Health
We Are Pushing Nature to the Edge—But Solutions Are Within Reach: Global Conversations on Sustainable Health
By Davidson Ndyabahika and Johanna Blomgren
We’ve all done it—tossed leftovers, ignored wilted greens, or shrugged at a half-eaten meal. Food waste is a quiet guilt we all share, a reflex in a world of abundance and scarcity. But what if this small act connects to a larger global issue? On February 26, 2025, experts from Uganda, Sweden, and beyond gathered in a virtual seminar, asking, “How can we nourish ourselves without harming the planet?” Hosted by the Centre of Excellence for Sustainable Health (CESH), the discussion revealed a harsh truth—our food habits are draining the Earth.
The discussion on sustainable food systems marked the beginning of the annual four-part global conversation on sustainable health, organized through a collaboration between Sweden’s Karolinska Institutet and Uganda’s Makerere University under the auspices of CESH.
In Kampala, the paradox is stark. Every day, 750 tons of food waste fill the city’s landfills, enough to feed thousands. Rotten mangoes spill from crates in Nakasero Market, and half-eaten Rolex wraps pile behind street stalls. Uganda’s Food Rights Alliance shows 37.8% of this waste comes from plates and markets. Across East Africa, organic waste, like spoiled vegetables and discarded tubers, makes up 79% of urban trash—a grim reflection of broken systems. Beyond this is a city stuck with piles and piles of organic trash, which has previously been fatal with a slide in one of Kampala’s major landfills. Meanwhile, 26% of Uganda’s children remain stunted.
At the heart of this week’s global conversation was the WWF’s Living Planet Report 2024, a sobering revelation of a 73% decline in global wildlife populations since 1970. Freshwater ecosystems have hemorrhaged 85% of biodiversity, Latin America’s species richness has plummeted by 95%, and Africa—home to smallholder farmers who feed millions—has lost 76%. “Nature is disappearing at an alarming rate,” warned Harold Turinawe, WWF Uganda’s Forest Markets Transformation Manager, his voice weighted with urgency.
“We are pushing Earth’s systems to irreversible tipping points, and despite the increase in food production and land use and the destruction of habitats, the world is still hungry; we have over 735 million people going to bed hungry every other night. The contradiction is striking,” Turinawe added.
The report highlights the Amazon’s lush canopies that are felled for cattle ranches. The interplay of man’s unsustainable utilization of Mother Nature, leading to the food paradox, feast, famine, and ecological ruin, underscores the urgency of addressing global goals in a coordinated manner.
The report’s indictment of industrial food systems is clear: agriculture claims 40% of habitable land, 70% of freshwater, and drives 25% of greenhouse emissions. Yet, 735 million people still starve nightly. “Our obsession with monocultures and processed foods isn’t just destroying habitats—it’s failing humanity,” said Dr. Rawlance Ndejjo, the seminar’s moderator and a public health lecturer at Makerere University.
Florence Tushemerirwe, a Ugandan public health nutrition expert based at Makerere University’s School of Public Health, pointed out the irony: 26% of children are stunted, while obesity rises among adults in Uganda. “We grow nutrient-rich crops but export them, leaving people dependent on cheap, processed imports. In fact, many people do not appreciate their nutrient value,” she said. Uganda’s iodine-depleted soils now rely on fortified foods—a temporary fix for a growing crisis.
All through the seminar, the message was clear: we are wasting abundance while ecosystems crumble and people go hungry. “Our salt is iodized because our soils no longer provide it. Biodiversity loss isn’t abstract—it’s stealing nutrients from our plates. But if we don’t maintain our nature’s health, or our environmental health, or our natural resources health, it means that whatever food we grow, we actually do not carry the nutrients we need to maintain a diverse diet,” said Tushemerirwe.
The panel dissected global food trade’s role. WWF’s Turinawe lamented, “90% of deforestation is for agriculture. In Uganda, the once-vibrant wetland ecosystems of Lwera at the shores of Lake Victoria now face severe degradation due to large-scale rice growers; in the Amazon, its cattle ranches.”
Dr. Rachel Marie Mazac of Stockholm Resilience Centre stressed Europe’s complicity: “Sweden’s ‘virtual biodiversity loss’—importing deforestation via beef and soy—shows how our diets export destruction.”
“From a Swedish perspective, we are highly dependent on imports, particularly raw materials, which contribute significantly to biodiversity loss in other regions. It’s difficult to pinpoint the exact impact, especially with biodiversity, but there’s a concept of “virtual impact,” says Dr. Mazac.
Food consumed in Sweden, though produced elsewhere, contributes to biodiversity loss in those areas. The issue links to trade, food production, and distribution. It’s not just about production or waste but also equitable distribution.
Dr. Ndejjo added starkly, “You could be eating a burger from a cow grazed on razed Amazon forest. Guilt isn’t enough—we need systemic change.”
Amid the grim statistics, the panelists outlined a roadmap for redemption: nature-positive agriculture, subsidy policy reform, improved localized diets, global accountability, and honest discussions on the GMO dilemma.
Turinawe emphasized the need for agroecology in extension services—integrating trees, crops, and livestock to rebuild soil health and biodiversity. He stressed while critiquing Uganda’s Parish Development Extension Model for prioritizing enterprises for profit over sustainability. “We are saying get one million to a farmer. What are they producing? They are engaging in commodities that are predetermined. Nobody’s talking about Mother Nature. Who takes care of the soil? Who takes care of the water needs? Who takes care of the diversification we are talking about? But diversification in the diet begins with diversification on the farm. So my first issue is strengthening the agricultural extension services,” says Turinawe.
Adding that things like soil health management, land tenure system farmer-to-farmer network for peer learning, and fair farmer subsidies should be key to planning and agricultural extension.
“In Uganda, where I come from, and currently in Kampala, if you head north towards Zirobwe in Luweero District, you’ll find people we call Bibanja owners—essentially squatters who don’t own the land they occupy. These individuals cannot engage in sustainable agriculture as we’re discussing; their focus is survival. What we need are programs that give farmers secure land rights, which can motivate them to invest in soil health and environmental conservation—investments that take time. Improving soil is not a short-term effort; it requires long-term actions like planting trees, integrating practices, and using farmyard manure. None of this is realistic for someone who fears being displaced tomorrow. We need to approach this challenge collectively.”
Subsidies must reward sustainable practices, not industrial giants.
“Why not tax breaks for farmers using organic manure?” Turinawe challenged. “I would love to hear that a farmer that is engaged in sustainable cocoa production and coffee production gets a tax holiday rather than having a blanket of investors getting a holiday. Put subsidies and investment incentives in the right direction. We shall spur production, and of course, this will also bring in corporate partnerships, and we can make our supply chains safer, better, more green, and more sustainable,” Turinawe added.
Dr. Mazac noted that “nature-positive production can feed the world by optimizing crops, livestock, and wild fisheries, and supporting aquaculture that works with wetlands, not against them.” For Mazac, policy is key: She is also an advocate of subsidies and taxes that benefit farmers. Those that ensure incentives that improve soil health and maintain water quality as well as tackle climate change in order to make sustainability profitable.
“We must rethink trade to avoid widening the gap between food-producing areas and markets and instead support local farmers. Subsidies and taxes should empower these communities to nourish their populations before focusing on exports. While exports generate income, they also have significant impacts. A possible solution is changing production systems, but we must also shift dietary and consumption habits, making this a collective effort, not just an individual responsibility.”
Tushemerirwe is hungry for reviving indigenous crops and regulating predatory marketing. “Awareness is power. We must teach communities to value their traditional foods over processed substitutes.”
“There is good food grown in rural areas and available in markets, but people don’t recognize its value due to lack of guidance. We need food-based data guidelines to raise awareness. The Uganda Ministry of Health has a draft for this, along with draft policies to regulate unhealthy food marketing, especially to children. Junk food is advertised everywhere: hospitals, schools, and even street billboards, with fast food chains clustered together. We must regulate this and educate people on the nutritional benefits of eating what they grow over imported alternatives,” she stated.
Dr. Ndejjo believes these draft guidelines to regulate unhealthy food marketing should be finalized into policies and urges policymakers and implementers to prioritize the urgent need for these documents.
The conversation also weighed in on the genetic engineering in agriculture for increased crop yields, popular for GMOs, a dilemma that panelists called for their democratization rather than demonizing them. While Dr. Mazac cautioned against corporate-controlled seeds, Turinawe acknowledged their potential: “If democratized, drought-resistant crops could save farms in a warming world.”
Dr. Mazac noted that while in Europe and the European Union, they are not allowed to grow or sell foods that have been genetically modified, the essence of them should not be overlooked, since they are a technology that seeks to solve the future food crisis.
“GMOs aren’t inherently evil. Drought-resistant crops could save farms—but corporate patents trap farmers,” she said.
Turinawe added, “Our approach to GMO’s is a measure one bordering more on ethics and responsible use of GMOs; we see GMOs as a tool to promote resilience, especially since everything has changed—the food we once relied on can no longer grow in the same way. If GMOs help improve crop resilience, that’s a valuable tool. However, there are concerns that companies like Monsanto could use the GMO technology as a tool of exclusion, e.g., the fear of monopolizing future seed markets. This is where caution is needed.”
A Call for Radical Collaboration
The seminar’s resounding theme was unity: multi-sectoral collaboration is non-negotiable. From street food vendors to policymakers in the boardrooms, every actor must align. “Food systems aren’t siloed,” Dr. Mazac asserted. “They’re woven into climate, economy, and culture.”
“I think we need to sit and agree and engage quite regularly and find solutions for us to be able to produce food but sustainably,” concluded Tushemerirwe.
The Path Ahead
CESH’s global conversations on sustainable health are a microcosm of a global awakening, especially in tracking progress to meet our goals for 2030 and beyond: This seminar on food systems emphasizes the interconnectedness of food security and biodiversity. With the next UN Climate Summit (COP29) on the horizon, the panel’s message is clear—transformative change is possible, but only through courage, equity, and an unyielding reverence for nature.
To find more about this global conversation on sustainable health and more, visit CESH.health
Davidson Ndyabahika and Johanna Blomgren are the co-organisers of the global conversation on sustainable health
Makerere University, through the College of Health Sciences (CHS), hosted the Sickle Cell Disease Stakeholders’ Engagement Meeting on 24th October 2025. The event was organized by the Center of Excellence for Sickle Cell Disease and Neglected Tropical Diseases, in partnership with Enhancing Research Capacity for Sickle Cell Disease and Related Non-Communicable Diseases Across the Lifespan in Uganda (ENRICH) and the Sickle Pan Africa Research Consortium (SPARCo). The meeting brought together a diverse group of stakeholders, including religious leaders from the Catholic Medical Bureau, Protestant Medical Bureau, and the Uganda Muslim Supreme Council, as well as members of academia and public health practitioners.
During the Stakeholders’ Engagement Meeting held under the theme; Addressing Sickle Cell Disease in Schools and Communities, panelists emphasized the importance of early detection and effective communication in managing the disease. One of the speakers highlighted the critical role of medical interns as the first point of contact in identifying symptoms such as unexplained anemia and limb swelling, urging them to take detailed patient histories for timely diagnosis and referral. Another panelist, Ms. Penina Agaba, a lecturer at the Makerere University, underscored the need to translate data-driven research into simple, accessible formats for policymakers and community leaders. She noted that findings should be communicated in local languages through channels such as workshops, radio programs, and community meetings to ensure wider understanding and practical policy action.
In her remarks, Dr. Rosemary Byanyima, the Executive Director of Mulago National Specialised Hospital, shared her personal and professional commitment to improving the management of sickle cell disease in Uganda. A sickle cell warrior herself, Dr. Byanyima revealed that Mulago is planning to establish a medical campus that will offer specialized care, including hip replacements for patients suffering from sickle cell disease. She also noted that the hospital has supported the establishment of several service centers in Mukono General Hospital, Pallisa District, and Kayunga, aimed at bringing services closer to the communities. Dr. Byanyima urged all stakeholders to work together to raise awareness, increase testing, and encourage early healthcare seeking among those affected by the disease.
The panel discussions at the Sickle Cell Disease Stakeholders’ Engagement Meeting underscored the shared responsibility of all sectors in creating a more inclusive and informed society for people living with the condition. The conversations, moderated by Dr. Deo Munube and Ms. Evelyn Mwesigwa, explored how schools, faith institutions, and communities can work together to support those affected. Speakers emphasized the need for inclusive school policies that accommodate children with sickle cell disease—such as allowing extra clothing, flexible restroom access, and special exam arrangements—alongside guidance and counseling services to combat stigma and nurture self-esteem. They also stressed the importance of honesty from parents in disclosing their children’s health conditions to enable appropriate care.
From a broader perspective, panelists like Mr. Kajiiko Shafik from the Uganda Muslim Supreme Council highlighted the potential of faith-based structures to advance community sensitization and advocacy. The discussions collectively called for greater collaboration between the Ministries of Education and Health, improved psychosocial support, and stronger legal and policy frameworks to ensure that every child and adult living with sickle cell disease can thrive in a compassionate and supportive environment.
In her closing remarks, Dr. Sarah Kiguli, the Director of the Centre of Excellence for Sickle Cell Disease and Neglected Tropical Diseases at Makerere University, expressed gratitude to all stakeholders for their active participation and thoughtful contributions. She noted her optimism about the existing systems that can be leveraged to strengthen collaboration and awareness efforts, saying, “I’m happy that there are systems already in place that we can use to engage everyone on this cause.” Dr. Kiguli emphasized the importance of collective responsibility in the fight against sickle cell disease, adding, “It is impossible for us here in Makerere to reach everyone, but I love the message of ‘train the trainers’ so that sensitisation work can be efficient and far-reaching.”
Makerere University’s continued commitment to public health research extends beyond academia into real community impact. Through the College of Health Sciences, the University has strengthened partnerships with the Ministry of Health and regional hospitals to enhance early screening, diagnosis, and management of Sickle Cell Disease. Recent efforts include supporting the expansion of the national Sickle Cell Registry and developing community-based counselling programs to raise awareness at the grassroots level. Despite progress, Uganda still faces significant gaps in screening and treatment, with thousands of children born each year with the condition remaining undiagnosed. Makerere’s initiatives, therefore, aim to bridge these gaps through research, training, and collaboration with government, faith-based, and cultural institutions to ensure that no child or family faces Sickle Cell Disease in silence.
STOCKHOLM — Makerere University and Karolinska Institutet (KI-Mak) marked 25 years of collaboration on Oct. 15, 2025, with a hybrid forum on research equity, highlighting lessons for universities striving toward fair and sustainable global partnerships.
The event, part of the Global Conversations on Sustainable Health, explored the theme, “Exploring Power Dynamics & Equity in Partnerships.” Scholars, policymakers, and university leaders gathered to discuss how institutions can build collaborations grounded in trust, shared ownership, and mutual respect.
Organized by the Centre of Excellence for Sustainable Health (CESH), a joint initiative between Makerere University and Karolinska Institutet, the forum reflected on how equitable partnerships drive progress toward the 2030 Sustainable Development Goals.
Hours before the event, Sweden’s Ambassador to Uganda, H.E. Maria Håkansson, posted on X (formerly Twitter):
“The partnership between Makerere University and Karolinska Institutet is both dynamic and exemplary in how many years of development cooperation can lay the foundation for mutually beneficial relations between institutions in Sweden and Uganda.”
Equity, Trust, and Warmth at the Core
Panelists navigated questions of power, agency, and mutual respect. Policymakers, researchers, and academics agreed that successful partnerships depend not only on fairness but also on warmth, the human connection that sustains collaboration and ensures initiatives respond meaningfully to local realities.
Dr. Andreas Göthenberg, executive director of the Swedish Foundation for International Cooperation in Research and Higher Education (STINT), recalled that earlier models often reduced African researchers to “data farmers” in one-directional projects led from the North.
“We now support balanced research collaborations, not capacity building alone,” he said.
Over the past decade, he added, STINT has seen a surge of high-quality proposals from African researchers seeking genuine collaboration.
“When partners bring different expertise and learn from each other, that is when collaborations work well,” he said. “Institutions with fewer resources can now do very advanced things; that’s a real game changer.”
Göthenberg said Africa’s rapid advances in microfinancing, cloud computing, and even space research show that “technology development means institutions with fewer resources can still do very advanced things,” offering lessons for innovation systems in Europe.
Why Equitable Partnerships Matter
Professors Rhoda Wanyenze and Stefan Swartling Peterson have argued that traditional models often concentrate leadership and funding in the Global North, thereby limiting the agency of Southern partners.
Their work from long-term collaborations in Ethiopia, Uganda, Lao PDR, and Vietnam shows that shifting leadership to where research occurs strengthens local capacity and aligns agendas with community needs.
They demonstrate that equity relies on mutual trust, transparency, and shared decision-making, principles that transform funding into a tool for empowerment rather than dependency. Joint PhD programs, reciprocal staff exchanges, and twinned supervision models have further enabled two-way knowledge flow and reduced brain drain.
“Partnerships grounded in reciprocity, inclusion, and respect are not only ethically sound but also more effective,” Wanyenze said. “They build local ownership, lasting capacity, and context-driven innovation.”
Championing South-to-South Knowledge Exchange
Associate Professor Caroline Wamala-Larsson, director of the SPIDER program at Stockholm University, underscored that the Global South must set its research agendas.
“The agenda must be set by Southern institutions. Swedish institutions act as collaborators, not directors,” she said.
She cited projects in Uganda, Tanzania, Rwanda, Bolivia, and Mozambique where South-to-South learning has flourished.
“Bolivians traveled to Tanzania to share source codes from a research management system. Now, the University of Dar es Salaam wants to adopt it,” she said. “Solutions developed within the South often fit local contexts better than Northern models.”
Wamala-Larsson added that innovation and digital transformation have strengthened institutional systems. “We need new funders, private sector partners, and universities to participate equally.” Respect for each partner’s contribution is essential for sustainability,” she said.
Adapting to a Changing Global Landscape
Shifting global priorities and limited funding are reshaping how universities collaborate. Ms. Brenda Wagaba, partnerships officer at Makerere University, noted that while funding remains limited, the Government of Uganda, for instance, has taken steps to support local research through the Research and Innovation Fund. “The government started setting aside money for university research even before the recent cuts,” she said.
“Now, with those cuts, the need for sustained domestic investment is even greater.” She added that such initiatives strengthen the confidence of Southern partners to engage as equal contributors in global collaborations.
Dr. Rawlance Ndejjo, a Makerere University researcher, said local initiatives could help sustain momentum. “Local funding opportunities allow countries to find resources for research and partnerships. Such efforts can improve equity through bottom-up collaborations,” he said.
Göthenberg noted that new opportunities lie in multidisciplinary work. “Many of the challenges we face today demand broadly defined solutions,” he said. “Multidisciplinary projects lead to broader societal impact and stronger partnerships.”
He also pointed to Africa’s demographic advantage: “With its young population and rapid innovation, Africa is driving technological development in ways that can benefit both continents.”
Equitable Partnerships Deliver Results
Wagaba said engaging communities early is key to success. “When we engage communities early, we can bridge the gap between large-scale interventions and local acceptance. Whether it’s water, vaccines, or health infrastructure, success depends on understanding immediate community priorities,” she said.
She cautioned that top-down projects often fail to deliver lasting impact.
“You may build a vaccine plant or develop a vaccine, but if a community’s immediate need is safe water, your intervention will falter,” she said, adding that warmth, respect, and open communication are as critical as technical expertise.
Makerere Vice Chancellor Prof. Barnabas Nawangwe highlighted tangible results from Sweden’s long-term support.
“Under the SIDA program, 500 PhD students were trained, all of whom returned to Uganda,” he said. “The program made them feel at home while gaining knowledge abroad. Without mutual respect, equity will always face challenges.”
Prof. Annika Östman Wernerson, president of Karolinska Institutet, said sustainable partnerships depend on continuous engagement.
“Every collaboration begins with people meeting. Warmth and curiosity are crucial between individuals and institutions,” she said. “Equity is not static; it requires continuous work. Trust and transparency are critical.”
A Global Model for Sustainable Partnerships
The 25-year collaboration between Makerere University and Karolinska Institutet demonstrates how long-term, equitable partnerships can strengthen research systems and inform policy.
As Nawangwe put it:
“Students return home, communities benefit, and research informs global health policy. This is a model of how equity and trust drive sustainable partnerships.”
The Makerere–Karolinska (KI-Mak) partnership shows how universities, funders, and governments can work together fairly and Like many others working in this field, the Center recognises that there is still much to learn and discuss about how partnerships can continue to evolve through openness, dialogue, and shared reflection.
As Makerere and Karolinska look to 2030, their renewed agreements promise more than ceremonial goodwill. The two universities will intensify exchanges between students and faculty, expand joint research, share academic output, and organise lectures, conferences, and workshops. They will also open new paths for training, scientific collaboration, and shared learning. After 25 years, the partnership has proven that long-term cooperation can endure and excel with mutual respect, steady investment, and a clear purpose.
Dr. Angelina Mwesige Kakooza, Associate Professor of Paediatrics in the Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences (MakCHS) received the 2025 TWAS-Fayzah M. Al-Kharafi Award in Medical Sciences. She was recognised for her research on neurodevelopmental disorders – particularly epilepsy, cerebral palsy, and nodding syndrome – and for advancing policy and research, mentorship, as well as local community interventions to enhance children’s health.
The award was given at the recent 17th General Conference of The World Academy of Sciences (TWAS) held in Rio de Janeiro, Brazil under the theme ‘Building a Sustainable Future: The Role of Science, Technology, and Innovation for Global Development.’ Organized in partnership with the Brazilian Academy of Sciences (BAS) and TWAS, the conference brought together leading scientists, policymakers, and institutional leaders from across the global South and beyond.
In her remarks after receiving the award, Dr. Kakooza said, “This award highlights the importance of neurodevelopmental disorders which are a great health problem worldwide, often diagnosed late and treated poorly,” said Kakooza. “It affirms my contribution to science in Africa, strengthens advocacy for gender equity in science and education and makes me a role model for others, increasing my influence in the scientific community.”
Dr. Angelina Kakooza Mwesige is a Ugandan scholar with over 25years teaching experience whose research focuses on neurodevelopmental disorders in children centred on their epidemiology, early screening, identification and community based interventions in Uganda. Her current areas of research cover studies on early detection and interventions for young infants at high risk of neurodevelopmental delay and disability in Nepal and Uganda; development of community engagement projects to empower adolescents living with epilepsy in Uganda reduce stigma in their communities; as well as development and testing of an interactive epilepsy smart phone application to improve resilience among them.
TWAS is a global merit-based science academy based in Trieste, Italy, and administered as a UNESCO Programme Unit. Read more here: https://twas.org/
-
General2 weeks agoMakerere is No.1 in the Region – THE University Rankings
-
General1 week agoMak Management Decries Student Violence at Mitchell Hall
-
General2 weeks agoTribute to Baba Rt. Hon. Raila Amolo Odinga
-
General2 weeks agoMak and University of the West of England Sign MoU to Advance Research, Innovation and Skills Development
-
General7 days agoMak Endowment Fund 3rd Board of Trustees Inaugurated