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.
At a ceremony held on 30th May 2025, themed ‘They taught us without saying a word’, the Makerere University College of Health Sciences (MakCHS) commemorated the silent teacher which are the cadavers (bodies) used in anatomy classes for medical students. In addition to a commemoration service, the event was used to create awareness and sensitise the public about the the importance of whole body donation.
The chief guest at the commemoration was Professor Mukadasi Buyinza, Deputy Vice Chancellor – Academic Affairs representing the Vice Chancellor, Professor Barnabas Nawangwe. The event attended by MakCHS students, staff and alumni was organised by students under Anatomy Society of MakCHS supported by Department of Anatomy and MakCHS leadership.
Welcoming guests to the event, Waziwu Mordecai–final year student of medicine and surgery who serves as President of the Anatomy Society, MakCHS explained that the reason for the gathering is three-pronged: to commemorate the silent teachers who make a profound contribution to medical education; to instill knowledge, compassion, and professionalism in future healthcare providers; and call on the community to support this noble act through awareness, advocacy, or future donation. ‘May the memory of our silent teachers live on in every life we will one day save’, he said.
The Anatomy society was founded in 2013 with aim of students providing peer mentorship to fellow students in lower years, such mentorship sessions help students appreciate better the anatomy of the human body. The society has supported:enhanced learning and mentorship; promoted academic participation including internal and external quizzes; and fostered connections including strengthen relationships between students across classes and with alumni.
Professor Elisa Mwaka, Head – Department of Human Anatomy welcomed all present for attending the ceremony. He thanked the College management led by the Principal, Professor Bruce Kirenga for the support provided in organizing the ceremony. He also expressed utmost appreciation to the Vice Chancellor for attending despite the competing priorities requiring his attention.
Professor Mwaka highlighted that we are here today, to pay our respect to the individuals whose bodies have been used for medical examination and research at MakCHS through offering prayers as well as sensitize people about willful/consented whole body donation.
Professor Mwaka explained that globally, sources of whole bodies for medical education and research are got through willed whole-body donation, unclaimed bodies in hospitals, imported bodies, executed persons among other means. In Uganda, unclaimed bodies in hospitals are used for medical as determined by the Uganda National Rules in the Penal Code Act of 1957.
In 2012 International Federation of Anatomy Associations (IFAA) recommended voluntary donation as the desirable and the only acceptable source for acquiring bodies. Almost all Africa countries and some European countries lack national body donation programs.
Speaking at the event, Professor Bruce Kirenga, Principal – MakCHS thanked Professor Mwaka for the insightful presentation. He welcomed Professor Buyinza to MakCHS and for accepting to attend despite the late invitation. He recognized the presence of the staff present and support towards the college activities.
Professor Kirenga underlined the importance of biomedical science under which human anatomy falls in medical education. ‘Biomedical sciences play a key role, once someone in grounded in the area, then he will be a good doctor’, he said.
The Principal also stressed that during his term of office operation efficiency will remain key ingredient for service delivery as well as rebuilding and rehabilitation of teaching and learning facilities. ‘Works to make the Biochemistry laboratory a model lab has commenced with a contract awarded to service provider; the refurbishment will be in phases’.
Professor Buyinza Mukadasi thanked the College, Human Anatomy department and the students for organizing the commemoration. ‘The amount of joy I have this morning, we should have done this a long time ago’, he said.
He expressed happiness at this commemoration for the silent teachers who unknowingly give so much to medical education and therefore mankind. He advised that community engagement to create awareness about the need for whole-body donation, regulatory compliance, and alignment to best practices.
He noted that disciplines like medicine is more like charity because medical practitioners give so much of themselves. ‘The number of people attending this ceremony is show of love for the discipline and commitment to the calling’ he said.
Professor Buyinza reiterated the commitment of Makerere University management to support MakCHS endeavours including this culture of commemorating the silent teacher. ‘Well-trained and season doctors are a result of the process explained here and the absence of bodies affects the quality of education provided and therefore the doctors produced’, he added.
Candles for the cadavers were lit and services representative of Anglican, Catholics and Muslims were conducted to remember the souls of the departed and wish them a peaceful rest. Ordinand Cosmas Ddembe for Anglican, Father Valentine Amuneke for Catholic and Dr. Haruna Kiryowa for Muslim preached the importance of respect for the dead and sacrifices of the dead for advancement of research and education in the medical field and health services.
Giving closing remarks, Professor Mwaka noted that setting up whole-body donation programs in Africa requires a holistic approach involving education, cultural sensitivity, legal structures, and partnerships with medical institutions.
Reasons why Africa has failed to establish body donation programs:
- Low awareness and willingness to donate bodies.
- Cultural and traditional beliefs
- Religious beliefs
- Fear of mishanding bodies
- Lack of legislation/ ambiguous regulations
- Lack of institutional policies and standard operating procedures
- Institutions should be encouraged to hold Services of thanksgiving or commemoration for those who have donated their bodies for medical education and research.
The following is required to change the current status:
- Cultural sensitivity and awareness
- Community engagement and awareness creation
- Educational campaigns
- Developing legal and ethical frameworks
- Building partnerships between hospitals and medical institutions
- Establishing local body donation systems i.e.,
- donation registration process,
- consent documentation,
- Logistical infrastructure necessary for the
- donation process.
- Effective communication, public trust,transparency.
- Training and professional development of healthcare providers.
- Global collaboration and funding: to share knowledge, best practices, and resources.
- Government support
- Funding and incentives
- Inclusion of body donation in national health strategies.
In a decisive step toward ending HIV as a public health threat by 2030, Uganda on Thursday, May 29, 2025, officially launched the third Uganda Population-based HIV Impact Assessment (UPHIA 2025) survey, a nationally representative household study expected to provide updated measurements on the status of the HIV epidemic by the end of the year.
The effort is led by Uganda’s Ministry of Health (MoH), with technical assistance from Makerere University School of Public Health (MakSPH), Uganda Bureau of Statistics (UBOS), Uganda Virus Research Institute (UVRI), and the U.S. Centers for Disease Control and Prevention (U.S. CDC), funded by the U.S. government through PEPFAR.
The Population-based HIV Impact Assessment (PHIA) surveys were first launched in 2014 as a global initiative at the International Center for AIDS Care and Treatment Programs (ICAP), based at Columbia University’s Mailman School of Public Health. Supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), through the U.S. CDC, the surveys have been conducted in at least 15 high-burden countries globally, including Uganda.
Led by national Ministries of Health, the PHIA surveys provide robust, population-level data on HIV prevalence, incidence, and viral suppression, offering a clear picture of epidemic trends and the effectiveness of national responses. They are designed to track progress, identify persistent gaps, and inform strategies to reach epidemic control, in line with global targets, including the fast-approaching goal of ending AIDS as a public health threat by 2030.
In Uganda, this survey was first rolled out between August 2016 and March 2017. The second followed in February 2020 but was disrupted by the COVID-19 outbreak, continuing through to March 2021. Both rounds were supported by ICAP at Columbia University, which provided technical assistance to strengthen data collection systems, improve laboratory infrastructure, and build national capacity to design, implement, and analyse the two national HIV surveys.
What sets UPHIA 2025 apart is the shift in technical leadership to Ugandan institutions for this third survey, reflecting local capacity to lead rigorous, high-quality public health research. For UPHIA 2025, Makerere University School of Public Health, in partnership with the Uganda Bureau of Statistics and the Uganda Virus Research Institute, is providing technical leadership to the Ministry of Health, alongside U.S. CDC. Implementation began with initial recruitment and training of over 300 field teams that begun on May 19, 2025, ahead of their nationwide deployment for data collection starting this June.
The first survey (UPHIA 2016) was an important milestone in informing Uganda’s national HIV response. This survey, concluded in 2017, measured, among things, the viral load suppression at the population level and provided household-based HIV testing and counselling, with results returned to participants and those who tested positive referred to care. The survey also assessed HIV incidence, HIV and syphilis prevalence, as well as hepatitis B infection rates. These findings would offer nationally representative data to track Uganda’s progress in controlling the HIV epidemic at both national and regional levels.
The next survey, UPHIA 2020, building on past success, was again executed with technical leadership from Columbia University’s ICAP, working with Uganda’s Ministry of Health alongside UVRI, UBOS, regional referral hospitals, local governments, and the U.S. CDC. It offered useful insights that showed encouraging progress, indicating that up to 88% of people living with HIV in Uganda at the time knew their status, 98% of them were on treatment, and 90% had achieved viral suppression. These results reflected momentum toward the UNAIDS global 95-95-95 targets, ensuring that most people living with HIV are diagnosed, treated, and have the virus under control, and advancing the broader goal of ending the epidemic by 2030.
Since the release of these findings nearly five years ago, which helped shape national HIV programming in Uganda, the country has made notable progress, but challenges remain. The UPHIA 2020 findings reported major gaps in testing coverage, particularly among young people and men. The results were also instrumental in identifying service delivery shortfalls and guiding decisions on resource allocation, program design, and policy. Yet today, Uganda remains one of the most heavily burdened countries in the world, with over 1.5 million people living with HIV and over 50,000 preventable new infections recorded per year.
It is this trend that Uganda’s Ministry of Health is working urgently to reverse. Launching UPHIA 2025 at the Ministry’s headquarters in Kampala on May 29, 2025, amidst great hope and expectation among the participants, Uganda’s Minister of Health, Dr. Jane Ruth Aceng Ocero, noted that the long-anticipated and previously delayed survey had arrived at such a critical moment. She welcomed UPHIA 2025 as both a measure of the country’s resilience and a guide for the final stretch toward ending AIDS by 2030, now just a few years away.
“The UPHIA 2025 survey comes at a strategic time to help us recalibrate and refocus our efforts,” the Health Minister said, underscoring the importance of its outcomes. “This will be Uganda’s final population-based HIV survey before 2030, the target year for ending AIDS as a public health threat. The findings will serve as a baseline for tracking our progress toward this national and global goal. They will also guide the next phase of strategic planning, ensuring that the final push toward 2030 is grounded in robust and reliable data.”
This third round of the survey will be carried out in 6,685 randomly selected households across the country. The exercise will involve interviews with approximately 15,000 individuals aged at least 15 and selected through a national household listing by UBOS. Of those, around 14,980 are expected to provide blood samples for HIV testing and analysis of viral suppression and other health indicators. The survey will also include interviews with 1,300 children and adolescents aged 10 to 14, though no blood draws will be taken from this group. Participation is voluntary, free of charge, and requires consent from the head of each household.
Dr. Aceng explained that beyond providing updated estimates of HIV prevalence, incidence, and viral load suppression, and examining regional and demographic disparities, the survey, which will cover the rest of the year, will include a qualitative post-survey assessment component to gather insights from people living with HIV, particularly those not virally suppressed, to understand their challenges and strengthen support services. Also, for the first time, this survey will assess the burden of non-communicable diseases among people living with HIV and include focused interviews with adolescents aged 10 to 14 in Mid-North and Mid-Eastern Uganda, where viral suppression was reported to be lowest in UPHIA 2020.
These activities are made possible thanks to the development support from the U.S. government, which invested $10 million (about UGX 37 billion) for this survey. Speaking at the UPHIA 2025 launch, U.S. Ambassador to Uganda William W. Popp noted that the United States has partnered with Uganda for over three decades to help people live longer, healthier lives;
“The bulk of our annual support, approximately $500 million this year, is dedicated to health programs, making the U.S. government the largest single provider of health assistance to Uganda,” the Ambassador said. He added, “Through PEPFAR, the United States has played a major role in Uganda’s progress toward ending HIV as a public health threat. Since 2003, when Uganda became one of the first countries to implement the program, we have invested nearly three billion dollars—almost 11 trillion Uganda shillings—in HIV prevention, care, and treatment services, saving millions of lives and making both our countries safer from HIV.”
With the benefit of hindsight, Uganda’s early encounter with HIV in the 1980s marked the beginning of one of the region’s most severe epidemics. But over the decades, a determined national response, driven by political leadership, community mobilisation, collaboration and global support, has delivered measurable progress. In the recent past, adult HIV prevalence fell from 7.2% in 2010 to 5.1% in 2023. Among women, it declined from 8.5% to 6.6%, and among men from 5.8% to 3.6%. AIDS-related deaths dropped from 53,000 to 20,000 over the same period, with female mortality declining by 66% and child deaths by 77%.
All these gains, amidst the challenge, go to show what is possible with sustained commitment. What is more, throughout this long journey of Uganda’s battle with eradicating HIV, Makerere University School of Public Health has played a pivotal role. From the early work of Prof. David Serwadda, whose ground-breaking research during the initial detection of HIV helped shape Uganda’s early response, to last year’s 2024 landmark Purpose 1 study on the twice-yearly injectable Lenacapavir that proved 100% efficacy in preventing HIV infection, MakSPH has remained at the forefront of innovation, evidence generation, and policy influence.
That legacy continues today, with the School providing technical leadership to the Ministry of Health in the implementation of UPHIA 2025. At the launch, MakSPH Dean Prof. Rhoda Wanyenze expressed pride in the School’s role as a trusted partner in Uganda’s fight against HIV and other public health challenges. She noted that for over 70 years, during which the School has existed, MakSPH has helped shape the country’s public health landscape through rigorous research, training, and policy support, anchored by a strong, long-standing partnership with the Ministry of Health and partners.
She also noted that the collaboration between Makerere University and the U.S. CDC has helped build national capacity in surveillance and epidemiology, while also strengthening Uganda’s ability to lead high-quality, large-scale national surveys, asserting that:
“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. After two decades of joint work, we are proud that UPHIA 2024–2025 is now a fully Ugandan-led effort. This is critical to the sustainability of the skills and knowledge generation to inform our local response.”
The survey builds on MakSPH’s experience conducting similar national studies, including those on tuberculosis, prison health, family planning, schistosomiasis, and non-communicable diseases such as the STEPS survey. It will leverage the School’s strong capacity in research and impact evaluation, both in Uganda and across the African region, with a firm commitment to delivering high-quality data guided by the same rigour and integrity that have defined our work over the years, Prof. Wanyenze affirmed.
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