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 University Public Health students recount hands-on experience in Ebola case finding in Uganda
On Tuesday January 14, 2025, under the radiant rays of the Ugandan sun, Laura Silovsky crossed the stage at Makerere University’s 75th Graduation Ceremony to receive her master’s degree in Public Health Disaster Management (MDM). Hers is a story of passion, dedication, and curiosity to rewrite the narrative of global education. Among 1,813 master’s graduates, Laura’s story stood out, as a blend of refugee roots, firefighting bravery, and a drive to decolonize learning.
Laura’s journey began long before her arrival in Kampala. Born in the UK to a father who fled from Czechoslovakia’s dictatorship in the 1970s, she grew up understanding displacement intimately. “My father was a refugee. Why would I fear refugees?” she once asked during her research fieldwork in Uganda’s West Nile, where her empathy bridged divides.
“People in Uganda may not expect that a muzungu could be the child of a refugee, but my family experienced displacement from (what was then) Czechoslovakia as well as the effects of the protracted conflict in Northern Ireland. Fortunate to have been born in the UK, I was raised to appreciate that disasters can affect anyone, anywhere, anytime.
After studying Sustainable Development at the University of Edinburgh, I worked on a behavior change project tackling non-communicable diseases in Scotland,” Laura says.
Her journey twisted through battling Australia’s bushfires and volunteering in a COVID pandemic, but it was Uganda’s welcoming refugee policies and Makerere University’s academic excellence that pulled her in next.
“In 2020, I relocated to Australia, just after the worst bushfires since records began and before the COVID-19 pandemic. The following two years, I qualified as a firefighter and supported bushfire recovery by volunteering with a community-based organization. After gaining some insight into these different disasters, I made the decision to return to higher education, and so I applied for the MDM programme at Makerere in 2022,” says Laura.
Armed with experience in emergency response, Laura was drawn to the field’s multidisciplinary nature and was convinced she needed to expand her expertise beyond immediate recovery efforts. She aimed to explore the full disaster management cycle and the intricate connection between health and environment.
“I needed to combine gaining academic knowledge with developing practical skills, so the field placement offered within the master’s degree in Public Health Disaster Management programme was a major motivator for me,” she shared.
The love for Uganda
Studying at the University of Edinburgh, Laura took a class in Kiswahili, that included a field-based short course on the Tanzanian shores of Lake Victoria. This experience sparked a desire to spend more time in the region, but she knew she needed to expand her skill set in order to genuinely add value to an organisation, if she was on the continent.
“I hoped studying at an East African university would teach me invaluable soft skills needed to work more effectively as an international team member. Makerere University School of Public Health (MakSPH) has a strong reputation, and I wanted to study somewhere that was locally grounded but globally recognized. Uganda’s progressive refugee policies were an added incentive to learn from experts here,” Laura says.
Laura’s intentional choice to decolonize her education
“I came to Uganda to learn from the experts here,” Laura declared, rejecting Eurocentric frameworks. “A big factor for me wanting to study at Makerere University was to decolonize my education, to recognize that the knowledge about responding to public health disasters and supporting refugees is here in Uganda,” she says.
She adds, “When I first arrived, I was quite vocal with my classmates about wanting to challenge that bias and truly acknowledge the wealth of knowledge within institutions like Makerere. The expertise here is invaluable, and I was intentional about decolonizing my education.”
At MakSPH, Laura immersed herself in courses like epidemiology, struggled briefly with statistics, but thrived on critical discussion groups and consultation with lecturers.
Collaborating with classmates from Uganda and across East Africa, she learned Luganda phrases and Somali proverbs, and built a “family” united by late-night study sessions and shared ambitions.
Beyond expectations
For Laura, studying at MakSPH was the best decision she could have made. She is still struck by the faculties’ wealth of academic and professional experience in public health and disaster management.
“I anticipated the programme would focus on applying the knowledge we gain to real-world scenarios. Of course, there were cultural differences that took me time to adjust to. I am grateful to faculty members such as Prof. Christopher Garimoi Orach, for his dedication and support, Prof. Elizeus Rutembemberwa for leading by example and valuing students’ time, and Dr. Justine Bukenya and Dr. Simon Kibira for offering their extensive support as my dissertation supervisors.”
The Fieldwork Attachment that Transformed Laura’s Research Experience
At Rhino Camp refugee settlement in West Nile, Laura’s work took on new meaning. Partnering with the Uganda Red Cross Society, she helped digitize data tools and walked long distances through Tika Zone, inspecting latrines and speaking with South Sudanese girls about their challenges in managing their menstrual health through their project that focused on schools.
“That experience in West Nile influenced my own research ideas, and it was a privilege to later return to Rhino Camp for data collection. I will always remember the long days walking with my research assistants through villages and being graciously welcomed by so many respondents,” she recalls, noting that the experiences crystallized her resolve to advocate for refugee dignity globally.
Life in Kampala
Life in Kampala, with its vibrant energy and unique challenges, was truly a ‘full sensory experience’ for Laura. “My parents live in a small village, so Edinburgh felt like a big city when I moved there. And Edinburgh is much smaller and quieter than Kampala! But on weekends, I loved going downtown to shop at Owino Market or heading to Kyadondo Rugby Club for some pork.”
These spaces were perfect for Laura, offering new cultural experiences, including matooke, a starchy dish not found in the UK, which is mainly eaten in Uganda as a local delicacy and staple meal. Despite the differences in culture, sharing meals with classmates provided Laura with a comforting sense of connection.
Back to academics, navigating the university administrative processes wasn’t seamless initially for Laura, though. She says administrative hurdles such as paper-based systems, could change for the university to comfortably enjoy its strong reputation.
She recalls, right at the beginning, when she couldn’t find sufficient information online to support her to complete her application to join Makerere University. However, she later received support from the University’s International Office that deals with the welfare of international students.
Other university officials, from finance, librarians, program administrators, to academic registrars, played a key role in supporting her in her research and postgraduate training. “The system relies on dedicated individuals,” she noted, calling for digital reforms while praising MakSPH’s “atmosphere of innovation.”
“From my experience, such as when obtaining my transcript, the system relies heavily on individual staff members working around these administrative challenges. I’m grateful for those who helped me navigate this, and I’m interested to see how the university continues its digital transition, as it could greatly streamline processes in the future,” says Laura.
A Bittersweet Graduation Day
On graduation day, Laura’s pride mingled with melancholy. Watching families cheer on graduates, she reflected on classmates sidelined by finances or family crises.
Having gone through the course and interacted with Ugandan students, Laura hints on the common financial and personal challenges preventing many from graduating: family illness, new children, sponsorship falling through.
“I know so many of my classmates had worked so hard and were almost over the finish line but, due to financial challenges or other commitments at home, it wasn’t possible for them to graduate this year,” she says.
“For me, I was able to make the choice to pursue this program before having children, so I had fewer responsibilities at home, and I had also been saving for many years to get the money to pay tuition. Because I knew I had the money for tuition before I started, I could focus on studying. As you know, the reality for many people is that that’s not always possible.
“Small supports can transform student experiences,” Laura emphasized, advocating for systemic empathy. She sees great potential for more pastoral support at the university, citing peers from UCU and Kyambogo who benefited from accommodations like private breastfeeding spaces and flexible deadlines in special circumstances. Such initiatives, alongside financial aid, could significantly improve student welfare.
Still, the ceremony’s electric energy—watched via livestream by her parents in Europe—symbolized hope. “Uganda taught me that collaboration transcends borders,” she reflected.
“You could feel this sense of how hard everyone had worked to reach up to that point and that this was really an opportunity for them to celebrate, particularly by having family and friends around to be able to see. I love the PhD awards, when you see the PhD students coming out and their families rushing up to greet them. To me, that’s the best part of the ceremony, because a PhD requires so much work and commitment, and I think it’s really emotional to see everyone share this moment with their support networks,” she says.
Adding that; “…I was so grateful that the ceremony was streamed online. My family were watching live at home in Europe and it was so special that they could see me on camera and participate in the ceremony that way as well.”
Laura noted striking similarities between Makerere and Edinburgh’s ceremonies, especially the moment when students were asked to turn and thank their families, an emotional and powerful tradition.
Looking Ahead
Now in Tanzania, Laura eyes roles with international NGOs, armed with Ugandan-taught pragmatism and a zeal to challenge Europe’s refugee policies. “MakSPH gifted me more than a degree—it reshaped my worldview,” she says.
“As a muzungu with a Ugandan postgraduate education, I feel privileged to have benefitted from different educational perspectives, and I hope that the skills and knowledge I acquired during my time at Makerere will help me to secure a role with an international NGO. After witnessing the incredible support that Uganda provides to refugees, I also hope to advocate for more dignified policies concerning refugees in Europe,” she shares.
“There’s a spirit of innovation and dedication at Makerere, particularly when passionate lecturers like Prof. Orach, Dr. Roy Mayega, or Dr. Victoria Nankabirwa engaged students through discussion and sharing lived experiences. You could really see a different level of engagement within the students as well. Overall, I’ve had such a fantastic experience at Makerere University.”
“I wouldn’t change a thing,” she smiles.“Except maybe convince more Europeans to study here. Africa’s wisdom is the future.”
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