Health
Ugandan sickle cell researchers keep pace with aging patients
Article courtesy Fogarty International Center
September/October 2024 | Volume 23 Number 5
Until recently in Uganda, most children with sickle cell disease (SCD) never celebrated their fifth birthday—only 30% lived past this milestone. This low survival rate was mainly due to inadequate health care interventions for these children, plus lack of widespread newborn screening, explains Dr. Sarah Kiguli , a professor at Makerere University College of Health Sciences. Things are different today. Over the past decade, the East African nation has instituted a policy of screening newborns while strengthening strategies to manage their health. This means more children with SCD are growing into adolescence and adulthood.
Challenges still exist, says Kiguli. For example, the community and district facilities where many Ugandan children are born cannot provide comprehensive services, including newborn screening. Another issue: the risk of SCD complications related to kidneys, lungs, heart—almost all organs—grows higher as patients grow older, yet scientific research in Uganda hasn’t caught up with the reality of these longer lives. As a result, teens and adults with SCD don’t get “the care they deserve,” says Kiguli.
“It’s very painful for us pediatricians to see our patients encounter challenges and problems when they transition to adult care.”
Renewed research focus
Despite years devoted to children’s health, Kiguli believes it’s time to prioritize studies exploring appropriate SCD management in teens and adults. “We need solutions that address all the patients’ needs, including reproductive health, as they transition out of childhood.” She’s spearheaded a multidisciplinary research training program for researchers focused on the needs of people with SCD at all ages: Enhancing Research capacity for Sickle Cell Disease and related NCDs across the Lifespan in Uganda (ENRICH).
“Among our PhDs, we don’t have anyone from pediatrics—and that’s fine,” says Kiguli. Importantly, the researchers are trained as a group to amplify the benefits of multidisciplinary collaboration. “We’ve been working in silos—pediatricians alone, physicians alone, social scientists alone—that won’t help us address the comprehensive needs of these patients.”
Methodology has also been given sufficient consideration. “We provide both individual and team mentorship from the beginning,” said Kiguli. Monthly meetings help trainees develop personal development goals and career path plans in the hope they will continue in the field. The program also provides research training to health professionals, such as medical doctors, laboratory personnel, and nurses, who are not necessarily doing degree programs, “so those who manage patients routinely might also benefit,” said Kiguli.
South-to-South unity
For the project, Makerere University has partnered with Busitema University, located in eastern Uganda, where “prevalence of the sickle cell trait is as high as 20%,” says Kiguli. (Sickle cell trait refers to when a person has inherited one mutated allele of the sickle cell gene, not two.) This local prevalence contrasts with about 13% prevalence elsewhere in the country. Studying the disease in a high burden locale is highly relevant, because results may influence policy and treatment guidelines.
Kiguli has other reasons for collaborating with Busitema University, which is less than 15 years old. “We want to build capacity at this young institution since our colleagues there have less chance of doing research than we at Makerere do.” Working and supervising trainees together will give Busitema’s faculty much-needed experience, while providing opportunities for faculty at both universities to learn from each other. Kiguli also hopes the new collaboration will advance progress made as result of the universities’ past partnerships. “Capacity must be built in a sustainable way,” says Kiguli.
“It’s important to work collaboratively and not competitively—this is just as important for Makerere University as it is for Busitema University.”
ENRICH trainees talk about their projects
Dr. Jackline Akello
Dr. Jackline Akello, PhD candidate
Dr. Jackline Akello, PhD candidate
My project is “Sickle cell disease in pregnancy: Experiences in provision and access to care and adverse pregnancy outcomes at Mbale and Kawempe Referral Hospitals.” As an obstetrician and gynecologist, I work as a lecturer at Makerere University and provide clinical care at the two national referral hospitals. I have encountered significant challenges in managing pregnant women with sickle cell disease (SCD) due to a number of healthcare navigation challenges. Additionally, the diverse cultural beliefs associated with SCD in Uganda affect access to care and ultimately outcome and quality of life for the patient.
By October, I will have started the enrolment of 161 pregnant women with confirmed SCD for my project. These participants will be followed throughout their pregnancies to track maternal and fetal complications, including stillbirths and low birth weight. Their experiences with the healthcare system will also be explored. As a Safe Motherhood champion, I have been focusing on hypertensive disorders in pregnancy, including pre-eclampsia, but this October at the Safe Motherhood Conference I will discuss the effects of SCD during pregnancy with the Ministry of Health. One of the endpoints of my study is to improve care for pregnant women who have SCD to enhance their pregnancy experience and outcomes.
Dr. George Paasi
Dr. George Paasi, PhD candidate
Dr. George Paasi, PhD candidate
My project is “The Clinical Epidemiology, Spatiotemporal Patterns and Disease Modifiers of Severe Malaria among Children with Sickle Cell Disease in Eastern Uganda.” Uganda ranks fourth among countries with high burden of SCD and is in the top 10 with respect to malaria burden. Eastern Uganda has the highest burden of both diseases. My project addresses this dual burden of SCD and malaria in eastern Uganda—I want to decipher the SCD-malaria syndemic in this region.
I’m a medical doctor, I have a master’s in public health, and I just finished a fellowship in infectious disease, epidemiology, and biostatistics. I’ve worked at Mbale Clinical Research Institute for the last 10 years. Previously, I worked on an NIH-funded trial in Africa called Realizing Effectiveness Across Continents with Hydroxyurea (REACH) as a medical officer, and now I’m embarking on this PhD training. My hope is that the findings from my study will improve the identification of patients with SCD at risk of adverse outcomes when they get malaria. I also want to identify, through spatial temporal analysis, hotspot locations that require priority interventions. I also want to gain skills as an independent researcher in SCD and make a meaningful contribution to this field.
Dr. Anita Arinda
Dr. Anita Arinda, PhD candidate
My project is “Prevalence, associated factors, course and impact of major depressive disorder in adolescents with SCD in Mulago National Referral Hospital.” We have limited data on mental health of adolescents with SCD, so that’s why my project mainly looks at depression in adolescents (ages 10 to 17).
In our setting, we are fortunate that children with SCD live past their fifth birthday thanks to improved health care, but this presents new challenges. During adolescence, patients enter a crucial stage where they’re trying to develop their identity, yet they’re also beginning to understand the implications of their condition—that having this serious health condition cuts their life short. I want to understand their experiences. How does depression in adolescents with SCD differ from depression in adolescents without SCD? We know that sickle cell disease causes inflammation, so does that contribute to their depression? How does depression affect clinical outcomes, if at all?
If we can understand the underlying mechanisms of depression in teens with SCD, then we might find new ways to manage their care (as opposed to conventional treatment with antidepressants). I’ll do my research at Mulago National Referral Hospital, which has a clinic dedicated to children and teens with sickle cell disease. The clinic provides many services, but unfortunately no specialized mental health services. One day I hope that changes, so that children with SCD and depression can get help early.
Makerere University College of Health Sciences (MakCHS) continues to advance its internationalization agenda by strengthening cross-border partnerships and expanding student and staff mobility in response to global health training needs. Recognizing international collaboration as a cornerstone of contemporary health professional education, the College has established strategic partnerships with leading institutions, including the University of the Western Cape (South Africa), the Medical University of Graz (Austria), and Universitas Syiah Kuala Faculty of Medicine (Indonesia). These collaborations focus on joint research initiatives and the training of dentists and physicians.
During the period July–September 2025, MakCHS recorded increased inbound student mobility, hosting 86 short-term international students. The majority (73%) came from eight partner institutions, with Europe accounting for 64% of all inbound students. Norway led with students from the University of Bergen and the University of Agder, followed by Italy and the Netherlands. The College also hosted students from Somalia International University, Moi University (Kenya), and institutions in the United States. Most visiting students were medical trainees, with placements mainly in Paediatrics at Mulago National Referral and Teaching Hospital, as well as Emergency Medicine and Obstetrics & Gynaecology at Kawempe National Referral Hospital.
These exchanges demonstrated strong bilateral commitment, notably with the Medical University of Graz, which sent students to MakCHS while simultaneously hosting MakCHS students, even in the absence of Erasmus Mundus Plus funding. Inbound mobility enriched the learning environment through intercultural exchange, inclusiveness, and exposure to diverse clinical and academic perspectives.
Outbound mobility also expanded significantly. MakCHS students undertook clinical rotations in the United Kingdom, the United States, and Austria. Two students completed hematology and oncology rotations at Addenbrooke’s Hospital, Cambridge, while others trained in plastic and reconstructive surgery at the University of Minnesota Medical Center–Fairview. Additional students undertook highly specialized rotations in paediatric surgery, orthopaedics, neurosurgery, and cardiac surgery at the Medical University of Graz, gaining exposure to advanced, patient-centred healthcare systems and strengthening their global clinical outlook.
Staff outward mobility was equally notable. Several MakCHS staff and graduate students participated in the Annual Global Health Conference organized by NUVANCE Health, an international partner. MakCHS faculty contributed through presentations, posters, and panel discussions, highlighting research on decolonization in global health education, adolescent health, and global mental health. These engagements provided valuable networking opportunities with global health funders and reinforced the importance of transnational academic partnerships in advancing health equity.
Through sustained partnerships, increased mobility, and active global engagement, MakCHS continues to position itself as a key contributor to global health education, research, and practice.
Health
Makerere University and Tsinghua University Launch Landmark China–Uganda Joint Laboratory on Natural Disaster Monitoring and Early Warning
Makerere University has taken a decisive step in strengthening Uganda’s and Africa’s capacity for public safety, disaster preparedness, and climate resilience with the official launch of the China–Uganda Belt and Road Joint Laboratory on Natural Disaster Monitoring and Early Warning, a flagship collaboration with Tsinghua University of China.
Launched during the Makerere University–Tsinghua University Symposium on Public Safety and Natural Disaster Management, the Joint Laboratory positions Makerere as a continental hub for cutting-edge research, innovation, and policy-relevant solutions in disaster risk reduction, early warning systems, and emergency response. The Laboratory will be hosted by Makerere University and is the only facility of its kind in Africa under this cooperation framework, underscoring its regional and global significance.
A Strategic Partnership Rooted in Research, Policy, and Practice
In his opening remarks, Prof. Barnabas Nawangwe, Vice-Chancellor of Makerere University and Ugandan Co-Director of the Joint Laboratory, traced the origins of the partnership to 2018, when a Makerere delegation visited Tsinghua University and the Hefei Institute for Public Safety Research. He recalled being deeply impressed by China’s advanced capacity in public safety research, disaster monitoring, and emergency management capabilities that directly respond to Uganda’s growing exposure to floods, landslides, epidemics, and other hazards.
The Vice-Chancellor noted that the successful establishment of the Joint Laboratory followed a competitive grant process under China’s Belt and Road Initiative, supported by the Government of Uganda and regional partners, including Nigeria and Côte d’Ivoire. He emphasized that the Laboratory aligns squarely with Makerere’s strategic ambition to become a research-led and research-intensive university, while also advancing its internationalisation agenda.
“This Laboratory will significantly enhance Makerere University’s ability to generate evidence-based research that directly informs government policy and public safety interventions. It will serve not only Uganda, but Africa at large,” Prof. Nawangwe said.
He further underscored the Laboratory’s national importance, noting that similar facilities in China are regarded as national-level laboratories, entrusted with supporting government decision-making and national resilience. Relevant Ugandan institutions, including the Office of the Prime Minister (OPM), UPDF, Uganda Police, Ministry of Health, and humanitarian actors, are expected to actively participate in the Laboratory’s work.
Tsinghua University: Advancing Science Diplomacy and South–South Cooperation
Speaking on behalf of Tsinghua University, Prof. Yuan Hongyong, Dean of the Hefei Institute for Public Safety Research and Chinese Co-Director of the Joint Laboratory, described the initiative as both a scientific milestone and a powerful demonstration of South–South cooperation.
He emphasized that natural disasters transcend national borders and demand collective, science-driven responses. By combining Tsinghua’s technological expertise, including satellite monitoring, AI-driven analytics, and integrated early warning systems, with Makerere’s deep regional knowledge and policy engagement, the Joint Laboratory provides a robust platform for innovation, applied research, and practical solutions tailored to African contexts.
The Laboratory will function not only as a research centre, but also as an operational platform for natural hazard monitoring, early warning, risk assessment, and capacity building, supporting Uganda and the wider African region in building more resilient communities.
Government of Uganda: Research as a Pillar of National Resilience
Representing the Office of the Prime Minister, Mr Frederick Edward Walugemba, reaffirmed the government’s strong support for the Joint Laboratory, recognizing research as a cornerstone of effective public safety and disaster management. The OPM highlighted its constitutional mandate to coordinate disaster preparedness and response through institutions such as the National Emergency Coordination and Operations Centre (NECOC).
He mentioned that the Office of the Prime Minister is committed to working closely with Makerere University and its partners, underscoring the importance of multi-agency collaboration, robust data systems, and timely policy advisories to address the complex, multidimensional nature of public safety challenges.
China–Uganda Relations and the Role of Science Diplomacy
Mr. WANG Jianxun, Commercial Counsellor of the Embassy of the People’s Republic of China in Uganda, lauded the Joint Laboratory as a concrete outcome of the growing China–Uganda Comprehensive Strategic Partnership. He emphasized that the collaboration reflects China’s commitment to knowledge sharing, technology transfer, and people-centred development, particularly in areas such as climate adaptation, disaster risk reduction, and sustainable development.
He also highlighted the Belt and Road Initiative as a framework that extends beyond infrastructure to include scientific cooperation, academic exchange, and innovation-driven development, with the Joint Laboratory standing as a model of how universities can advance diplomacy through science.
Makerere’s Multidisciplinary Strength at the Core
In his concluding remarks, Prof. Nawangwe reaffirmed Makerere University’s readiness to operationalize the Laboratory through a multidisciplinary research team spanning public health, geography, engineering, computing, artificial intelligence, social sciences, and the built environment.
He stressed that effective disaster management must integrate technology, human behaviour, governance, and community engagement, noting the importance of sociological insights in addressing risk perception and public compliance during disasters. Makerere will also engage emerging universities and regional partners to ensure the Laboratory’s benefits are widely shared.
The Vice-Chancellor also commissioned an interim, multidisciplinary coordination committee to operationalise the Joint Laboratory, drawing expertise from health, climate science, engineering, artificial intelligence, social sciences, and government agencies.
Hon. John Chrysostom Muyingo Officially Launches the Laboratory
The Joint Laboratory was officially launched by the Honourable John Chrysostom Muyingo, Minister of State for Higher Education, who applauded Makerere University and Tsinghua University for securing the prestigious grant and advancing Uganda’s science and research agenda.
Hon. Muyingo reaffirmed the Government’s commitment to supporting research that informs national development, public safety, and disaster preparedness. He urged Ugandan researchers to fully leverage the partnership to learn from China’s experience in transforming research into actionable solutions for society.
“This Laboratory is a clear demonstration of how strategic international partnerships can strengthen national capacity, inform policy, and protect lives,” the Minister said, as he formally declared the symposium and laboratory launch open.
Positioning Makerere as a Regional Centre of Excellence
Makerere University already plays a critical role in public safety, disaster preparedness, and early warning through a range of research, training, and operational partnerships. Through the School of Public Health (MakSPH) and the Infectious Diseases Institute (IDI), the University has led national and regional initiatives in epidemic preparedness, emergency response, and early warning, including Field Epidemiology Training, risk prediction modelling, and multi-hazard risk assessments that inform district and national preparedness planning. A national assessment of 716 health facilities conducted by MakSPH revealed widespread exposure to climate-related hazards and systemic preparedness gaps, directly informing the Ministry of Health’s Climate and Health National Adaptation Plan (H-NAP 2025–2030)
Makerere has also been at the forefront of disaster risk reduction innovation and community resilience through the Resilient Africa Network (RAN), which has supported scalable, evidence-based solutions such as EpiTent, a rapidly deployable emergency health facility; RootIO, a community-based radio communication platform used for risk communication and early warning; and RIAP Horn of Africa, which advances climate-resilient water harvesting technologies for drought-prone pastoralist communities.
Earlier, the University led the USAID-funded PeriPeri U project (2014–2019) and a disaster management collaboration with Tulane University, strengthening applied research, training, and early warning systems across Africa, efforts that laid the foundation for RAN and Makerere’s current disaster resilience agenda.
In collaboration with government and international partners, Makerere has supported the strengthening of Emergency Operations Centres, including the development of Regional Emergency Operations Centre (REOC) dashboards to improve real-time coordination and situational awareness. IDI has further contributed to epidemic intelligence and early warning, supporting districts to update WHO STAR-based risk calendars, strengthen sub-national preparedness, and enhance real-time decision-making during outbreaks. Makerere teams have also been deployed regionally to support Marburg and Mpox outbreak responses in Rwanda and the DRC, while advancing outbreak modelling as an early warning tool for high-consequence infectious diseases.
Complementing these efforts, the Department of Geography, Geo-Informatics and Climatic Sciences conducts transdisciplinary research on floods, landslides, droughts, soil erosion, and land-use change, using geospatial analysis, earth observation, modelling, and participatory methods to translate complex data into actionable early warning and risk information for policymakers and communities. These ongoing initiatives collectively demonstrate Makerere University’s established capacity in public safety, disaster preparedness, and early warning, providing a strong operational and scientific foundation for the China–Uganda Belt and Road Joint Laboratory.
With strong backing from the Governments of Uganda and China, as well as leading international partners, the China–Uganda Belt and Road Joint Laboratory on Natural Disaster Monitoring and Early Warning is poised to become a regional centre of excellence for disaster risk reduction research, training, and innovation.
The Laboratory will contribute to improved early warning systems, faster emergency response, stronger policy coordination, and enhanced scientific capacity, cementing Makerere University’s role at the forefront of addressing some of the most pressing public safety challenges facing Uganda, Africa, and the global community.
Caroline Kainomugisha is the Communications Officer, Advancement Office Makerere University.
Health
Makerere University Explores Strategic Partnership with Tsinghua University in Safety Science, Disaster Resilience and Public Health
Makerere University has taken a significant step toward strengthening global research collaboration following a high-level meeting between Vice Chancellor Prof. Barnabas Nawangwe and a delegation from Tsinghua University’s Hefei Institute for Public Safety Research, one of China’s leading centres of excellence in disaster prevention, public safety, and emergency management. The engagement marked a renewed commitment to advancing scientific cooperation between the two institutions, particularly in addressing complex environmental and public health challenges that continue to shape national and global development.
A Partnership Anchored in Shared Challenges and Global Priorities
In his remarks, Prof. Nawangwe emphasized that the concept of comprehensive public safety, spanning natural disasters, epidemics, infrastructure failures, and social risks, is increasingly relevant to all colleges and disciplines at Makerere. Uganda’s experience with epidemics such as Ebola, cholera, and COVID-19; frequent landslides in mountainous regions; flooding events; and rising traffic-related incidents place the University in a unique position to contribute applied research, community-based insights, and local knowledge to a global scientific dialogue.
He noted that the Tsinghua presentation revealed new areas of alignment, particularly in epidemic modelling, early-warning systems, and integrated emergency management, areas where Makerere’s public health scientists, medical researchers, and social scientists have extensive expertise.
“This collaboration offers meaningful opportunities for nearly every college at Makerere,” he noted. “Public safety touches the environment, public health, engineering, social sciences, ICT, humanities, and urban planning. The challenges we face as a country make this partnership both timely and essential.” Prof. Barnabas Nawangwe noted.
Tsinghua University: A Global Leader in Comprehensive Public Safety.
The delegation from Tsinghua University outlined China’s national investment in Public safety over the past two decades, an effort driven by the recognition that life and security are the foundation of sustainable development. Tsinghua’s Hefei Institute for Public Safety Research has developed nationally recognised research platforms and large-scale simulation facilities dedicated to Natural disaster modelling (earthquakes, landslides, floods, typhoons, Infrastructure and urban systems safety, Public health emergencies and epidemic preparedness, Early-warning, monitoring, and emergency communication, Traffic and transportation safety, Post-disaster reconstruction and resilience planning.
Their systems currently support over 100 provincial and municipal emergency management centres in China, underscoring their global leadership in practical, scalable solutions for disaster risk management. The delegation reaffirmed that Uganda’s lived experience with multiple hazards presents opportunities for meaningful knowledge exchange. They expressed particular interest in learning from Makerere’s work on epidemic response, community health systems, and the social dimensions of disaster management.
Emerging Areas of Partnership
The meeting identified several promising pathways for long-term collaboration:
1. Joint Research in Disaster Risk Reduction and Climate-Related Hazards
Both institutions expressed readiness to co-develop research projects on landslides, floods, urban resilience, and multi-hazard modelling, drawing on Tsinghua’s advanced simulation technologies and Makerere’s environmental expertise and geographic field realities.
2. Public Health Emergency Preparedness and Epidemic Response
Makerere’s renowned public health schools and research centres will collaborate with Tsinghua on epidemic prediction, early-warning systems, and integrated preparedness frameworks, leveraging Uganda’s decades of experience managing high-risk disease outbreaks.
3. Infrastructure and Urban Safety, Including Traffic Systems
With Uganda experiencing rapid urbanisation and high rates of motorcycle-related road incidents, Tsinghua shared insights from China’s own transformation, including infrastructure redesign, transport modelling, and public transit innovations. Collaborative work in this area would support city planning and road safety interventions in Kampala and other urban centres.
4. Academic Exchange and Capacity Building
Both sides expressed interest in student exchanges, staff mobility, co-supervision of postgraduate research, and specialised training programmes hosted at Tsinghua’s world-class safety research facilities.
5. Development of a Joint Public Safety Laboratory at Makerere
The institutions are exploring the establishment of a collaborative safety research platform in Uganda. This initiative could serve as a regional hub for innovation in emergency management, environmental safety, and technology-driven risk assessment.
Towards a Long-Term, Impactful Collaboration
The meeting concluded with a shared commitment to develop a structured partnership framework in the coming months, supported by both universities and aligned with Uganda–China cooperation priorities. Both teams acknowledged that the partnership must yield tangible results that enhance community resilience, bolster national preparedness systems, and foster scientific capacity for future generations.
Prof. Nawangwe commended Tsinghua University for its willingness to co-invest in research and capacity building, noting that such collaborations position Makerere not only as a leading research institution in Africa but as an active contributor to global scientific progress.
“This partnership has the potential to transform our understanding of the science of public safety to deliver solutions that safeguard lives.” Prof. Barnabas Nawangwe noted.
“It aligns perfectly with Makerere’s mission to be a research-led, innovation-driven university responding to the world’s most urgent challenges.” He added.
As part of this strategic partnership engagement, Makerere University will, on Wednesday, 17th December, co-host the Makerere University–Tsinghua University Symposium on Public Safety and Natural Disaster Management. The symposium will run from 8:00 AM to 2:00 PM in the University Main Hall, Main Building.
This symposium represents a deepening of collaboration not only between Makerere University and Tsinghua University, but also a broader strategic partnership between Uganda and the People’s Republic of China.
During the event, H.E. Zhang Lizhong, Ambassador of the People’s Republic of China to Uganda, together with the State Minister for Higher Education, Government of Uganda, will officially launch the China–Uganda Belt and Road Joint Laboratory on Natural Disaster Monitoring and Early Warning. The Laboratory will be hosted at Makerere University, positioning the University to play a central role in strengthening Uganda’s and the region’s capacity for natural disaster preparedness, public safety, and emergency management research.
Caroline Kainomugisha is the Communications Officer, Advancement Office, Makerere University.
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