizing the visit, noting that exposing learners to university environments early helps them make informed career choices. He explained that the College introduced the Open Day concept after receiving numerous requests from schools seeking career guidance visits.
He congratulated the students for choosing science subjects, describing science as the foundation for solving society’s most pressing challenges.
“You have already made one of the most important decisions by choosing to become scientists. Even more importantly, you have chosen life sciences—a field dedicated to preserving and improving life,” he remarked.
The Principal emphasized that careers in life sciences extend far beyond medicine, encouraging students to remain open-minded as they consider their future.
“Everything that has life requires professionals to keep it healthy—from human beings and animals to crops and the environment. The opportunities are immense, including agriculture, veterinary medicine, biomedical sciences, public health and many other emerging fields.”
He also advised students not to limit themselves to only one academic programme during university applications, recalling instances where highly qualified students narrowly missed admission because they selected only one course.
“Remain open to the opportunities available. Medicine is an excellent profession, but there are many other programmes that are equally rewarding and are shaping the future of healthcare and scientific innovation,” he said.
Prof. Kirenga further encouraged the students to embrace lifelong learning, reminding them that scientific knowledge remains valuable regardless of the career path they eventually pursue.
Addressing the students, the Dean of the School of Medicine, Prof. Annette Nakimuli, acknowledged the growing competition for admission into medical programmes and urged learners to work hard while keeping an open mind about the diverse opportunities available within health sciences.
She explained that admission into the Bachelor of Medicine and Bachelor of Surgery (MBChB) programme has become increasingly competitive due to the rising number of high-performing applicants.
“This year we witnessed unprecedented competition for government sponsorship, with many applicants scoring triple A at Advanced Level and outstanding grades at Ordinary Level. That tells you that you must prepare yourselves to excel academically,” she said.
Prof. Nakimuli noted that while many students aspire to become medical doctors, the health sector today offers numerous innovative programmes that are equally important.
“There are many programmes that parents, teachers and students are still not familiar with. Biomedical Engineering, for example, is one of the exciting fields driving the future of healthcare, yet many students overlook it because they focus only on medicine.”
She encouraged students to explore emerging disciplines that combine medicine, engineering, technology and research, noting that the future of healthcare increasingly depends on multidisciplinary professionals.
The Dean also introduced students to the structure of the School of Medicine, explaining that it comprises twelve academic departments and two specialised units covering a broad spectrum of clinical disciplines, including Internal Medicine, Surgery, Obstetrics and Gynaecology, Orthopaedics, Ophthalmology, Ear, Nose and Throat (ENT), Family Medicine, Anaesthesia and Critical Care, among others.
She explained that students are trained by specialists across these disciplines to become competent general practitioners before pursuing further specialization.
Prof. Erisa Mwaka, the Chair of the Department of Human Anatomy, shared with the students about the School of Biomedical Sciences (SBS). He said the school is one of the four schools that make up the Makerere University College of Health Sciences (MakCHS). As the foundation of medical education, the School provides students with a comprehensive understanding of the biological and molecular sciences that underpin modern healthcare, disease prevention, diagnosis and treatment.
The School comprises several departments, including:
- Human Anatomy
- Biochemistry
- Physiology
- Pharmacology and Therapeutics
- Pathology
- Microbiology
- Medical Illustration
The School offers undergraduate programmes such as the Bachelor of Science in Biomedical Sciences, which equips students with strong laboratory, research and analytical skills, and the Bachelor of Science in Biomedical Engineering, an interdisciplinary programme that integrates engineering, medicine and technology to develop innovative healthcare solutions.
At postgraduate level, the School offers a wide range of master’s and doctoral programmes, including Human Anatomy, Physiology, Pharmacology, Bioinformatics, Immunology and Clinical Microbiology, Health Bioethics, Medical Illustration, Pathology and other biomedical specializations that prepare graduates for careers in research, academia, diagnostics, biotechnology and the pharmaceutical industry. The school also offers a wide range of diploma courses.
Throughout the Career Fair, students interacted with faculty members, toured laboratories and learning facilities, and received guidance on university admission, academic programmes and career prospects within the health sciences.
The Career Fair forms part of the College’s broader outreach programme aimed at nurturing the next generation of healthcare professionals by exposing learners to university life and equipping them with the information needed to make informed academic and career decisions.
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