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).
Makerere University’s School of Public Health (MakSPH) showcased research, training and international partnerships supported through European Union funding during the EU Uganda Research and Study Fair 2026 held at Makerere University.
The fair brought together students, researchers, academics, government representatives and development partners to explore opportunities in education, research, innovation and international collaboration, while celebrating 50 years of partnership between Uganda and the European Union.
Through its exhibition, MakSPH highlighted research and capacity building initiatives addressing public health challenges including infectious diseases, non communicable diseases, health systems, climate change and pandemic preparedness.
18 EU funded projects supported at MakSPH
Prof. Rhoda Wanyenze, Dean of Students, School of Public Health, said the School has benefited from 18 EU funded projects over the past five years, supporting research and training across several areas of public health.
She said the projects have contributed to the training of PhD researchers and the development of research addressing infectious diseases and prevention, non communicable diseases, health systems, climate change and health.
Prof. Wanyenze also highlighted a new five year programme which started in 2021 that is aiming at strengthening capacity for research on pandemic preparedness and response, including outbreaks such as Ebola.
Another programme being undertaken with the Ministry of Health and Karolinska Institute focuses on improving maternal health while also addressing adolescent pregnancy and the health of mothers and children.
She described partnerships as critical to advancing science and innovation, noting that collaboration allows researchers in Africa and Europe to share knowledge and strengthen the impact of research on communities.
Research partnerships strengthen innovation
Prof. Robert Wamala, Director of the Directorate of Research, Innovation and Partnerships at Makerere University, said the exhibition provided an opportunity to showcase EU funded projects across the University.
He noted that the School of Public Health alone has more than 18 such projects, while other colleges also have several EU supported initiatives.
One of the projects showcased was PREPARE TID, a partnership aimed at developing rapid diagnostic technologies for emerging and re emerging infectious diseases.
Prof. Julius Okuni, Associate Professor of Veterinary Pathobiology and Molecular Diagnostics at Makerere University, said the project brings together universities, industries and other organisations from Africa and Europe.
The project is working to develop technologies that can quickly identify pathogens responsible for outbreaks such as Ebola, Rift Valley fever and Crimean Congo haemorrhagic fever.
According to Prof. Okuni, Makerere is involved in field and laboratory work to test and refine the technologies before they can be delivered to end users.
Fair provides platform for research visibility
For researchers at MakSPH, the fair also provided an opportunity to increase the visibility of ongoing research and create new connections with researchers, policymakers and potential funders.
Dr. Raymond Tweheyo, Honorary Lecturer and Senior Research Fellow in the Department of Health Policy, Planning and Management, said such exhibitions allow researchers to share their work and identify others working on related challenges.
He cited the CONNECT for Health project, which focuses on transforming non-communicable disease care in Uganda through collaboration with partners across several countries.
Dr. Tweheyo said exhibitions can help researchers connect with policymakers, civil society organisations and other partners who can contribute to translating research into practical solutions.
Assoc. Prof. Angelina Kakooza Mwesigye, Associate Professor and Child Neurologist at Makerere University College of Health Sciences, also emphasised the importance of exposing young people to international research opportunities.
She said the long standing Uganda Europe partnership provides opportunities for the next generation of researchers to learn, build networks and prepare for future research collaborations.
The School of Public Health’s participation highlighted the role of international partnerships in strengthening research capacity, supporting innovation and developing evidence based responses to Uganda’s public health challenges.
Uganda has strengthened its ability to respond rapidly to Ebola and Marburg outbreaks once cases are confirmed, but delays in frontline detection, health worker exposure, emergency financing bottlenecks and incomplete implementation of lessons from previous outbreaks continue to undermine preparedness, a study has found.
The findings were presented today, October 6, 2026, during a country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks. The study was undertaken by Makerere University School of Public Health and FHI 360.
Presented by Dr. Steven Kabwama, the synthesis examined Uganda’s experience with recurrent Ebola virus disease (EVD) and Marburg virus disease (MVD) outbreaks between 2000 and 2026, drawing particularly on After-Action Reviews from the 2017 Marburg outbreak and the 2019, 2022 and 2025 Ebola outbreaks. The work seeks to consolidate recurring strengths, weaknesses, innovations and lessons that had previously been documented separately.
Uganda has recorded 12 filovirus outbreaks over the 26-year period, including nine Ebola and three Marburg outbreaks, according to the research team. Among the four outbreaks examined closely were the 2017 Marburg outbreak in Kween and Kapchorwa, the cross-border Ebola outbreak in Kasese in 2019, the multi-district Sudan Ebola virus outbreak in 2022, and the 2025 outbreak whose index case was a health worker.
Strong systems after confirmation
Across the outbreaks reviewed, the synthesis found that Uganda has developed significant capacity to mobilise after laboratory confirmation. National and district task forces and technical response structures are activated quickly, supported by strong laboratory capacity, established coordination mechanisms and increasingly sophisticated surveillance systems.
The country has also built laboratory capacity around the Uganda Virus Research Institute, mobile laboratories, genomic sequencing, sample referral systems and the Results Dispatch System. Digital surveillance tools, Village Health Teams, survivor champions and established national and district coordination structures have further strengthened response capacity.
Detection remains a weak point
However, the findings point to a critical problem before confirmation: recognising a possible outbreak early enough.
For outbreaks originating within Uganda, the synthesis found that the period between a patient’s first presentation and confirmation ranged from nine to 27 days. This the study found is linked to low clinical suspicion and weaknesses in screening. Other recurring challenges included delayed access to emergency financing, infections among health workers, disruptions to essential health services, community mistrust and stigma, and limited follow-through on recommendations from previous After-Action Reviews.
Opening the workshop, the Dean, Prof. Rhoda Wanyenze, said understanding these delays requires going beyond identifying broad weaknesses to examining where response systems fail in practice.
“We can identify a broad challenge such as delayed detection from the literature, but your experience on the ground can help us understand the specific factors that create that challenge,” Prof. Wanyenze said while addressing district health officials from across the country.
“When we begin looking for solutions, we need to be able to target the actual problems rather than simply identifying broad challenges.”
The workshop brought together partners and colleagues from districts, including people directly involved in outbreak response, to validate the synthesis against frontline experience. Prof. Wanyenze noted that published literature, scientific papers and response reports cannot capture every operational reality, making practitioner experience essential to understanding where delays occur and what interventions have worked. Remarks validation workshop
Turning outbreak experience into continuous readiness
Among the priority actions proposed are stronger screening and alert systems for earlier detection; ring-fenced emergency financing and more reliable responder payment systems; routine infection prevention and control training; stronger occupational protection for health workers; continued investment in laboratories and genomic sequencing; and preparedness extending beyond districts traditionally considered outbreak hotspots. The study also recommends stronger community engagement and a formal mechanism to track and finance implementation of recommendations from After-Action Reviews.
Dr. Andrew Acero, Director of the EPiC project at FHI 360’s Uganda Office said the central challenge is ensuring that experience accumulated during successive outbreaks translates into lasting institutional capacity.
“The real value lies in ensuring that what we learn changes what we do. Our findings should inform policy, shape guidelines and training, strengthen systems and ultimately improve practice.”
He noted that preparedness cannot begin only after an emergency has been declared, but must be built through sustained relationships, systems and capacity before outbreaks occur. Remarks validation workshop
The EPiC project is led by FHI 360 with core partners including Right to Care, Palladium and Population Services International.
Uganda’s latest national HIV survey reveals lower viral suppression among adolescents and young adults living with HIV than among older adults, even as the country records substantial improvements in controlling the virus. The findings come from Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey examining HIV prevalence and whether people living with the virus know their status, receive treatment, and achieve viral suppression.
Releasing the preliminary UPHIA 2025 findings at the Uganda Media Centre on 1 October 2026, Minister of Health Hon. Dr. Chris Baryomunsi called for earlier prevention and testing, particularly among adolescent girls and young women, alongside support for treatment adherence. “We must reach out to the young people, ensure that they have information, they test, take treatment, and adhere to the treatment guidance,” he urged.
Hon. Baryomunsi recalled how fear had discouraged testing during his university years: “I remember when we were at university, we went for testing at the university hospital. We sat there for three hours. Some of us left without even testing because it was scary.” Today, he explained, “even if you test HIV positive, you can be initiated on treatment, and you live normally like the rest of those who don’t have HIV.”
UPHIA 2025 was locally led under the Ministry of Health’s overall leadership, with Makerere University School of Public Health serving as the prime implementer, a role ICAP at Columbia University held in the previous two surveys. The Uganda Bureau of Statistics led sampling, while the Uganda Virus Research Institute and National Health Laboratory and Diagnostic Services led laboratory operations. Regional referral hospitals and local governments supported implementation, and the U.S. government provided US$10 million through PEPFAR, along with technical assistance from the U.S. CDC.
UPHIA collected data from July to September 2025 among people aged 15 and above, including those outside routine treatment services. Of 6,283 eligible households, 94.4% completed interviews. Researchers interviewed 13,801 people and tested 13,477 for HIV.
Testing followed Uganda’s national algorithm, with laboratory confirmation of positive samples, viral-load measurement, and checks for antiretroviral medicines to establish treatment use. Researchers weighted the estimates to account for the sampling design. Participants received counselling and results, and those who tested positive were referred for treatment.
Hon. Baryomunsi thanked participants and their families for welcoming survey staff and contributing their time, information and samples, without which the national evidence would not have been available.
National progress and the youth gap
The survey estimated HIV prevalence, which means the proportion of people living with HIV, at 5.9% among those aged 15 and above, corresponding to about 1.496 million people in this age group nationwide. Prevalence was 7.3% among women and 4.1% among men, ranging from 1.3% in Karamoja to 8% in the South Western region.
Among people aged 15 and above living with HIV, 86% had achieved viral suppression, meaning a low amount of HIV in the blood, measured in UPHIA as fewer than 1,000 copies per millilitre. Suppression stood at 69.3% among adolescents and young adults aged 15–24 living with HIV, compared with 89.9% among those aged 50 and above. These estimates cover people living with HIV regardless of whether they know their status or receive treatment.
HIV prevalence among people aged 15–24 was 1.5%, including 2% among young women and 1% among young men. Among young women, prevalence was 1.3% at ages 15–19 and 2.8% at ages 20–24. These differences support attention to earlier prevention and testing, although they do not establish when infections occurred.
The highest prevalence estimates occurred among middle-aged adults: 15.7% among women aged 40–44 and 11.7% among men aged 45–49. Lower suppression among young people therefore requires attention alongside the higher HIV prevalence among middle-aged adults. Comparing the same age group across both surveys, viral suppression among people aged 15–64 increased from 74.9% in 2020–21 to 86.1% in 2025, while HIV prevalence remained at 5.9%.
Diagnosis and the path to 2030
The treatment results identify diagnosis as the main national gap. Among people aged 15 and above living with HIV, 85.3% knew their status. Of those aware, 99.1% were receiving treatment; among those receiving treatment, 96.5% had achieved suppression.
The 95-95-95 targets aimed for 95% of people living with HIV to know their status, 95% of those diagnosed to receive treatment, and 95% of those receiving treatment to achieve viral suppression by 2025. Among people aged 15 and above, Uganda exceeded the treatment and suppression targets, while diagnosis remained below target. UNAIDS’s Global AIDS Strategy 2026–2031 retains these targets towards ending AIDS as a public health threat by 2030.
According to WHO, viral suppression protects health and helps prevent HIV transmission. Uncontrolled HIV weakens the immune system, increasing the risk of serious illness. With continued treatment as prescribed, sexual transmission risk is negligible when HIV remains suppressed but detectable, and zero when undetectable. The Uganda AIDS Commission estimated over 34,000 new HIV infections in 2025, underscoring the importance of early diagnosis, timely treatment, and sustained suppression alongside other prevention measures.
The demographic stakes are substantial. People aged 15–24 constituted 21.2% of Uganda’s population in the 2024 census. The country’s Fourth National Development Plan, covering 2025–2030, prioritises a healthy, knowledgeable, skilled and productive population and reducing HIV through primary health care. Protecting young people’s health, therefore, supports their participation in education, work, and national development; UPHIA helps identify where services need greater attention.
Turning evidence into action
The study’s conclusions identify three priorities: sustain treatment outcomes, find people unaware of their status, and improve suppression among younger people. Permanent Secretary Dr. Diana Atwine connected the findings to the Ministry’s planning.
“We do believe that these results are a true reflection of what is happening in our country as far as the HIV status is concerned, and we do believe that it will give us a very clear direction and the roadmap that we are going to take in the next five years to target and to get our targets achieved.”
Acting on these priorities requires funding for services and research. Hon. Baryomunsi outlined plans to target resources where needs are greatest, strengthen district services and align partner support with government priorities. Responding to journalists’ questions, he noted the government’s intention to increase domestic funding for the HIV response, including research.
“The HIV/AIDS response, including research and surveys such as this one, has largely been funded by partners in the past. The government of Uganda is committed to allocating more resources from our domestic budget to support the response and research,” he noted.
For the first time in the UPHIA series, the survey assessed selected noncommunicable disease indicators among people aged 15 and above: 15.5% had elevated blood pressure, 24.8% were overweight or obese, and 0.9% had raised random blood glucose. These screening findings align with the Ministry’s integration agenda and Hon. Baryomunsi’s call to bring HIV and chronic care services together to address people’s wider health needs.
Speaking at the release of the preliminary results, U.S. Embassy Chargé d’Affaires Mikael (Mika) Cleverley described UPHIA 2025 as the first Population-Based HIV Impact Assessment worldwide fully led and implemented by the country itself.
“The study was led by Ugandan scientists, Ugandan managers, Ugandan public servants, Ugandan field teams, from design to data collection to analysis. And this is what two decades of focused strategic U.S. foreign investments in the public health sector was meant to produce, is to reinforce Ugandan leadership and Ugandan-led efforts.”
At the survey launch on 29 May 2025, MakSPH Dean Prof. Rhoda Wanyenze highlighted the partnership’s contribution: “The partnership between Makerere University and CDC has not only helped build national capacity in surveillance and epidemiology, but has also strengthened our ability to lead high-quality, large-scale national surveys.”
The Dean added: “After two decades of joint work, we are proud that UPHIA is now a fully Ugandan-led effort. This is critical to the sustainability of the skills and knowledge generation to inform our local response.”
UPHIA 2025 shows how far Uganda’s HIV response has advanced and where gaps remain. As the country works towards ending AIDS as a public health threat by 2030, reaching young people with testing, treatment, and continued care will be essential to extending those gains.
Read the full UPHIA 2025 summary results here:
-
General1 week agoStatement on Concerns Circulating Regarding a Member of Academic Staff
-
General1 week agoPress Statement: Incident Involving Death of a Student at Makerere University
-
General2 weeks agoMakerere Marathon 2026 – Running to Equip the Disability Support Center
-
General1 week agoBeyond Map Size: Africa’s Agency Should Not Be Funded by Other People
-
General1 week agoJNLC Leadership Symposium Equips Young Leaders for Responsible and Transformative Leadership