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 major milestone in Uganda’s efforts to reduce newborn mortality was marked on June 17, 2026, when Makerere University College of Health Sciences graduated the first cohort of fellows from the Perinatal and Neonatal Medicine Fellowship Programme.
The pioneering cohort of five specialists completed the two-year sub-specialty fellowship designed to equip pediatricians with advanced competencies in newborn care, leadership, research, advocacy, and neonatal intensive care. The programme is accredited by the Uganda Medical and Dental Practitioners Council and is implemented through a partnership involving Makerere University, Mulago Specialised Women and Neonatal Hospital, Kawempe National Referral Hospital, St. Francis Hospital Nsambya, Seed Global Health and Elma Philanthropies.
Speaking at the graduation ceremony, the Principal of the College of Health Sciences, Prof. Bruce Kirenga, described the occasion as a significant achievement for Makerere University and Uganda’s health sector.
“Today is a very important occasion for the College of Health Sciences, and indeed the health sector in Uganda,” he said, noting that the fellowship was established to develop highly skilled specialists capable of responding to increasingly complex healthcare needs.
Prof. Kirenga emphasized that Uganda’s changing disease patterns, increasing life expectancy, and growing demand for specialized healthcare services have created an urgent need for super-specialized training programmes. He challenged the graduates to use their newly acquired knowledge and skills to improve newborn health outcomes and save lives.
Addressing Uganda’s Neonatal Health Burden
Presenting an overview of the fellowship programme, the Head of the Department of Paediatrics and Child Health, Prof. Victor Musiime, highlighted the urgent need for specialists in neonatal care.
He noted that neonatal deaths, those occurring within the first 28 days of life, remain one of the leading contributors to child mortality in Uganda. The country continues to face a shortage of professionals with advanced skills in neonatal care, research, leadership, and advocacy.
“The demand for neonatologists remains extremely high,” Prof. Musiime explained, adding that the Ministry of Health envisions deploying neonatologists to regional referral hospitals and other health facilities across the country.
The fellowship programme was established to build a critical mass of neonatologists, strengthen care for high-risk newborns, develop expertise in advanced neonatal procedures, and produce leaders and advocates for newborn health.
A unique feature of the programme is its strong clinical apprenticeship model, complemented by international placements at leading institutions, including Yashoda Hospital in India and Aga Khan University Hospital in Nairobi, Kenya.
Ministry Commits to Expanding Neonatal Services
Representing the Ministry of Health, Commissioner for Maternal and Child Health, Dr. Richard Mugahi, congratulated the graduates and commended Makerere University and its partners for establishing the fellowship programme.
Dr. Mugahi revealed that the five graduates join another five neonatologists already serving in Uganda, bringing the country’s total number of neonatologists to ten. He described the locally trained fellows as a critical addition to Uganda’s healthcare workforce.
“The Ministry’s vision is to have a neonatologist at every Regional Referral Hospital,” he said, adding that Uganda aims to have at least 14 neonatologists by 2030.
He further outlined government plans to strengthen newborn care through the establishment of specialized neonatal care units at different levels of the health system, ranging from Health Centre IVs to Regional Referral Hospitals and super-specialized facilities such as Mulago Specialised Women and Neonatal Hospital.
Dr. Mugahi assured the graduates that the Ministry of Health is investing in equipment and infrastructure to support advanced neonatal services and pledged to advocate for improved career progression pathways for super-specialized health professionals.
Makerere’s Commitment to Advanced Medical Training
Representing the Vice Chancellor, the Deputy Vice Chancellor (Finance and Administration), Prof. Henry Alinaitwe, congratulated the fellows and their families on the achievement.
He praised the College of Health Sciences for its contribution to national development and noted that programmes such as the Perinatal and Neonatal Medicine Fellowship enhance Makerere University‘s position as a leader in knowledge generation and societal transformation.
Prof. Alinaitwe paid tribute to the graduates’ families, particularly their spouses and children, for supporting them through the demanding years of specialist training.
“The work you do is truly priceless,” he told the fellows. “The contribution you make to humanity is immeasurable.”
Graduates Hailed as Future Leaders in Newborn Health
In attendance were the director of Mulago Specialized Women and Neonatal Hospital, Dr. Sam Ononge, Deputy Director Mulago Referral Hospital, Dr. John Sekabira, Dr. Mary Nyanzi from Kawempe Referral Hospital, Sr. Dr. Assumpta Nabawanuka, the Director of St. Francis Hospital Nsambya, Dr. Irene Atuhaire from Seed Global Health Uganda and Ms. Ritah Akankwasa from ELMA Philanthropies Services, who partnered with the college in training the fellows.
The training partners described the graduates as pioneers who had demonstrated exceptional resilience and commitment throughout the rigorous training programme.
They applauded their contributions to patient care, teaching, mentorship, and supportive supervision, noting that their work had already contributed to improvements in maternal and newborn health services in Kampala and other regions of Uganda.
“As Kawempe National Referral Hospital, we have been privileged to witness your growth, not only as clinicians but also as leaders and advocates for newborn health,” Dr. Nyanzi said.
The graduates
- Dr. Tumwebaze Anita Kiiza Muhumuza
- Dr. Ediamu Tom Didimus
- Dr. Kezia Kibedi
- Dr. Hellen Kyokutamba
- Dr. Gerald Ojambo
For most people, the thought of death evokes grief, fear, or loss. But at Makerere University‘s College of Health Sciences, death became a lesson in gratitude, service, and humanity as students, faculty, and health professionals gathered to honour a unique group of teachers, individuals who continued to educate future doctors long after their passing.
At the Second Cadaver Commemoration Ceremony, on June 11, 2026, organized by the Makerere Students’ Anatomy Society, candles flickered softly as students paid tribute to what they fondly call their “silent teachers”, the human bodies that make it possible for medical students to learn anatomy and develop the skills that will one day save lives.
Standing before fellow students and guests, Chairperson of the Makerere Students’ Anatomy Society, Joseph Mwera, reminded the audience that the ceremony was not about mourning the dead.
“Today, we gather not only to remember those whose bodies have contributed to medical education but also to celebrate their lives,” he said. “Their legacy continues to inspire and serve humanity even after death.”
For many medical students, the anatomy laboratory is where they first encounter the reality of the profession they have chosen. Behind every lesson on muscles, nerves, blood vessels, and organs is a person who once lived, loved, worked, and contributed to society.
That reality was brought to life by the keynote speaker, Rev. Prof. Dr. Samuel Luboga, a surgeon, anatomist, and priest who spent nearly four decades teaching anatomy at Makerere University.
Reflecting on his own days as a medical student, Prof. Luboga recalled spending long hours in the anatomy laboratory after his classmates had gone home, studying human anatomy in detail.
Many people wondered whether he was afraid to spend so much time among cadavers.
His answer was simple.
“These men and women had lived productive lives. They had raised families, served their communities, and contributed to Uganda’s development. Even in death, they continued to teach us the science and art of medicine. They had earned my admiration, my respect, and my gratitude.”
His remarks resonated deeply with the students in attendance.
In a society where discussions about death and body donation remain sensitive, Prof. Luboga challenged participants to view the individuals in anatomy laboratories not as lifeless remains but as people who continue to contribute to humanity through education.
“The silent teachers before us today made learning possible,” he said. “The impact of their contribution is reflected in the doctors you have become and those you are yet to become. It is reflected in the countless patients you will treat and the innumerable lives you will save.”
Legal framework to guide body donation
The ceremony also sparked important conversations about the future of anatomical education in Uganda.
Head of the Department of Anatomy, Prof. Elisa Mwaka, highlighted the need for a national legal framework to guide body donation and anatomical research. While anatomy training in Uganda has traditionally relied on unclaimed bodies obtained through hospitals, he noted that many countries are increasingly embracing voluntary body donation programmes.
According to Prof. Mwaka, building public trust will be essential if Uganda is to establish a sustainable body donation programme.
“We must help the public understand how human bodies contribute to medical education, how they are treated with dignity, and how appropriate legal safeguards can protect donors and their families,” he said.
He revealed that discussions are already underway to develop an Anatomy Act that would provide a modern legal and ethical framework for the use of human remains in medical education and research.
Representing the Deputy Vice Chancellor (Academic Affairs), Prof. Julius Kikooma described the ceremony as much more than an academic event.
“Behind every competent healthcare professional stands an invaluable source of learning that often remains unseen and unheard,” he said. “These individuals taught us without speaking a single word. Though they are no longer able to communicate, their contribution continues to educate, inspire, and shape future generations of healthcare professionals.”
He commended the medical students for organizing what remains the only cadaver commemoration ceremony of its kind in Uganda, noting that the initiative reflects the values of compassion, professionalism, and respect for human dignity that are at the heart of medicine.
The event concluded with recognition of past and present leaders of the Department of Anatomy whose contributions have shaped anatomical education at Makerere University over the decades. Students also honoured exceptional educators who have inspired generations of future health professionals.
Yet the most powerful tribute of the day was reserved for those who could not be present to receive awards or applause.
The silent teachers
Individuals whose names may never appear in textbooks, whose stories may never be fully known, but whose gift continues to echo through hospital wards, operating theatres, and communities across Uganda.
Every doctor trained, every surgery performed, and every life saved carries a small part of their legacy.
And for one day at Makerere University, students paused to say the words that are rarely spoken aloud: Thank you.
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