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We Are Pushing Nature to the Edge—But Solutions Are Within Reach: Global Conversations on Sustainable Health

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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.

Mr. Harold Turinawe, Forest Markets Transformation Manager, World Wide Fund for Nature, Uganda Country Office. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa-Karolinska Institutet, Sweden, Centre of Excellence for Sustainable Health (CESH)-Global Conversations on Sustainable Health.

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.

Ms. Florence Tushemerirwe, Public Health Nutritionist and Research Associate. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa-Karolinska Institutet, Sweden, Centre of Excellence for Sustainable Health (CESH)-Global Conversations on Sustainable Health.

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.

Dr. Rachel Mazac, Postdoctoral Researcher, Stockholm Resilience Centre, Stockholm University. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa-Karolinska Institutet, Sweden, Centre of Excellence for Sustainable Health (CESH)-Global Conversations on Sustainable Health.

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.

Dr. Rawlence Ndejjo, Lecturer, Department of Disease Control and Environmental Health. Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa-Karolinska Institutet, Sweden, Centre of Excellence for Sustainable Health (CESH)-Global Conversations on Sustainable Health.

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 School of Public Health (MakSPH), Kampala Uganda, East Africa-Karolinska Institutet, Sweden, Centre of Excellence for Sustainable Health (CESH)-Global Conversations on Sustainable Health.

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Announcement: 2026 Intake – Certificate in Applied Health Systems Research

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Announcement: 2026 Intake – Certificate in Applied Health Systems Research. Photo: Nano Banana 2

Makerere University School of Public Health invites applications for the 2026 intake of the Certificate in Applied Health Systems Research, a short, intensive virtual programme designed for professionals working at the intersection of research, policy, and health system practice.

Why this course matters

Health system challenges are rarely linear. They are shaped by institutional complexity, political realities, and competing stakeholder interests. In many cases, the issue is not the absence of evidence, but the difficulty of producing research that is relevant, timely, and usable within real decision-making environments. This course is designed to address that gap, equipping participants to generate and apply evidence that responds to actual system constraints.

Apply via: https://docs.google.com/forms/d/1SjPWK37nZGuLb25S2X6d9NPtME2AKlEW_kJjCimivhY/viewform?ts=6821a62d&edit_requested=true

What you will gain

Participants will develop the ability to:

  • frame research problems grounded in real system conditions
  • analyse complex interactions within health systems
  • design policy-relevant and methodologically sound studies
  • translate findings into actionable insights for decision-making

Course format and key details

The programme runs virtually from 6th to 17th July 2026 (2:00–5:45 PM EAT) and combines interactive sessions, applied learning, and expert-led discussions across:

  • systems thinking and problem framing
  • research design and mixed methods
  • evidence use in policy and practice

For full course details:https://sph.mak.ac.ug/program-post/certificate-in-health-systems-research/

Who should apply

This course is suited for:

  • Researchers and graduate students
  • Policy analysts and programme managers
  • Health practitioners involved in planning, implementation, or evaluation

Fees

  • Ugandan participants: UGX 740,000
  • International participants: USD 250

Application Deadline: 14 June 2026

Please find the course details below:

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WHO Report Highlights Global Drowning Burden as MakSPH Contributes to Evidence and Action

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Demonstration of emergency medical procedures performed by the Uganda Red Cross Society at the first-ever National Water Safety Swimming Gala organised by the Ministry of Water and Environment at Greenhill Academy in Kibuli on March 21, 2026. Photo: Makerere University School of Public Health (MakSPH), Kampala Uganda, East Africa.

Makerere University School of Public Health, through its Centre for the Prevention of Trauma, Injury and Disability, contributed to the Global Status Report on Drowning Prevention 2024, the first comprehensive global assessment of drowning burden, risk factors, and country-level responses.

Published by the World Health Organisation, the report estimates that approximately 300,000 people died from drowning in 2021, with the highest burden in low- and middle-income countries, which account for 92% of deaths. The African Region records the highest mortality rate, underscoring the urgency of targeted interventions. Children and young people remain the most affected, with drowning ranking among the leading causes of death for those under 15 years.

While global drowning rates have declined by 38% since 2000, progress remains uneven and insufficient to meet broader development targets. The report highlights critical gaps in national responses, including limited multisectoral coordination, weak policy and legislative frameworks, and inadequate integration of key preventive measures such as swimming and water safety education.

It further identifies persistent data limitations, with many countries lacking detailed information on where and how drowning occurs, constraining the design of targeted interventions. At the same time, the report notes progress in selected areas, including early warning systems and community-based disaster risk management.

MakSPH’s contribution to this global evidence base reflects its role in advancing research, strengthening data systems, and supporting context-specific approaches to injury prevention. Through its Centre, the School continues to inform policy and practice, contributing to efforts to reduce drowning risks and improve population health outcomes in Uganda and similar settings.

The full report can be accessed below:

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MakSPH Contributes to Global Strategy to Reduce Drowning Deaths

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Illustrative photo of a man splashing in a water body. Photo: MakSPH

Makerere University School of Public Health, through its Center for the Prevention of Trauma, Injury and Disability, contributed to the Global Strategy for Drowning Prevention (2025–2035): Turning the Tide on a Leading Killer, a landmark framework guiding coordinated global action to reduce drowning.

Developed through the Global Alliance for Drowning Prevention, a multi-agency platform hosted by the World Health Organization, the strategy identifies drowning as a leading yet preventable cause of death, responsible for over 300,000 deaths annually. The burden falls disproportionately on low- and middle-income countries, particularly among children and young people.

The strategy sets a global target of reducing drowning deaths by 35% by 2035 and outlines six strategic pillars, including governance, multisectoral coordination, data systems, advocacy, financing, and research. It also prioritises ten evidence-based interventions such as strengthening supervision, improving water safety and swimming skills, enhancing rescue capacity, and enforcing safety regulations.

MakSPH’s inclusion in the Global Alliance for Drowning Prevention reflects its contribution to advancing research, policy engagement, and capacity strengthening in injury prevention. Through its Centre, the School supports the generation and application of context-specific evidence, positioning itself as a key contributor to global efforts to reduce drowning and strengthen community resilience.

The full document can be accessed below:

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