Health
Uganda becomes second country, after Nepal, to unveil Climate Health Adaptation Plan
Kampala, 24 August 2024 – Uganda’s Ministry of Health on Thursday August 22nd launched its Climate Change Health National Adaptation Plan (H-NAP), a comprehensive strategy aimed at bolstering the nation’s health system resilience against the impacts of climate change.
Adapting to climate change presents a substantial financial burden, with Africa projected to need up to $2.8 trillion by 2030 to fulfill its commitments under the Paris Agreement, according to the African Development Bank.
Uganda’s Health National Adaptation Plan (H-NAP), a critical step in this effort, requires an estimated $63 million by 2030.
Unveiled at Sheraton Hotel in Kampala by Third Deputy Prime Minister Hon. Rukia Isanga Nakadama, the H-NAP marks a milestone in Uganda’s response to the escalating climate crisis, particularly within the health sector. This ambitious plan underscores the urgent need to address climate-related health challenges and strengthen the country’s resilience.
Uganda has committed to addressing climate change as a signatory to key global agreements, including the UNFCCC, Paris Agreement, and Kyoto Protocol. In line with these frameworks, the Ugandan government has established supportive policies and laws, such as the National Climate Change Policy (2015), the Climate Change Act (2021), the Nationally Determined Contributions (2022), and Vision 2040.
Rt. Hon. Rukia Nakadama congratulated the Minister of Health and partners for developing the Climate Change Health National Adaptation Plan. She affirmed that the government would integrate climate resilience into the Parish Development Model, Uganda’s strategy for improving household incomes and welfare. The PDM focuses on multi-sectoral community development and addresses key aspects of livelihood enhancement, including human, natural, social, financial, and physical resources.
“In the Parish Development Model there is a need to integrate Climate change interventions. In addition, the National Development Plan III and the newly developed National Development Plan IV highlights Climate change as a cross-cutting issue requiring mainstreaming for all sectors,” said Rt. Hon. Nakadama.
Drawing on the latest climate science and projections, Uganda’s health sector adaptation plan pinpoints critical areas where enhancing resilience is urgent, with the goal of strengthening the adaptive capacity of the health system to climate change and related hazards.
“It is moments like this that make me optimistic and excited about a healthier future. We have gathered at a transformational moment in unprecedented times. I am sure all of you have seen and felt the effects of our changing world. Unpredictable weather events have brought both droughts and extreme flooding as you have heard. Outbreaks of cholera, malaria, yellow fever, measles, and more have become increasingly common,” said William Asiko, The Rockefeller Foundation Vice President for Africa.
Asiko noted that climate change is now the greatest threat of health and wellbeing of billions of people worldwide and that to meet that threat head-on, human beings must “innovate,” “rethink,” and “adapt our health systems from the threats.”
Rebuilding systems is a huge task, especially when lives are at stake, said Asiko, before adding that overcoming these obstacles has been The Rockefeller Foundation’s mission for over a century. “The fight for global health, has always been at the health of our work,” he stated.
The 2022 report on climate change from the United Nations noted that at least 3.3 billion people’s daily lives are “highly vulnerable” to climate change, and people are 15 times more likely to die from extreme weather than in years past, the Intergovernmental Panel on Climate Change (IPCC) report said.
Uganda’s Ministry of Health data show that malaria remains the leading cause of illness among pregnant women and children under five. Uganda also faces critical challenges, with 81% of the population lacking access to safe water, and only 35% having basic sanitation. This results in approximately 19,700 child deaths annually due to diarrheal diseases—equivalent to 54 children that die every day from poor sanitation.
Malnutrition further contributes to infant and child deaths, with 12% of infants born underweight. Adding to this burden are pollution-related deaths; in 2021 alone, over 1,000 people in Kampala died due to poor air quality, this is according to a scientific publication by researchers at the Makerere University School of Public Health (MakSPH).
The World Health Organisation (WHO) estimates that more than 13 million deaths worldwide, each year are due to preventable environmental causes. Just to mention that air pollution from fossil fuels alone, kills 13 people every minute from lung cancer, heart disease or stroke.
These alarming statistics underscore the urgent need for Uganda’s Health National Adaptation Plan (H-NAP) to address these interconnected challenges and build a more resilient health system.
Dr Christine Musanhu, the Acting WHO Representative in Uganda contends that; “We urgently need to take concrete and timely measures, to protect the health of our populations and build a resilient future.”
According to Dr. Musanhu, climate change is not just an environmental issue; but a profound threat to the health, well-being, and development of mankind.
“Our actions today, will have a long-term effect on protecting future generations from the health consequences of climate change. In collaboration with the Ugandan government, I therefore call upon all partners, to mobilize efforts to join our quest to protect the environment,” she said.
Following numerous disasters globally, WHO has been at the forefront of efforts, to build climate change-resilient health systems. Some of the key, WHO-supported global developments in this area include the: WHO Climate Resilient Health Systems Framework, a comprehensive framework, to guide countries in making their health systems resilient, to the impacts of climate change.
The Uganda’s H-NAP covers ten components based on the WHO framework aimed at building a climate resilient low-carbon health system which is capable of anticipating, responding to, coping with, recovering from. and adapting to climate-related shocks and stress, while minimising the greenhouse gas emissions and other negative environmental impacts to deliver quality care and protect the health and well-being of present and future generations of Uganda.
Professor Barnabas Nawangwe, the Vice Chancellor Makerere University called for determination and solidary in implementing the H-NAP to safeguard the population and generations to come against the uncertainties of climate change.
“The success of the National Adaptation Plan depends on the strength of our collaborations. It requires the concerted efforts of government ministries, health agencies, civil society organisations, the private sector, and the academic community. I wish to reiterate Makerere University’s commitment to being a key partner in this endeavor,” said Professor Nawangwe.
Hon. Dr. Jane Ruth Aceng, Minister of Health of the Republic of Uganda said; “moving forward, any infrastructure projects in the health sector will be made to withstand the impact of climate change. In addition, Uganda will move forward to address the issue of greenhouse gas emissions by introducing solar lighting and solar refrigeration where applicable.”
On his part, Mr. Alfred Okot Okidi, the Permanent Secretary in the Ministry of Water and Environment, says as a ministry mandated to coordinate climate change related issues in Uganda, they assess sector budgets to ensure they are climate smart. He noted communities must be protected from the dangers of climate change. He also called on citizens to play their roles in ensuring they mitigate climate change risks.
“We have been encouraging our population to take care of their individual responsibilities. This is not just a government responsibility but a responsibility for everyone. Climate change affects us irrespective of where we come from, our department etc. I want to applaud the Ministry of Health for coming up with this H-NAP because health is one of those components that had not been taken seriously at the global level in respect to climate change,” said Mr. Okidi.
On her part, Dr. Rhoda Wanyenze, a Professor and Dean, MakSPH said the School and Makerere University as whole will be working around research, teaching and partnering with various institutions to provide required evidence especially around supporting Uganda to be able to comfortably predict climatic issues, to ensure quality decisions.
Uganda’s National Climate Change Action Plan (2030) show that all sectors of the economy are vulnerable to climate change effects.
Mrs. Margaret Mwebesa Othieno, the Commissioner of Climate Change at the Ministry of Water and Environment said she was happy to have the Ministry of Health coming on board.
“We are very happy to see that sectors are coming on board. I would also like to say that Uganda is the second country to have the Health -National Adaptation Plan after Nepal. So, to us, this huge and I would like to congratulate the Ministry of Health and all other partners that have supported these efforts. Climate change is everybody’s business. We shouldn’t leave it only to a few sectors,” said Mrs. Othieno Mwebesa.
On behalf of the Government of Uganda, Rt. Hon. Nakadama urged all the Development Partners and stakeholders to continue supporting the implementation of the Climate Health National Adaptation Plan both at national and sub-national levels. She committed that her office would spearhead the mobilisation of the population towards climate resilient systems.
“The Office of The Prime Minister will coordinate the multisectoral engagements for Ministries, Departments and Agencies (MDAs) and also create awareness of the Climate Change Health Adaptation Plan,” said Rt. Hon. Nakadama.
Health
Makerere Researchers Find Psychological Therapy Effective in Improving Diabetes Care in Uganda
By Nelson Bahati
Researchers from Makerere University‘s School of Psychology have found that psychotherapy intervention can improve the well-being of adults living with Type II diabetes mellitus, opening the door for integrating psychosocial support into diabetes care in Uganda.
The findings were disseminated on 16 June 2026 during a research dissemination workshop held at the Physiology Lecture Theatre at the College of Health Sciences, Mulago Hospital.
Led by Professor Peter Baguma, the study titled “The Effectiveness of Cognitive Behavioural Therapy for Diabetes Distress, Depression, Health Anxiety, Quality of Life and Treatment Adherence among Adult Patients with Type II Diabetes Mellitus” investigated whether Cognitive Behavioural Therapy (CBT), a psychological treatment that has proven effective in Western countries, could also work in the Ugandan context.
Presenting the findings, Professor Baguma said the study was motivated by the growing burden of diabetes and the psychological challenges that often accompany the disease but are rarely addressed in routine healthcare.
“Diabetes affects many people in Uganda and across the world. It kills, and those who live with it face many challenges. While psychological interventions have been developed and applied in the Western world, we did not know whether these approaches could work in Uganda. That is why we decided to undertake this study,” he said.
He explained that Cognitive Behavioural Therapy focuses on changing negative thoughts and behaviours that affect people’s wellbeing and ability to manage chronic illnesses.
The researchers sought to determine whether CBT could reduce psychological distress among diabetes patients and improve treatment outcomes.
The controlled study involved 200 adult participants with Type II diabetes mellitus. One hundred participants received the CBT intervention while another 100 formed the control group. Participants in the intervention arm attended eight counselling sessions over four months, with each session lasting between one and one-and-a-half hours.
The therapy covered several modules, including psychoeducation on diabetes, cognitive restructuring, medication adherence, problem-solving, coping strategies, physical exercise, relaxation techniques and strategies for maintaining treatment.
According to Professor Baguma, the findings showed that psychotherapy significantly improved participants’ wellbeing.
“The group that received the intervention experienced reduced stress levels and lower blood sugar levels compared to those who did not receive the therapy. We conclude that CBT is effective and should be adopted as part of diabetes care,” he said.
The study also yielded another important discovery.
“We have discovered that CBT as practised in the Western world is somewhat narrow. Their manual contains only eight elements. In Africa, we found that three additional components are necessary: effective communication between patients and health workers, goal setting, and instilling hope among patients. We call this African CBT,” Professor Baguma explained.
He added that the findings had also revealed the need to incorporate psychosocial care into the management of chronic illnesses and to train healthcare workers to address the psychological dimensions of disease.
Professor Andrew Marcel Otim, one of the co-investigators and founder of the Uganda Diabetes Association, said the study had brought to the fore an aspect of diabetes care that has long been neglected.
“There have been many efforts to address the physiological effects of diabetes, but we have largely ignored the psychological part of the disease. Yet the psychological aspect is huge,” he said.
He added that, diabetes management should go beyond medication but rather intergrate other components of care.
“Education, nutrition, exercise and self-monitoring are extremely important. Even simply knowing what to do is a very powerful intervention. Psychological distress and depression can increase blood sugar levels, so we need to help patients remain calm and hopeful,” he said.
Drawing from his experience as a clinician and educator, Professor Otim encouraged people living with diabetes to embrace physical activity.
“I tell my students and my patients to put on some music, dance, sweat and enjoy themselves. Nutrition, education and exercise remain central to managing diabetes.”
Dr. Wilber Karugahe, a counselling psychologist at Makerere University‘s School of Psychology and one of the co-investigators, said the findings demonstrate the need to integrate psychological care into the management of chronic diseases.
“A lot of studies focus on physical illness and not the psychological conditions that accompany these illnesses. This study confirms that diabetes has a significant psychological aspect and that patients need psychological interventions as part of their care,” he said.
Explaining the essence of Cognitive Behavioural Therapy, Dr. Karugahe noted that the approach helps people restructure their thoughts and behaviours.
“Imagine putting a sticker on your fridge that reminds you that some foods are not good for you and that healthier options are better. That is CBT. It helps people change the way they think and behave, and it can be used to address many behavioural challenges.”
The dissemination workshop was also attended by officials from the Ministry of Health, including Mrs. Christine Ninsiima Ahimbisibwe, Senior Programme Officer for Mental Health and Substance Abuse Control, and Mrs. Patience Butesi from the Department of Mental Health and Drug and Substance Abuse.
Mrs. Ahimbisibwe welcomed the findings and emphasised the need to integrate the study’s recommendations into Uganda’s clinical guidelines to enable healthcare workers to provide psychosocial support to patients living with chronic illnesses such as diabetes.
The human impact of the intervention was perhaps best illustrated by testimonies from participants who underwent the psychosocial training.
Tebugulwa Josephine, a retired teacher and employee at Mulago National Referral Hospital, said the intervention restored hope in her life.
“When we first joined the programme, we thought we were moving dead people. But now we have hope. I have hope of reaching 90 years. We were taught how to exercise and take care of ourselves. Even our families no longer treat us as sick people because we can now walk and participate in daily activities.”
Another participant, Bunje Joice, described the intervention as life-changing.
“People had already given up on me and were waiting for me to die. I could hardly walk, but now I can walk long distances and my diabetes levels have improved. Physical exercise has become my first medicine.”
Kyomuhendo Kate said the programme helped her manage stress and improve her health.
“I was so stressed and my legs were swelling, but after attending the treatment sessions, I am now much better.”
Sebuliba Bernard said the training transformed how he manages his condition.
“They taught us how to exercise, how to live and how to eat. If we follow what we were taught, we can change our lives.”
Based on the findings, the researchers recommended scaling up the intervention to district, regional and national referral hospitals, integrating psychosocial interventions into the training of health workers, and undertaking policy reforms to strengthen mental health support for people living with chronic illnesses.
The study was funded by the Makerere University Research and Innovations Fund (Mak-RIF) and brought together researchers from psychology and medicine, including co-investigators: Dr. Fredrick Nakwagala, Dr. Wilber Karugahe and Dr. Anne Ampaire.
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