Health
Makerere & Johns Hopkins Universities Release Report on Speed and Helmet Use in Kampala
Makerere University School of Public Health (MakSPH) and the Johns Hopkins International Injury Research Unit (JH-IIRU) have launched the status summary report 2023; Road Risk Factors for Kampala, Uganda, in partnership with Kampala Capital City Authority (KCCA) and Vital Strategies.
The report was launched at Hotel Africana in Kampala on January 16, 2024. It delineates key findings, including the average speed of speeding vehicles at a high average of 57km/hr, higher speeds on roads partially accessible to pedestrians compared to roads freely accessible to pedestrians. Also, helmet usage remains low among motorcyclists and is almost non-existent among passengers, contributing to a rise in accidents and fatalities since 2020.
There has been a variable trend in the reported numbers of deaths and serious injuries since 2018. Specifically, in 2022, there was a 1% increase in reported deaths compared to 2021, while serious injuries witnessed a 4% decrease during the same period.
In 2018, a total of 294 death were recorded, 315 recorded in 2019 while 236 were recorded in 2020. In 2021, there were 419 road traffic death and 425 recorded in 2022. Motorcyclists accounted for nearly half (49%) of the reported deaths followed by pedestrians made up 44% of deaths. In a bid to improve road safety by providing quality data, the research the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS) made roadside observations on speed and helmet use in Kampala City.
The researchers made six observation rounds citing 500,000 for speed and 600,000 cyclists to determine helmet use. The results, based on data collected between February 2021 and October 2023 indicate that the mean speed among speeding vehicles was high mostly among sport utility vehicles (SUVs) at 10%, sedans/saloons at 9%, minibuses/minivans at 8), and pickup/light trucks at 7%. Five percent of the observed vehicles were exceeding the posted speed limit.
Speeding in Kampala
Presenting findings, Mr. Bonny Balugaba, a Researcher based at the Trauma, Injuries and Trauma Unit of MakSPH noted that the international best practices for speed management recommend a safe speed of 30 km/h on roads where conflicts between cars and unprotected users are possible. Also, 50 km/h speed is recommended at intersections where side-on conflicts between cars may occur. This is particularly applicable in urban areas.
“If in Kampala we are seeing 57km/h speed, it means that we are way above the recommended speed limits and we know that beyond 40km/h, the chances of survival of someone that has been knocked are very minimal,” says Balugaba.
The researchers recommend enforcing a 50 km/h speed limit in metropolitan areas and a 30 km/h limit in places where motorized traffic interacts with bikes and pedestrians. In order to safeguard vulnerable road users, particularly the Ministry of Works and Transport and the Kampala Capital City Authority, it suggests implementing speed-calming techniques including bumps and signage as well as designating low-speed areas.
Investigators further advise the Kampala Metropolitan Traffic Police to increase enforcement, especially on local roads and on vehicles such as SUVs, sedans, pickup trucks, minibuses on routes with limited pedestrian access. It is recommended that public awareness campaigns and enforcement measures regarding the dangers of speeding be regularly monitored and evaluated to ensure continued efficacy.
Balugaba noted; “Mass media is good but if you are telling me the dangers of speed but am not apprehended on speed then it tends to entertainment. You come, entertain me with your campaign and adverts and go away but you are not enforcing.”
Helmet Use in Kampala
Helmet use compliance among motorcyclists was notably low at 39%, and even lower for passengers at 2%. This trend persisted on both local and collector roads (39%) and arterial roads (40%). During weekends, helmet use dropped by 20%. Ride-share motorcycle drivers, particularly Safe Boda, exhibited the highest compliance at 84%, surpassing commercial motorcycle drivers (50%), taxi drivers (55%), and private/government motorcycle users (55%).
From 2020 to 2022, 210 motorcycle occupants and 185 pedestrians lost their lives. Notably, 40% of pedestrian fatalities resulted from collisions with cars, SUVs, or pickups, whereas 36% of motorcycle deaths were attributed to accidents involving other motorcycles.
“We saw that only 2% of the motorcycles are using helmets. This really means that the situation is still bad. We need to put in place measures knowing that helmets save those that are wearing them,” says Balugaba.
Adding that while four of every 10 riders are wearing a helmet but less than one in every 10 passengers has a helmet. “is it that passengers have harder heads than riders? That in case they are involved in a crash, they don’t get affected? These are issues we need to work on.”
While sharing the data outcomes, Dr Raphael Awuah, the African Regional Advisor on Data and Surveillance for Vital Strategies notes that while many of the cities in Africa, pedestrians constitute the majority fatalities, this is different for Kampala. “For most parts of Africa, we see that pedestrians account for most fatalities. However, in Kampala, this is not the case. We see that majority of the deaths are among the motorcyclists and this trend has been observed since 2018. So clearly this emphasizes the need to prioritize the vulnerable road users in Kampala particularly motorcyclists and pedestrians.”
The top five locations for pedestrian fatalities and serious injuries from 2019 to 2022 are high-capacity roads: Kampala Road, Jinja Road, Bombo Road, Entebbe Road, and Masaka Road.
The distribution of motorcycle fatal crash locations does not exhibit any clear pattern, but there is a noticeable concentration on high-capacity highways. Kampala Road, Masaka Road, Bombo Road, Kisaasi Road, and the Northern Bypass are the top five places.
“While it is true that these are high capacity roads, speeding is probably one of the causes of fatalities. I hope we will use this data to inform the discussions, actions, plans, strategies to reduce the outcomes that I have just shared,” observed Dr Raphael Awuah.
The Kampala Metropolitan Traffic Police has been urged to increase the enforcement of proper helmet use, with a focus on passengers, taxis, and commercial motorbikes on arterial, local, and collector roads all week round. Also, KCCA and the Ministry of Works and Transport may want to start public awareness programs promoting the appropriate use of helmets and advocate for sanctions and fines for improper helmet wear in conjunction with coordinated increased enforcement.
“This is about behavioral change. It is extremely difficult. We are all humans. All of us know that speeding is bad for us but when we get behind the wheel, we will still try to speed. All of us know that wearing a helmet will protect our heads, but only 2% of us wear helmets when we are riding on a motorcycle. So what else is needed? Yes, knowledge is important, it is important to tell people why they should be putting on these helmets and the consequences they will face if they don’t wear them but it is also important to have reinforcing mechanism. Yes, mass media campaigns are important but equally important is visible and widespread enforcement,” explained Dr. Abdulgafoor Bachani, Director of JH-IIRU.
On his part, Dr. Fredrick Oporia said “Road safety is an issue of concern to everyone. To improve this safety, we must have high-quality data on the risk factors and share it with our stakeholders. Most importantly, we need local stakeholders who are charged with making laws and policies for the country because this is a systems issue that calls for systems thinking. We must involve the local to get the attention of the international.”
SP. Michael Kananura, spokesperson, Traffic and Road Safety Directorate, Uganda Police Force says there is a regulation on helmet use targeting not only riders but also passengers, although he acknowledges challenges with enforcement. He calls on the public support these public health and road safety measures.
“We really appreciate our colleagues from MakSPH and the rest for this work and the academia generally for the work you are doing in as far as research is concerned and also being able to share with us this data. We also use this data to improve in our enforcements. It guides us on areas of improvement and prioritization. The data really is so helpful to us and we also continue to work to see how we can improve in that area. We have a unit in traffic directorate that is for enforcement basically,” SP Kananura.
Comments from KCCA leadership
Hon. Kizza Hakim Sawula, the lord councilor from Lubaga and Executive Secretary and a Minister for Works and Physical Planning –KCCA noted that one of the causes of this these accidents in the capital city is the poor-quality roads that wear out easily with numerous potholes and the meagre maintenance budget appropriated by parliament to the city authority.
“Can you imagine that each kilometer of the road within Kampala is constructed at an average cost of 14 billion shillings. For the last three budgets, we were getting 78bn but but in the current budget, we received only 43 billion shillings for the entire capital, for the entire financial year for roads, drainages and traffic lights. How many kilometers are we looking at? 3 kilometers for a financial year, 43 billion shillings?
We used to get Shs26 billion from the national road fund, for road maintenance every financial year. You can confirm from the mayors and load counselors here. This time around, we received only 11 billion for all the maintenance. Now, what do we expect out of that money? So, the task is upon the members of the Parliament to improve on the budget. We have 2,110 kilometers of roads within Kampala. Only 654 kilometers are paved, when shall we complete the entire balance? So, we need a budget, enough budget from the members of parliament. When we talk to MPs they only talk about loans we get from development partners which is usually for new roads,” explained Hon. Sawula.
Concerned, Nakawa Division Mayor, Paul Mugambe said it was disheartening that many people continue to lose their lives prematurely. He cited that not every death is predetermined by the Lord. “Driving at excessively high speeds, and resulting in a crash is not the Lord’s decision. Many individuals lose their lives prematurely due to reckless behavior, and it’s truly regrettable.”
Mr. Mugambe urged Police to use the evidence provided to improve on the enforcement of road traffic laws and regulations.
Prof. Elizeus Rutebemberwa, the Deputy Dean, MakSPH thanked the Bloomberg Philanthilopies “for supporting us to help ourselves” and the JH-IIRU for the technical support to the TRIAD unit, the university and many partners. He also noted that the urban population in Uganda is steadily increasing and called for proactive and inclusive urban planning.
“From 2012, the urban population was 20%. In 2022, which is one year and a half ago, it was 26%. So, one in four people in Uganda were in urban areas. Now in 2040 it is estimated that 33 million would be living in urban areas and that would be 46%. So, it’s not getting better, it’s getting worse. So, we need to manage our urban areas so that people don’t shift from the rural areas to come to die in urban areas,” said Prof. Rutebemberwa.
He called on government and the city authority to fast-track mass transport systems to reduce congestion on the roads. “Look at the traffic that come to Kampala. They are in private cars and each one is carrying one person. In very few cases, two people. Now, if you have all those cars for one kilometre stretch, you could actually park all those people in one bus. And you have all space and you reduce the pollution, why should this be difficult for people to know that. For you to have an organized urban area, you need mass transport. You don’t need to research to know that. So why don’t we have them? Some of these things, some of them we talked about in the national drive, dedicated walk lanes.
According to Becky Bavinger, from the public health area of Bloomberg Philanthropies, road traffic injuries are the leading cause of death for people aged 5 to 29. She mentioned that the fatalities from road traffic are at a crisis level in Uganda.
“I want to say this again. This is the leading cause of death. It’s not HIV. It’s not tuberculosis. It’s real traffic injuries for people aged 5 to 29. Those are the young people. We had the mayor talking about the economic impact as well. These are young people going to school, getting trained, coming back into your workforce, starting out in the workforce, and you’re losing their lives. There’s a forthcoming research from the Road Safety Coalition Uganda looking at the loss of GDP from road traffic injuries. In 2017, your government reported 3,500 deaths. The WHO estimated it was double that at about 6,000. It has gone up. In 2021, your government reported 4,159 deaths. Again, the WHO estimated it was about double that at 7,300. This is not good. This is a crisis and we need everyone working together on it,” Ms. Bavinger said.
She noted that Bloomberg Philanthropies will be working over these next two years with KCCA and with the government of Uganda to institutionalize data collection and the surveillance of road traffic injuries and deaths to improve its accuracy.
“These data are critical to forming your decision making. I just want to conclude by saying congratulations to Makerere University, to Johns Hopkins University, but ultimately to KCCA for launching this report, for conducting this research and this is not easy research to conduct. To the stakeholders, use these data. Please, please do not go home and put this report on your shelf. Look through it. Talk to the journalist. Get the media to write stories about this, let everyone know what is happening,” said Bavinger.
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:
Uganda has released the preliminary findings of the 2025 Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey that provides a current picture of the country’s HIV response and selected non-communicable disease indicators.
At the Uganda Media Centre today, 1 October 2026, the Minister of Health, Hon. Dr Chris Baryomunsi, released the preliminary results and said the evidence would guide policy, resource allocation and service improvement, with particular attention to people and communities with the greatest gaps. He urged Ugandans to know their HIV status, use prevention services and, when diagnosed, start treatment promptly and adhere to it.
Among adults aged 15 years and above, HIV prevalence was 5.9 percent, including 7.3 percent among women and 4.1 percent among men. Among adults aged 15–64, prevalence was also 5.9 percent, unchanged from 2020/21. Across the country, prevalence ranged from 1.3 percent in Karamoja to 8.0 percent in the South Western region. Of adults living with HIV, 85.3 percent knew their status; 99.1 percent of those aware were on treatment; and 96.5 percent of those on treatment had achieved viral load suppression. HIV-status awareness remains the central gap in the 95-95-95 cascade.
The survey also measured selected non-communicable disease indicators for the first time. Elevated blood pressure affected 15.5 percent of adults, while 24.8 percent had overweight or obesity and 0.9 percent had raised blood glucose.
Conducted from July to September 2025, UPHIA 2025 was the first population-based HIV impact assessment to be fully country-led. The Ministry of Health provided overall leadership, while Makerere University School of Public Health served as the prime implementing organisation, working with UVRI, UBOS, regional referral hospitals and local governments. PEPFAR funded the survey through the U.S. CDC.
Watch the UPHIA 2025 preliminary results launch:
https://www.youtube.com/live/QfHFBaJ-L-w
Read the UPHIA 2025 summary results:
https://drive.google.com/file/d/1nElGNwgcAcZyAo9CLCQKRpO2jJgyxjSc/view?usp=drive_link
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