Health
Inside Uganda’s National Health Adaptation Plan to Combat Climate Change
By John Okeya
On August 22, 2024, Uganda made history as the first African nation to launch a National Health Adaptation Plan (H-NAP), fulfilling the country’s global commitments at the UN Conference of Parties (COP) 26 and 28 summits in Glasgow (2021), and Dubai (2023), respectively, in response to the growing global climate change risks and challenges.
The National Health Adaptation Plan 2025-2030, dubbed H-NAP, which was launched by the health ministry yesterday in Kampala, seeks to fortify the country’s healthcare system against the current mounting health challenges driven by climate fluctuations, to safeguard public well-being amid the rising temperatures, erratic weather patterns, and associated health risks.
Officiating the H-NAP launch, Uganda’s Prime Minister, Rt. Hon. Robinah Nabbanja, represented by the third Deputy Prime Minister and Minister without Portfolio, Rt. Hon. Lukia Isanga Nakadama, commended the fruitful collaborative initiative of the government, development, and civil society partners in delivering the Health National Adaptation Plan.
“The government of Uganda has created an enabling policy and legal environment to tackle the climate change challenges,” she noted emphatically, revealing that: “In the Parish Development Model (PDM), we need to integrate climate change interventions. I was recently talking to my people (constituents in Mayuge district) about the PDM programme, I told them; ‘we gave you money and we know you are doing well. They said no, all our crops were washed away by the heavy rains, we did not get anything.’ So, it’s not all that easy.”
She said the current five-year term National Development Plan (NDP) III which is bound to expire and the new NDP IV underscore climate change as a cross-cutting issue requiring mainstreaming across all sectors, assuring that the Office of the Prime Minister (OPM) will coordinate multisectoral engagements for Ministries, Departments, and Agencies (MDAs) and support awareness raising for the new Health National Adaptation Plan.
“I congratulate the Ministry of Health and all sectoral partners for developing the Health National Adaptation Plan that we are launching today. This Plan is based on evidence from the Climate Change Health Vulnerability and Adaptation Assessment and should provide a systematic guide to building a resilient health system for Uganda,” the Prime Minister observed, urging the different multi-stakeholders to support the implementation of the Plan to harness its full potential in guiding the country’s climate change adaptation action.
Climate change adaptation, commonly used, means the steps taken to help both natural and human environmental systems adjust to the impacts of climate change, whether those changes are happening now or expected in the future. Such interventions may include actions, policies, and strategies designed to specifically reduce the negative effects of climate change while making the most of any potential benefits that may arise.
On the other hand, climate change refers to the long-term shifts in temperatures and weather patterns, mostly caused by human activities like burning fossil fuels, which release greenhouse gases (also known as GHGs) into the atmosphere. These changes lead to more extreme weather events, rising sea levels, and ecosystem disruptions, impacting everything, from agriculture to human health.
One of the key successes arising out of the two weeks deliberation between 120 world leaders and over 40,000 registered participants, including 22,274 party delegates, 14,124 observers, and 3,886 media representatives at COP26 summit in Glasgow, from Sun, Oct 31, 2021 – Fri, Nov 12, 2021, was the compromise to step up support for climate change adaptation, reflected in the Glasgow Pact calling for the doubling of finance to support developing countries like Uganda in adapting to the adverse weather impacts and build resilient health systems.
A key highlight during the Glasgow negotiations, was the realisation by the global actors of the critical linkage between climate change and health, as the discussions culminated in the consensus that the worsening climate crisis directly threatens global health through increased extreme weather events, the spread of diseases, and the increased strain on healthcare systems, thus necessitating urgent integrated action to protect public health.
Subsequently, nation states committed to developing national climate change health vulnerability and adaptation assessments and the health national adaptation plans, both documents that Uganda has now concluded, to emerge as a regional and global leader in the charge towards adaptation to combat climate change effects and build resilience.
The November 2023 Climate Change Health Vulnerability and Adaptation Assessment (VAA) for Sound Management of Climate Change-related Health Risks in Uganda and the Health – National Adaptation Plan (H-NAP) 2025- 2030, were conducted through a collaboration led by Uganda’s Ministry of Health, with partners including Rockefeller Foundation, Makerere University, World Health Organization, Ministry of Water and Environment, Amref Health Africa, Reproductive Health Uganda, Pathfinder Uganda, Tree Adoption Uganda, Seed Global Health Uganda, Clinton Health Access Initiative and Regenerate Africa.
Makerere University School of Public Health’s Dr. John Bosco Isunju, who led the teams in the development of both the VAA and H-NAP, was honoured by the Ministry of Health with the 2024 Climate and Health Champions Award during the Health National Adaptation Plan Launch, for his significant contributions to building a climate-resilient health system in Uganda.
The Rockefeller Foundation’s investment played a pivotal role in funding the development of these two strategic documents. Mr. William Asiko, Vice President and head of The Rockefeller Foundation’s Africa Regional Office, emphasised, “Climate change is now the gravest threat to the health and well-being of billions of African people. Initiatives like Uganda’s Health National Adaptation Plan demonstrate how African countries are rising to the challenge by scaling the necessary climate solutions and setting an example for the world.”
Makerere University Vice Chancellor, Prof. Barnabas Nawangwe, in his remarks delivered by the University Secretary, Mr. Yusuf Kiranda commended the role played by the partners in the development of the Plan, noting that: “Our academics from the Makerere University School of Public Health played a vital role in leading the Climate Change Vulnerability and Adaptation Assessment (VAA), which has been instrumental in shaping the development of the H-NAP.”
“This is just one example of Makerere University’s strategic commitment to research, innovation, and capacity-building. We are dedicated to generating evidence and human resources capabilities that guide decision-making and contribute to the development and implementation of climate-resilient strategies in health, agriculture, and other sectors,” the Makerere University Vice Chancellor observed.
He stated that the success of the National Adaptation Plan depends on the strength of our collaborations, which requires concerted efforts of government ministries, health agencies, civil society organisations, the private sector, development partners, and the academic community, as he reiterated University’s commitment to being a key partner in the endeavour.
Today, Uganda, like the rest of the region and the globe, continues to grapple with the adverse effects of climate change. Subsequently, the Health National Adaptation Plan’s overarching goal is to enhance the resilience of Uganda’s health sector against climate-related impacts by incorporating climate adaptation into health strategies and planning, ensuring sustainable and continuous healthcare services during climatic challenges;
“Uganda is already experiencing severe climate change effects, such as floods, droughts, and temperature changes, which contribute to health issues like waterborne diseases, vector-borne diseases, malnutrition, and mental health problems.” The H-NAP report reads in part.
Its precursor, the 2023 Climate Change Health Vulnerability and Adaptation Assessment (VAA) survey, conducted across 716 selected health facilities in Uganda, highlighted the significant risks and challenges that climate change poses to public health.
The Vulnerability Assessment revealed that many healthcare facilities in Uganda are highly vulnerable to climate change-related hazards, due to unpreparedness across several critical components. In terms of energy, healthcare facilities were found to lack secure locations to protect emergency energy sources from hazards, had inadequate coverage for critical service areas, and failed to consistently check alternative energy sources.
The health workforce was also underprepared, with gaps in participation in climate adaptation plans, insufficient readiness for outdoor work during extreme conditions, and limited capacity to identify and manage health conditions, worsened by climate impacts.
Significant weaknesses were apparent in water, sanitation and hygiene, and healthcare waste management, including inadequate strategies to monitor and reduce water contamination, limited preparedness to prevent vector breeding in facility water systems, and a lack of comprehensive water safety and contingency plans. Post-hazard recovery plans were insufficient, with no safe locations for critical equipment during emergencies, inadequate safety measures for vital supplies, and inconsistent evacuation mechanisms for health workers and patients.
“These findings highlight a need for implementation of climate change adaptation plans and policies, building capacity of the health workers, and strengthening WASH management systems and water safety plans. There’s also a need for improvement of the reliability of energy infrastructure, development of contingency plans and enhancement of infrastructure resilience, evacuation plans, and post-disaster recovery,” the VAA report reads in part.
Today, Uganda has established a robust policy and legal framework to address climate change, including the National Climate Change Policy of 2015, the Climate Change Act of 2021, and the updated Nationally Determined Contribution of 2022. These frameworks aim to transform Uganda into a climate-resilient, low-carbon society by 2050.
The Uganda National Health Adaptation Plan (H-NAP) aligns with these policies, emphasising the integration of climate change adaptation into health sector plans and policies.
“A key recommendation to tackle climate change issues in Uganda is the integration of climate services for health. These services involve the provision of climate data, tools, and information tailored to the health sector’s needs, enabling health professionals to better anticipate, prepare for, and respond to climate-related health risks. Climate services for health include forecasting climate variables, monitoring and predicting the spread of climate-sensitive diseases and issuing early warnings for heatwaves and air pollution episodes,” The H-NAP reads in part.
According to the Plan, by integrating these services into health planning and operations, Uganda can enhance its public health resilience against the impacts of climate change. Furthermore, the H-NAP proposes a range of short-term and long-term interventions across ten components that include climate-transformative leadership, climate-smart health workforce, integrated risk monitoring, and sustainable financing.
From the H-NAP, specific actions identified include developing guidelines for mainstreaming climate and health, training health workers, enhancing disease surveillance systems, and revising infrastructure standards for climate-proofing. Also, the plan presents a financing framework to mobilise resources for implementing the identified interventions. This includes developing a comprehensive resource mobilisation plan, increasing national budgets for health and climate change policies, and advocating for health issues in climate funding streams.
Uganda is all too familiar with the harsh realities of climate change, having continuously experienced rising temperatures, prolonged droughts, and increasingly severe rainy seasons—each intensifying public health challenges. This National Health Adaptation Plan marks a critical step in the country’s climate action efforts, standing as the first of its kind. It serves as a crucial component of Uganda’s broader strategy to mitigate climate impacts and safeguard public health in the face of growing environmental threats.
A Voice for Excellence, Equity and African Sovereignty
When Dr. Michael Makanga walked onto the stage at the 8th Galien Forum Africa in Dakar on 31 October 2025 to receive the Special Career Achievement Galien Prize, presented by President Bassirou Diomaye Faye under the theme Health sovereignty: an imperative for Africa, the moment carried weight beyond any medal or citation. “It is a celebration of a lifelong commitment,” he said, “but also a reminder of a responsibility I have never been willing to compromise: to inspire others to raise their voices for excellence, science, and equity.”
For more than two decades, Dr. Makanga has been a quiet architect of Africa’s health sovereignty. His work has unfolded far from cameras: in laboratories constrained by resources, in policy rooms where African priorities demanded a stronger voice, and in mentoring sessions with young scientists seeking reassurance that their ideas mattered.
Born and trained in Uganda, Dr. Makanga earned a Bachelor of Medicine and Surgery from Makerere University before pursuing a master’s degree and PhD at the Liverpool School of Tropical Medicine. His career spans nearly 30 years, encompassing tropical medicine, clinical trials in Africa and Europe, and senior international management roles. Since joining EDCTP in 2004, he has guided its growth as a unique Africa–Europe partnership, strengthening African capacity for high-quality, ethical clinical research while accelerating solutions for poverty-related diseases. Today, he leads the Global Health EDCTP3 Joint Undertaking under the EU’s Horizon Europe programme.
President Faye captured the essence of Dr. Makanga’s achievement: “Scientific excellence is not negotiable; it is earned. It underpins our credibility and our sovereignty.” For Dr. Makanga, the statement is a call to action. “I hope this recognition reminds us that Africa’s scientists and innovators can lead global health research with excellence and purpose. We owe it to the next generation to build the systems and confidence that make this possible,” he said.
Dr. Makanga’s peers describe him as a “builder”: someone who strengthens research systems, mentors emerging scientists, and fosters equitable partnerships long before “local ownership” became a policy buzzword. In his own words, the award honors his “career’s contribution to advancing Africa’s health sovereignty” while reinforcing his commitment to ensure younger scientists do not have to fight for legitimacy as previous generations did.
The 2025 Prix Galien Africa celebrated Dr. Makanga alongside innovators reshaping African science. La Ruche Health, a Côte d’Ivoire-based digital health platform, won for connecting users to certified providers through an AI-powered system. Senegalese computer scientist Adji Bousso Dieng received a special prize for applying artificial intelligence to the natural sciences, including spotting emerging viral variants using her “Vendi Score” tool. The awards were organised with the support of the Presidency of Senegal, the Gates Foundation, the West African Health Organization, and the Rockefeller Foundation, with a jury co-chaired by Dr. John Nkengasong and Professor Souleymane Mboup.
Yet the award’s true weight lies not in ceremony, but in its symbolism. Dr. Makanga’s career exemplifies how African scientists can lead, shape policy, and influence global health priorities when empowered and supported.
Makerere University colleagues attest to this impact. Dr. Victoria Nankabirwa, a clinical researcher and epidemiologist, reflects: “EDCTP support allowed me to build multidisciplinary teams, enhance laboratory and trial infrastructure, and generate evidence relevant for policy and practice. It strengthened my scientific independence and expanded the long-term sustainability of my research, particularly on childhood vaccines.”
She adds, “Dr. Makanga’s vision and commitment have strengthened institutions, built capacity, and fostered equitable partnerships, enabling African investigators to lead complex studies that address the continent’s priorities. His recognition shows what is possible when scientists are empowered, trusted, and supported.”
Dr. Alex Kayongo, an immunologist at Makerere University, describes EDCTP support as “catalytic,” enabling advanced training and a platform to study microbiome–immune interactions in HIV-associated COPD. His work is shaping mechanistic insights and strengthening Uganda’s capacity for complex respiratory immunology research. “Global health funding is increasingly competitive, making EDCTP’s role even more vital,” he says. “Africa needs sustainable support for complex, lab-intensive research. Continued investment in infrastructure, leadership, and fair partnerships is essential if African institutions are to drive innovation and secure true scientific sovereignty.”
Dr. David Musoke, an associate professor of disease control, credits his EDCTP fellowship with deepening his malaria research and advancing his career. His studies combined housing improvements, environmental management, and behavioural measures to complement traditional malaria prevention, shaping practical, community-informed interventions. “Dr. Makanga’s contribution to African science has been tremendous, and his continued stewardship gives us confidence that evidence generated on the continent will increasingly shape policy and practice,” he observes.
Dr. Makanga’s impact is visible not only in individual careers but across institutions and nations. Through EDCTP, he has championed African-led trials, strengthened laboratory capacity, and fostered cross-country collaboration. Colleagues emphasize that his leadership has created a generation of African scientists who are confident, collaborative, and globally competitive.
“My experience with EDCTP-funded programmes has shown the transformative impact of African-led research,” Dr. Nankabirwa reflects. “Dr. Makanga’s vision and commitment have strengthened institutions, built capacity, and fostered equitable partnerships, enabling African investigators to lead complex studies that address the continent’s priorities. His recognition shows what is possible when scientists are empowered, trusted, and supported, inspiring the next generation of research leaders.”
Dr. Makanga’s recognition is a tribute to perseverance, vision, and mentorship: a scientist who kept going when resources were scarce, a leader who refused partnerships that treated Africans as subjects, and a mentor who reminded young researchers that they belong at the centre of global science.
As he stood among Africa’s leading innovators in Dakar, the message was unmistakable: Africa can lead, Africa must lead, and it will lead, through science, excellence, and equity.
Makerere University is proud to celebrate Dr. Michael Makanga, one of its distinguished alumni, on receiving the Special Career Achievement Prize of the Prix Galien Africa 2025. This honor recognises his exceptional leadership in medical research and his role in advancing African-led science. Through his work, Dr. Makanga continues to strengthen institutions, mentor emerging researchers, and amplify Africa’s voice on the global health stage.
Kalangala, an idyllic archipelago often romanticised for its sunsets, today witnessed a historic leap in healthcare. Makerere University Vice Chancellor, Prof. Barnabas Nawangwe, launched the Infectious Diseases Institute (IDI) Kalangala Clinical Research Centre—the island’s first modern research facility.
“This is more than a building; it’s a lifeline,” said Prof. Nawangwe. “IDI is not only Uganda’s leading health partner, managing over 20% of HIV cases, but research is first on its agenda. If people are not healthy, they can’t work—it’s useless to invest in anything else.”
Kalangala ranks third in HIV prevalence nationwide at 13.1%, with fishing communities hardest hit. Until now, residents endured perilous boat rides to the mainland for advanced care. “Accessing healthcare has always meant a journey across waves—long, costly, and sometimes dangerous,” said District Chairperson Jajab Ssemakula. “You have not only invested in Kalangala; you have brought Makerere University to Kalangala.”
Supported by the Gates Foundation, the centre is part of a multinational HIV prevention study conducted across 31 sites in Kenya, South Africa, and Uganda. Its first mission: testing whether a monthly pill can protect adolescent girls and young women from HIV—a breakthrough that could transform vulnerable communities.
“This centre means access without barriers,” said Dr. Andrew Kambugu, IDI Executive Director. “Kalangala residents no longer need to travel long distances for clinical trials or advanced care.”
Prof. Samuel Luboga, IDI Board Chairperson, reassured residents of IDI’s long-term commitment:
“We are not a fleeting partner. This sentinel research centre aligns with our vision of freeing Africa from the burden of infectious diseases. The assurance I give Kalangala is—we are here to stay.”
Henry Ssebunya, Deputy Resident District Commissioner, praised IDI’s innovation and consistency:
“IDI has treated and cared for people living with HIV, deployed medical drones to deliver life-saving medicines, and now built a research centre. This is a new chapter for Kalangala.”
From a sleeping sickness camp in 1906 to a cutting-edge research hub in 2025, Kalangala’s story is one of resilience, innovation, and hope.
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