Health
The Sugar That Killed My Mother: A Generation Drowning in Cheap Drinks, Cigarettes and Lies
Published
4 months agoon

On October 15, 2021, the beep of a glucose monitor flatlined in our living room. My mother, Rebecca Nabiteeko (R.I.P.), took her last labored breath as her veins, swollen, burning, and numb, finally surrendered to a decade-long siege by diabetes. Her final days were a cruel liturgy: mornings began with insulin injections, and nights ended with prayers to a God who never answered. “Nsaba Yezu, mpone obulwadde bwa sukaali,” she prayed for deliverance from the sugar sickness. The same sickness that caused numbness of her feet, then her sleep, and finally her life. I miss her.
In our little cramped Kyebando-Kisalosalo home, medication such as pregabalin, Metformin, and Insulin Mixtard—became part of the day’s meals and everyday companions as relatives. We memorized their shapes: the amber vials crowding the dining table, the syringes tucked like shrapnel in drawer corners. Her body was a battleground. Her faith, a fragile ceasefire.
Her story is not unique. It is now becoming every household’s and a Ugandan story. Our country is under attack! While HIV, cholera, and malaria dominate headlines, a quieter killer stalks Uganda: non-communicable diseases (NCDs) like diabetes, hypertension, and cancer now claim 1 in 3 lives, eclipsing infections as the nation’s grim reaper.
“Our clinics are grappling with constant drug stockouts. For hypertension, diabetes, and asthma medications, funding covers just 2% of the actual needs,” reveals Dr. Freddie Ssengooba, a professor of health economics at Makerere University School of Public Health (MakSPH).

In one of the Health Policy Advisory Committee (HIPAC) meetings of Uganda’s Ministry of Health, where key stakeholders gather, a concerning reality about medicine availability was shared.
In schools, teenagers trade 500-shilling cigarettes like sweets. In markets, soda and unregulated sweetened juices flow cheaper than clean water. Uganda’s health system, already strained by several public health issues, is buckling under the NCD surge. “80% of the early 335 COVID-19 deaths in Uganda had NCD comorbidities as an underlying condition,” stated Dr. Eric Segujja, a public health systems researcher, while coronary heart disease, once rare in Africa, now claims 12% of Uganda’s disease burden.
This is a plague of policy, profit, and paralysis, a war where lobbyists outgun public health advocates and sugar drowns out science. My mother didn’t just die of diabetes. She died in a system that incentivizes manufactured epidemics while pushing back on public health responses.

At a dissemination meeting on the political economy analysis of health taxes on unhealthy commodities in Uganda at Kabira Country Club in Kampala in late January this year, Dr. Ssengooba emphasized that, “When discussing NCDs, we need to be very practical.”
Adding that, “Currently, we rely heavily on a few donors and pharmaceutical companies, who provide us with a set of donated drugs each year. If these donors begin to reduce their support, similar to what we’re seeing with the US in the coming days, we will face even greater challenges. This is a critical issue: as we talk about NCDs, there’s no provision within the national budget to address medicine shortages. While there are healthcare professionals trained to manage these diseases, they may end up advising patients to purchase medicines from pharmacies—something that’s not affordable for many, especially those without financial means.”
The culprits? Cheap, sophisticated distribution channels and aggressively marketed unhealthy commodities. For instance, between 2015 and 2023, beer production rose by 42%, soft drinks by 67%, and cigarette sales surged despite taxes.
A presentation titled “Impact of Taxation on the Production, Sales, Revenue, and Consumption of Selected Unhealthy Commodities in Uganda: A Nine-Year Analysis” reveals a significant increase in the production of non-alcoholic beverages, particularly sugar-sweetened drinks, over the years. The highest production levels in the country were recorded during the 2022/2023 financial year. Richard Ssempala a Makerere University lecturer at the School of Economics and a current PhD candidate at Osaka Metropolitan University in Japan, who is also one of the researchers, attributes this growth to the rise in the number of factories and small-scale firms entering the market, coupled with low tax rates on these commodities.
Are Health Taxes, a “Best Buy,” Stalled by Competing Interests?
The World Health Organization (WHO) ranks health taxes on tobacco, alcohol, and sugary drinks among its top “Best Buys” to curb NCDs. Yet in Uganda, implementation faces fierce resistance. Dr. Henry Zakumumpa, a health systems and NCDs researcher at Makerere University, says industry lobbyists have impressed upon government technocrats, people, and commissioners at the Uganda Revenue Authority that when you increase taxes, then there will be distortion of the economy due to low consumption and the government won’t get those taxes, which he says is not true.

“When the taxes remain low, we as public health advocates realize that we shall not achieve our objective of reducing consumption of cigarettes and tobacco because they become affordable. Young people in secondary schools can afford cigarettes, which, of course, as we know, lead to cancer and heart disease. The tobacco industry is interested in maintaining taxes at a level where they’re ineffective, where they are so low that the prices are so low and young people can afford them,” said Dr. Zakumumpa.
But do health taxes work?
Studies that have been conducted elsewhere have shown that, when you increase taxes, the government increases revenue, and also the population reduces consumption of harmful products.
While the industry argues that taxes generate government revenue, a 2017 report by the Center for Tobacco Control in Africa (CTCA), based on a World Bank study, revealed that for every dollar the Ugandan government receives in tobacco taxes, it spends four dollars treating tobacco-related diseases. The government incurs costs at the Cancer Institute, Lung Institute, and Heart Institute, treating individuals with lung cancer, throat cancer, and heart disease linked to smoking in their youth.
“The industry has been successful in misinforming the public, even government officials, by scaring them that if they increase taxes, the economy will suffer and the government will lose revenue, which we have found is actually misinformation,” argues Dr. Zakumumpa.
Dr. Segujja explains, “Health taxes collide with national priorities like the industrialization growth trajectory that the government is pursuing and getting a bulk of the population from the subsistence to a cash economy. Manufacturers of alcohol, tobacco products, and sodas advance this as the rationale for their businesses and, along the way, were attracted to the country with tax incentives to contribute to this objective. Now, they argue new levies will kill jobs and take them out of business.” Industry lobbying has kept Uganda’s tobacco taxes at 30% of retail prices, far below WHO’s 70% recommendation.
The Chemical Hook

For the smokers, every puff injects their veins with 70 cancer-causing chemicals. Smoking doubles their risk of diabetes or that 90% of lung cancers trace back to this habit. But they know one thing: they can’t stop and this is how big tobacco engineers addiction in Uganda’s backyard
“Tobacco is one of the most addictive products,” explains Dr. Zakumumpa. “But do you know why? Manufacturers lace it with nicotine—a chemical trap designed to hook you for life.”

The irony is as bitter as the smoke. In rural Uganda, farmers have chewed raw tobacco leaves for generations without addiction. But in the hands of multinationals like British American Tobacco (BAT) and Marlboro, those same leaves are chemically altered. Nicotine, absent in natural foliage, is added like a sinister seasoning, transforming a plant into a predator.
Profitability of their businesses thrives through repeated consumption by a bulk of consumers.
“They want you as a tenant for life,” Dr. Zakumumpa says. “Even when your lungs scream, your wallet empties, or your blood sugar spikes. When the poor can’t afford cigarettes, they smoke less. The rich? They fund their own demise,” he adds notes.
But isn’t this the science of slavery?
Science demonstrates that nicotine is not only addictive, but also a master manipulator. It rewires brains to crave more, while tar and formaldehyde, some of the 7,000 chemical substances, carve silent graves in lungs. Yet Uganda’s tobacco taxes remain among the lowest globally, keeping packs accessible to teens.

“This isn’t commerce,” Dr. Zakumumpa argues. “Its chemical warfare, and the casualties are in our wards, gasping for air.”
He advises those who are addicted to enroll in nicotine reduction therapies and healthcare treatment at centers designated to help people with tobacco addiction.
“There is something called the National Care Centre (NACARE); we have Serenity Centre Uganda. We have about five centers which treat people who have tobacco addiction and who want to leave tobacco because it’s a chemical addiction, so they should approach the School of Public Health, they can approach us researchers, we can link them to these centers and they will leave and drop this habit,” says Dr. Zakumumpa
Revenue vs. Health, the Fiscal Tightrope
Uganda’s dilemma mirrors a global challenge. While health taxes could reduce NCD risks and fund healthcare, policymakers fear economic fallout usually advanced by opponents of tax increases. “Taxes on unhealthy commodities are sensitive, fought against by companies”—acknowledges Ssempala. Yet data from his nine-year analysis demystified this: Production and sales of taxed goods like beer and sodas keep rising, even as revenues plateau. During COVID-19, sales dipped briefly but rebounded sharply.
The Ministry of Health’s Dr. Oyoo Charles Akiya remains pragmatic:
“We need compromise. If manufacturers won’t accept higher taxes, let’s mandate health warnings or limit marketing to children.”
Dr. Akiya is the Commissioner of Health Services-Non-Communicable Diseases, and he hopes there can be a path forward through coalitions, evidence, and political will. Despite hurdles, advocates see hope. South Africa’s success in taxing sugary drinks and Kenya’s tobacco levies offer blueprints.

Regionally, a coalition of East African NCD managers is advocating for unified policies. The 4th Global NCD Alliance Forum, held at the Convention Centre in Kigali, Rwanda, on February 13, 2025, was the first of its kind in Sub-Saharan Africa. The event brought together 700 advocates, experts, and ministerial representatives from over 66 countries working in NCD prevention and care. This forum is a key global health forum as we race to the 4th UN High-level Meeting on NCDs, scheduled for September 2025 in New York.
“Change requires top-down pressure,” says Dr. Akiya.
With multinationals at the centre of manufacturing these commodities, exerting enormous pressure sometimes may prove difficult to confront as individual countries.
“We’re engaging the AU and UN to put NCDs on presidential agendas.” Locally, the Ministry of Health is mobilizing patients with lived experience: “They matter the most. The media plays a crucial role in this endeavor and holds significant importance for us. We cannot leave them out in these efforts. The leadership at the Ministry of Health, the minister, and the PS [Permanent Secretary] are all passionate about NCDs,” he added.
Is it a race against time or a behavioral issue?
As Uganda’s youth embrace processed snacks and tobacco, the clock ticks. “Every day without action, we lose more people to preventable diseases,” warns Professor Ssengooba.
The other day, Mubiru (not his real name) was jogging on the street, and a motorcycle taxi called Boda Boda knocked him, and he has just come out of the cast. He’s trying to manage NCDs; he got injured. At a Kampala hotel buffet, 28-year-old Miriam (not her real name) stares at her plate—a mountain of matoke, fried rice, boiled rice, vegetable rice, roasted gonja (plantain), and three golden potato wedges. “Finish it all,” her aunt insists. “Food is a blessing!” But Professor Ssengooba sees a different truth in these heaping portions: “Our plates have become battlegrounds. We pile carbohydrates like trophies—fried, boiled, mashed—while our bodies crumble.”
Uganda’s love affair with carbohydrates has turned toxic. Meals once centered on balanced staples like beans and greens now drown in oil and starch. “We’ve confused ‘tasty’ with ‘excessive,’” he says, adding that “at weddings, funerals, and even home dinners, its six carbohydrates competing on one plate. Why? Tradition says ‘more is generous.’ Science says, ‘more is deadly.’”

At what cost? Surging diabetes and hypertension rates. “We’re eating our way into clinics,” he warns. Yet change faces cultural roadblocks: How do you convince a nation that less on the plate isn’t disrespect—but survival? In this high-stakes battle between public health and profit, Uganda’s choices will shape a generation’s survival.
Davidson Ndyabahika is the Communications Officer, Makerere University School of Public Health.

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Health
MakSPH, DJC Launch Short Course on Health Communication
Published
7 days agoon
June 20, 2025
By Okeya John and Primrose Nabankema
The intensive one-month course, running for the first time from June 5 to July 24, 2025, is jointly offered by Makerere University School of Public Health (MakSPH)’s Department of Community Health and Behavioural Sciences (CHBS) and the Department of Journalism and Communication (DJC) at the School of Languages, Literature, and Communication (SLLC), co-designed in 2024 with support from the Rockefeller Foundation through Amref Health Africa.
It seeks to equip healthcare providers at the community level, public health and environmental health practitioners, communication specialists, health educators, community development officers, social scientists, and policy makers, among others, with strategic communication skills to improve public health messaging, strengthen community engagement, and support evidence-based interventions, ultimately empowering participants to effectively engage communities and improve population health outcomes across Uganda and the region.
Launching the course, the heads of the Department of Journalism and Communication and the Department of Community Health and Behavioural Sciences noted that participants who complete the short course will gain practical tools to influence behaviour change, build trust, and deliver timely, accurate, and relevant health information to the communities they serve. The first cohort attracted more than 60 applicants, with 36 reporting for the opening in-person session on June 5, 2025, at MakSPH in Mulago. Between now and July, participants will undergo a hands-on, multidisciplinary learning experience within the Certificate in Health Communication and Community Engagement program, which combines theory and practice.
Among the participants in the first cohort of the certificate course, designed as a pilot for the anticipated Master of Health Promotion and Communication to be jointly offered by the two departments at Makerere University, is Ms. Maureen Kisaakye, a medical laboratory technologist specialising in microbiology and antimicrobial resistance (AMR), and currently pursuing a Master’s in Immunology and Clinical Microbiology at Makerere. She is driven by a passion to help reverse the rising tide of AMR, a growing global health threat where drugs that once worked are no longer effective. Kisaakye is particularly concerned about common infections, like urinary tract infections, becoming increasingly resistant and harder to treat.
“I enrolled in this course because I’m an advocate against antimicrobial resistance, and it came at a time when I needed to deepen my knowledge on how to implement our projects more effectively and engage with communities. The experience has broadened my understanding of AMR and its impact on society, and strengthened my passion for community-driven health initiatives and advocacy,” Kisaakye said, explaining why she enrolled for the short course.

Kisaakye’s work in antimicrobial resistance extends beyond the lab. Having earned her degree in medical laboratory science from Mbarara University of Science and Technology, she founded Impala Tech Research in 2024 to drive impact and save lives. She has led grassroots AMR campaigns that integrate antimicrobial stewardship with water, sanitation, and hygiene (WASH) education in underserved urban communities, including the informal settlements in Kampala. She also has since designed peer-led initiatives that empower university students as AMR Champions, building a network of informed youth advocates. Kisaakye believes the health communication course will sharpen her ability to design and deliver impactful, community-centred interventions in response to the growing threat of drug resistance.
“The department collaborates with many partners within and beyond the University, including the School of Public Health, where we are working to develop the subfield of health communication and promotion. Our goal is to train specialists in this area and build a community of practice, something we have each been doing in our own spaces. There’s a lot of work ahead, and COVID-19 showed us just how urgently we need a generation trained to do this kind of work, and to do it very well,” said Dr. Aisha Nakiwala, Head of the Department of Journalism and Communication, during the opening of the short course on June 5.

She assured participants they were in good hands and underscored the importance of the partnership between the Department of Journalism and Communication and the School of Public Health, describing it as a vital collaboration that brings together strategic communication and public health expertise. This dynamic, multidisciplinary approach, she noted, is essential to developing practical solutions that empower communities, strengthen health systems, and ultimately improve livelihoods.
The course offers a hands-on, multidisciplinary learning experience, with participants intended to explore key modules including Health Communication and Promotion, Risk Communication, Smart Advocacy, Community Mapping, Community Mobilisation and Empowerment, and Strategies for Community Engagement. The course combines theory with real-world application, and its assessment includes a field-based project and a final exam.
“You are our first cohort. We are seeing the fruits of our efforts in bringing this short course to life. It was born out of a joint initiative to develop a Master’s programme in Health Promotion and Communication,” said Dr. Christine Nalwadda, Head of the Department of Community Health and Behavioural Sciences. “We carried out extensive consultations with our different key stakeholders during the process and discovered a real need for such a course. It was the stakeholders who even named it; this course name didn’t come from us.”
For Kisaakye, by the end of the course in July, she hopes to have sharpened her skills in health promotion and strategic communication, particularly in crafting targeted messages that help individuals and communities effectively respond to threats such as antimicrobial resistance. She also aims to gain practical experience in designing, implementing, and evaluating community health initiatives that can strengthen her advocacy and drive lasting impact.

Health
Call for Abstracts: 2nd East African Symposium and Expo on Trauma, Injuries, and Emergency Care – 2025
Published
1 week agoon
June 19, 2025By
Mak Editor
The Makerere University School of Public Health (MakSPH) is excited to invite researchers, professionals, and students to be part of an inspiring and impactful event!
Venue: School of Public Health Auditorium, Makerere University Main Campus
Dates: August 7–8, 2025
Theme: “Understanding the burden and impact of injuries in East Africa to improve Emergency Care preparedness, mitigation, and response.”
Submit Your Abstracts Now!
Join the conversation that drives change in trauma and emergency care across East Africa. Share your research, innovations, and insights that can shape the future of healthcare response in our region.
Submission Deadline: July 10, 2025
Submit here: triadcommunications@musph.ac.ug
Register to Attend: https://aapug.org/east-african-symposium-and-expo-on-trauma-injury-disability-and-emergency-care-2025/
Together, let’s drive change and improve lives through research and collaboration. Don’t miss this opportunity to make a difference!
Health
Scholarship Opportunity: Impact of Food Supplementation
Published
2 weeks agoon
June 16, 2025By
Mak Editor
MAKERERE UNIVERSITY CHILD HEALTH AND DEVELOPMENT CENTER
PhD SCHOLARSHIP FELLOWSHIP TRAINING ADVERTISEMENT
Impact of Food Supplementation on Health, Growth, and Development for Stunted
Children
We are seeking to appoint a full-time PhD Fellow to conduct a randomized controlled clinical trial (RCT) among 300 young children with stunting to assess the effect of Soy Lipid-based Nutrient Supplement with high versus low levels of antinutrients on growth and health of children on a DANIDA-supported project entitled “Climate-resilient soybean for improved growth and health of children in Uganda” (Healthy Soy). The PhD fellow will coordinate the RCT protocol development and its implementation, develop and nest his/her PhD protocol as part-of the RCT study. The PhD student will be hosted at the Child Health and Development Center School of Medicine College of Health Sciences, Makerere University. The PhD student will take part in literature review; designing, planning and conducting of studies; analysing results; writing reports and contributing to technical and policy briefs, journal articles and thesis; project management; organizing research seminars and stakeholder workshops; and guiding junior researchers and teaching. The PhD student will have access to online libraries, scientific databases and software for data analysis throughout their work. In addition, the student will be mentored by national and international researchers to develop scientific research and project management skills with three months stay in Denmark. By the end of the project, the selected candidate will have obtained significant competencies to explain the interactions between nutrition and health of children, growth and development. In addition, the student will gain skills in assessment of body composition, development and conduct of clinical trials design, scholarly writing and presentations, data analysis and interdisciplinary research.
Prospective candidates must:
- Hold Masters in any of the following or equivalents: Human Nutrition, Dietetics, Public
Health Nutrition, Medicine in Paediatrics and Child Health, Public Health or - Epidemiology with undergraduate training in Medicine and Surgery (MBChB/MBBS/MD).
- Having publication experience will be an added advantage.
- Be highly motivated and interested in pursuing rigorous research
- Be committed to a long-term research career in Human Nutrition and Health
- Be of untainted integrity
- Be able to use different software for data analysis and graphics.
Successful fellow will be expected to:
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ready to work towards publishing a minimum of one quality paper per year). - Contribute to research capacity building including training of undergraduate and M.Sc.
students in the host department. - The project will avail financial support to the successful PhD Fellow for 4 years. Funds
will cover: PhD tuition for 4 years; monthly stipend; research supplies and reagents;
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Interested applicants should send an application letter, motivation statement, two
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qualifications in an email titled “PhD Fellowship Application – Healthy Soy Project” to
chdc.desk@mak.ac.ug by 26th June 20205.
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