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Dr. Nanyeenya Nicholus Hopes to Guide Uganda’s HIV Response with Research

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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.”

Dr. Nicholus Nanyeenya presents during his PhD Defense on Thursday, December 7, 2023. College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Nicholus Nanyeenya presents during his PhD Defense on Thursday, December 7, 2023.

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.

"By virtue of the authority entrusted in me, I confer up on you a degree of Doctor of Philosophy of Makerere University," these were exactly the words by the Chancellor as he conferred a PhD to Dr. Nicholas Nanyeeya. 74th Graduation Ceremony, Day 1, 29th January 2024, School of Public Health, College of Health Sciences (CHS), Freedom Square, Makerere University, Kampala Uganda, East Africa.
“By virtue of the authority entrusted in me, I confer up on you a degree of Doctor of Philosophy of Makerere University,” these were exactly the words by the Chancellor as he conferred a PhD to Dr. Nicholas Nanyeeya.

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.

Dr. Nicholus Nanyeenya at a PhD Colloquium at MakSPH in 2022. College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Nicholus Nanyeenya at a PhD Colloquium at MakSPH in 2022.

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.

Dr. Nanyeenya with MakSPH Faculty (L-R) Dr. Esther Buregyeya, Head, Disease Control and Environmental Health Department, Dr. Christine Nalwadda, Head, Community Health and Behavioral Sciences Department and Professor Christopher Garimoi Orach. 74th Graduation Ceremony, Day 1, 29th January 2024, School of Public Health, College of Health Sciences (CHS), Freedom Square, Makerere University, Kampala Uganda, East Africa.
Dr. Nanyeenya with MakSPH Faculty (L-R) Dr. Esther Buregyeya, Head, Disease Control and Environmental Health Department, Dr. Christine Nalwadda, Head, Community Health and Behavioral Sciences Department and Professor Christopher Garimoi Orach.

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.

Dr. Nicholus Nanyeenya with Dr. Juliet Babirye during a PhD Colloquium at MakSPH in 2022. College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Nicholus Nanyeenya with Dr. Juliet Babirye during a PhD Colloquium at MakSPH in 2022.

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.

Dr. Nicholus Nanyeenya cuts cake shortly after his PhD Defense on Thursday, December 7, 2023. College of Health Sciences, Makerere University, Kampala Uganda, East Africa.
Dr. Nicholus Nanyeenya cuts cake shortly after his PhD Defense on Thursday, December 7, 2023.

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).

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Davidson Ndyabahika

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The silent teachers: why body donation matters

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Assoc. Prof. Erisa Sabakaki Mwaka, Consultant Orthopaedic Surgeon and Chair, Department of Anatomy, College of Health Sciences (CHS). Makerere University, Kampala Uganda, East Africa.

By Assoc. Prof. Erisa Mwaka and Joyce Nabukalu-Kiwanuka

In every hospital, there is a moment when knowledge becomes a matter of life and death. A doctor must know where to place an incision, how to avoid damaging major organs, how to identify a nerve, how to deliver a baby safely, how to interpret a scan, or how to explain disease to a worried family. That knowledge does not begin in the operating theatre, it begins much earlier, in the anatomy laboratory.

For generations, the study of the human body has been the foundation of medical education. The regular use of human bodies for medical training purposes began in the late Middle Ages and spread during the 18th and 19th centuries. Initially, anatomists depended on gallows, poor houses, mental asylums, or jails as sources of bodies. However, the 1960s and 1970s saw the emergence of wilful body donation. Before students become doctors, surgeons, dentists, nurses, physiotherapists, radiographers, and other health professionals, they must first understand the human body in its real form. They must learn not only from books and diagrams, but from the body itself. This is why cadavers, though silent, remain the most important teachers in medical education. In simple terms, a cadaver is a dead human body used by health professions students to study anatomy; and Anatomy is the study of the physical structure and organization of the human body, both at macroscopic and microscopic levels.

As the Department of Anatomy at Makerere University College of Health Sciences  prepares to commemorate the “silent teachers” whose bodies are used for medical education on June 11, 2026,  Uganda is invited to reflect on a subject that is rarely discussed in the public domain, willed body donation. Body donation simply means a person willfully donates their body for educational purposes after death, and consent to it in life. This is a sensitive topic, but it is also a deeply human one. It touches our beliefs, families, culture, understanding of death, and responsibility to future generations.This commemoration ceremony is not symbolic but, it is a public statement that the contribution of silent teachers is sacred, educational, and deeply appreciated.

To donate one’s body after death is not an ordinary decision; it is an altruistic act of extraordinary generosity. It is a final gift to society. It allows health professions students to learn and appreciate the human body before they treat living patients. Cadavers are therefore not “specimens”, they are silent teachers and partners in medical education who continue to serve humanity even after death. Learning anatomy using a cadaver helps students to understand and appreciate the complexity of the human body, appreciate its natural variations, and develop the confidence and competence needed to serve the public. Students are also taught laboratory etiquette that emphasises dignity, empathy, and utmost respect for the cadavers, which attributes they carry into the clinical years when they interface with hospital patients.

In Uganda, where the demand for health workers continues to grow, medical education must be strengthened at every level. Our country needs well-trained doctors and health professionals who can serve in hospitals, health centres, universities, research institutions, and communities. But good training requires good teaching resources. One of these resources are the silent teachers who never complain, but impart immeasurable knowledge to future health professionals. Modern technology has introduced many useful tools into medical education. Students can now learn from videos, computer applications, digital images, plastic models, three-dimensional models, and virtual platforms. These tools are important and should be embraced, however, they cannot completely replace learning from the real human body. A cadaver teaches what a diagram cannot fully show; the true position of organs, the texture of tissues, the relationship between structures, and the natural differences that exist from one person to another. More importantly, cadaver-based learning teaches respect. It reminds students that medicine is not simply a technical profession, it is a calling rooted in human dignity. The first lesson students learn in the anatomy laboratory is that the body before them belonged to a person who had a name, a family, a story, and a life. That lesson shapes how they later treat patients.

Currently, most, if not all universities in Uganda, and similar settings in Africa use unclaimed bodies for learning Anatomy. The use of cadavers in Uganda is governed by the Penal Code (Anatomy Rules) of 1957 that permits public hospitals to transfer bodies unclaimed for at least 14 days to a medical training institution like Makerere University. Unfortunately, these cadavers are used without the consent of the deceased because most of them are unknown and with no known relatives to claim them. Many opponents to the use of unclaimed bodies opine that the practice is unethical. There is a global push toward ethical use of cadavers in medical education, where a person consents and bequeathes his/her body for medical education when still alive. For this practice to be sustainable, there is a need for a well regulated body donation program. Unfortunately, the concept of willful body donation is still not well understood by many people, and neither has it been a topic of public debate. Further, there are lots of myths surrounding death and dying in Africa, including Uganda that have hindered the establishment of successful body donation programs. Willingness to donate bodies for medical education is however, influenced by several factors including cultural and religious beliefs, respect for the dead and the need to fulfil burial rites, fear for mutilation and disrespect, to mention a few. These concerns are real and should not be dismissed. But they should be addressed with accurate information, openness, and utmost respect.

It is important to understand that body donation does not mean that a person is forgotten. On the contrary, it creates a legacy. A body donor may teach hundreds of future health professionals, in that way, one person’s final act of generosity can touch and save countless lives.  This is kind of patriotism is largely unkown in Uganda and we do not speak about enough. We often talk about serving our country through leadership, business, farming, teaching, parenting, or community service. But there is also service beyond life. Body donation is one way of saying: “Even when I am gone, let me contribute to the health of my people.”

Currently, Uganda now has more than 15 universities training medical students and the demand for cadavers for learning anatomy is on the rise. Actually, the supply of cadavers cannot fulfil the demand, and medical educationists need to find alternative source of cadavers. Wilful body donation is the answer. 

Uganda needs a national conversation on body donation. There is a need for deliberative public engagement involving various stakeholder including the public, religious and cultural leaders, civic leaders, the media, educationists, health professionals, medical training institutions, etc. 

This commemoration ceremony will involve inter-denominational prayers for the silent teachers, and a reflection of their contribution to healthcare in Uganda. We hope this ceremony will provoke public debate on a subject that is hitherto considered a taboo by many. We talked about some of these issues last year, in the first ever such ceremony in Uganda, and have received several requests for more information on the procedure for donating one’s body for teaching purposes upon death. Like President Obama’s said, “yes we can”, an the dialogue starts from you and me. You are all invited for the commemoration ceremony at 9.00 am on June 11, 2026, at the Makerere University School of Public Health auditorium on main campus. 

To donate one’s body is to give a final lesson, a final service, and a lasting gift to the nation.

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Makerere Health Services Guidance on Ebola Virus Disease (EVD)

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How to protect yourself and your loved ones from Ebola. Ministry of Health, Kampala Uganda, East Africa.

The Democratic Republic of Congo (DRC) and Uganda recently reported an outbreak of Ebola Virus Disease (EVD), which is a serious and often deadly disease caused by a person being infected by the Ebola virus.

The virus spreads through direct contact with body fluids such as blood, saliva, faeces, vomit, urine, sweat or genital fluids from a person who is infected with EVD.

The symptoms of EVD usually develop after 8 – 10 days from contact with an infected person and may include fatigue, high fever, headache, sore throat, muscle and joint pains, vomiting and diarrhea and in severe cases, bleeding.

What should we do as the Makerere University community?

The Chief, Makerere Health Services, Prof. J.K. Byamugisha advises as follows:

  1. Avoid unnecessary contact such as shaking hands, hugging etc.
  2. Place alcohol disinfectants or hand washing equipment at all entry points within the University and ensure everyone is using them.
  3. Students should sit in single-person chairs while in class, avoiding contact with their neighbours.
  4. Do not sit too close to one another especially in frequently crowded places such as classrooms, library or any other waiting area.
  5. While at the University Hospital, wash hands a the gate, use alcohol disinfectant at the reception.
  6. All patients should have a maximum of one caretaker – others can check on them by calling.
  7. Avoid bringing luggage to the University Hospital.
  8. Target to do as instructed by the health worker.
  9. For further information and guidance on Ebola, please call Dr. Charles Basigara on Tel: 0702 966652 and Sr. Eunice Namubiru on Tel: 0779 950978 (Contact persons for the University Health Services)

Additionally, always look out for and ensure full compliance with Ministry of Health (MoH) Infection Prevention and Control measures such as the one below.

How to protect yourself and your loved ones from Ebola. Ministry of Health, Kampala Uganda, East Africa.
How to protect yourself and your loved ones from Ebola.

How to report suspected Ebola cases to Health Authorities. Ministry of Health, Kampala Uganda, East Africa.
How to report suspected Ebola cases to Health Authorities.

Please find attached detailed communications from Prof. Byamugisha and
the Permanent Secretary Ministry of Health.

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Call for Applications: Masters Support in Self-Management Intervention for Reducing Epilepsy Burden

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An aerial photo of the College of Health Sciences (CHS), Makerere University showing Left to Right: The Sir Albert Cook Memorial Library, School of Biomedical Sciences, Davies Lecture Theatre, School of Public Health, Mulago Specialised Women and Neonatal Hospital (MSWNH)-Background Left and Nakasero Hill-Background Right, Kampala Uganda, East Africa.

The Makerere University College of Health Sciences and Case Western Reserve University, partnering with Mbarara University of Science and Technology, are implementing a five-year project titled “Self-management Intervention for Reducing Epilepsy Burden Among Adult Ugandans with Epilepsy.”

The program is funded by the National Institute of Health (NIH) and the National Institute of Neurological Disorders and Stroke (NINDS). One aspect of the program is to provide advanced degree training to qualified candidates interested in pursuing clinical and research careers in Epilepsy. We aim to grow epilepsy research capacity, including self-management approaches, in SSA.

The Project is soliciting applications for Master’s Research thesis support focusing on epilepsy-related research at Makerere University and Mbarara University, cohort 3, 2026/2027.

Selection criteria

  • Should be a Master’s student of the following courses: MMED in Internal Medicine, Paediatrics, Surgery and Neurosurgery, Psychiatry, Family Medicine, Public Health, Master of Health Services Research, MSc. Clinical Epidemiology and Biostatistics, Nursing, or a Master’s in the Basic Sciences (Physiology, Anatomy, Biochemistry, or any other related field).
  • Should have completed at least one year of their Master’s training in the courses listed above.
  • Demonstrated interest in Epilepsy and Neurological diseases, care and prevention, and commitment to develop and maintain a productive career, and devoted to Epilepsy, Clinical Practice, and Prevention.

Research Programs:

The following are the broad Epilepsy research priority areas (THEMES), and applicants are encouraged to develop research concepts in the areas of: Applicants are not limited to these themes; they can propose other areas.

  • The epidemiology of Epilepsy and associated risk factors.
  • Determining the factors affecting the quality of life, risk factors, and outcomes (mortality, morbidity) for Epilepsy, epilepsy genetics, and preventive measures among adults.
  • Epilepsy in childhood and its associated factors, preventative measures etc.
  • Epilepsy epidemiology and other Epilepsy related topics.
  • Epilepsy interventions and rehabilitation

In addition to a formal master’s program, trainees will receive training in bio-ethics, Good Clinical Practice, behavioral sciences research, data and statistical analysis, and research management.

The review criteria for applicants will be as follows:

·      Relevance to program objectives

  • Quality of research and research project approach
  • Feasibility of study
  • Mentors and mentoring plan; in your mentoring plan, please include who the mentors are, what training they will provide, and how often they propose to meet with the candidate.
  • Ethics and human subjects’ protection.

Application Process

Applicants should submit an application letter accompanied by a detailed curriculum vitae, two recommendation letters from Professional referees or mentors, and a 2-page concept or an approved full proposal describing your project and addressing Self-Management Intervention for Reducing Epilepsy Burden Among Adults or an epilepsy-related problem.

For more information, inquiries, and additional advice on developing concepts, don’t hesitate to get in touch with the following:

Makerere University College of Health Sciences

Prof. Mark Kaddumukasa:  kaddumark@yahoo.co.uk

Mbarara University

Ms. Josephine N Najjuma: najjumajosephine@yahoo.co.uk

Only short-listed candidates will be contacted for Interviews.

A soft copy should be submitted to the Administrator of the Epilepsy Project. Email: smireb2@gmail.com; Closing date for the Receipt of applications is 5th July 2026.

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