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
On 27th November 2025 the Makerere University Infectious Diseases Institute (IDI) unveiled the second cohort of fellows—marking a significant step forward in strengthening global health security across the region. The cohort brings together five exceptional emerging scientists whose research areas reflect the continent’s most urgent health priorities. They include Mr. Dickson Aruhomukama in Antimicrobial Resistance (AMR); Dr. Rodgers Ayebare in Case Management, Infection Prevention and Control; Mr. Julius Okwir in Epidemic Intelligence and Community Health; Dr. Robert Zavuga in Vaccines and Medical Counter Measures; and Ms. Phionah Tushabe in Planetary Health, Water, Sanitation and Hygiene (WASH). Their selection marks a new chapter in nurturing homegrown expertise capable of safeguarding Africa’s health systems for generations to come.
The Acting Vice Chancellor, Prof. Sarah Ssali while presiding over the event emphasized the significance of launching the Sewankambo Training Program for Global Health Security as a milestone not only for IDI but for Makerere University and the continent at large. She highlighted the urgency of strengthening Africa’s capacity to predict, prevent, and respond to emerging epidemics, noting the rapid rise in zoonotic disease outbreaks and the persistent weaknesses exposed by crises like Ebola and COVID-19. She celebrated the legacy of Prof. Nelson Sewankambo and the scholars shaped by his leadership, stressing that the program embodies the university’s commitment to producing transformative health leaders grounded in multidisciplinary expertise and One Health principles.
She also called for stronger collaboration across colleges—particularly with the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB)’s Center for Biosecurity and the College of Health Sciences (CHS) to ensure that scarce scientific resources are fully utilized and that future health professionals are prepared for an evolving global landscape. In closing, she reaffirmed Makerere University’s dedication to advancing research excellence, nurturing responsible stewardship, and upholding the values that define the Sewankambo legacy.
The Academic Registrar Prof. Buyinza Mukadasi also conveyed his heartfelt congratulations to IDI and Prof. Nelson Sewankambo upon this remarkable milestone. He reflected on his recent engagements with the Institute—most notably the launch of the African Centre of Excellence in Bioinformatics—and expressed his admiration for the world-class research emerging from IDI, including publications in leading journals such as The Lancet and Nature. He noted that Makerere takes great pride in IDI’s work across multiple initiatives, from THRiVE to ongoing research collaborations, and wished the newly launched fellows a rewarding and impactful journey in research.
The Deputy Principal CHS, Prof. Richard Idro congratulated the new cohort and welcomed them into what he fondly referred to as “the cookhouse,” where future scientific leaders are shaped. Drawing from his own formative encounters with Prof. Nelson Sewankambo, he reflected on the deep mentorship culture that has defined generations of clinicians and researchers at Makerere—sharing stories of being challenged, supported, and pushed toward excellence. He reminded the fellows that their research will influence health policy and clinical practice far beyond individual patients, carrying long-term implications for national and global health.
Prof. Idro also acknowledged the critical challenges facing clinical disciplines, especially the constraints of promotion pathways that disadvantage highly skilled specialists without PhDs. He appealed for reforms to safeguard the future of key fields like anesthesia and surgery. Closing his remarks, he celebrated the College’s 100-year legacy, expressed gratitude for the university’s continued support, and invited alumni and partners to contribute ideas that will shape the next century of innovation, training, and service.
Dr. Charles Olaro, the Director General of Health Services, highlighted the essential role of academia in strengthening Uganda’s global health security, noting how recent outbreaks—from COVID-19 to Ebola—have revealed both the country’s progress and remaining gaps. He emphasized that programs like the Sewankambo Training Program are vital for building resilient health systems, advancing research, and shaping policies that can respond swiftly and effectively to public health threats.
Reflecting on the strong collaboration between the Ministry of Health and institutions such as Makerere University and IDI, he pointed out how research emerging from academia continually informs national policy, including work presented at recent conferences on non-communicable diseases and community health. Dr. Olaro congratulated the new cohort, reminding them that their work carries significant responsibility, as their research and leadership will influence health outcomes far beyond individual clinical care. He also underscored the need for stronger regional capacity, improved emergency response systems, and sustained mentorship to ensure that communities across Uganda—and the region—benefit from timely, coordinated outbreak preparedness.
In his address, Prof. Nelson Sewankambo commended the achievements of the first cohort and challenged the new fellows to uphold—and even surpass—the high standards already set. Reflecting on the rigorous selection process, he reminded the cohort that they were chosen because they demonstrated exceptional promise in a highly competitive field. He noted that the launch of this program comes at a particularly critical moment, as Africa CDC has just established a new Division for Health Security and Sovereignty, even as global financing for health research continues to decline. This, he said, makes the commitment to sustaining the program both bold and necessary.
Prof. Sewankambo also addressed concerns about the future of clinical scholars at Makerere, arguing that rigid promotion policies risk driving away talented specialists who are vital to the university’s mission. Emphasizing that “it is wise people who change direction when it is necessary,” he urged university leadership to protect pathways that allow clinicians to grow, serve, and undertake PhDs without being pushed out of the system. His message underscored both the responsibility carried by the new fellows and the collective duty to safeguard the future of medical education and research.
Dr. Andrew Kambugu, Executive Director (ED) of IDI, warmly welcomed all guests and reflected on the Institute’s long-standing culture of adaptation and innovation in response to Africa’s evolving health challenges. He celebrated the presence of Prof. Nelson Sewankambo—honoring his legacy as a founder, mentor, and active research collaborator—and acknowledged the strength of Cohort One as a living example of what the program can produce.
The ED emphasized that the Sewankambo Program stands on three pillars: rigorous selection, structured support with clear accountability, and strong alignment with national health priorities. He reminded the new fellows that IDI itself was born from the principle “adapt or perish,” and urged them to carry forward that spirit as they confront emerging threats like antimicrobial resistance and disease outbreaks across the continent. He also reflected on the power of mentorship, sharing personal experiences that illustrated how deeply mentorship can shape a scientific career. In closing, he expressed confidence that the five new fellows will honor the name they bear and continue building a legacy that inspires future generations.
Prof. Harriet Mayanja-Kizza reminded the newly selected fellows that while this achievement is significant, it marks only the beginning of a demanding but deeply meaningful journey. She expressed pride in the diversity of the cohort—drawn from ten African countries—and noted with delight that one of the brightest candidates emerged from the smallest country represented.
Reflecting on the evolution of impactful careers, she encouraged young people to embrace emerging fields such as bioinformatics, biotechnology, AI, molecular biology, and biostatistics, which she believes will define the future of science and global health. Prof. Mayanja spoke passionately about the diseases the fellows will tackle, highlighting the severe threat of antimicrobial resistance, the persistent burden of malaria, the dangers of resurfacing viral infections, and the transformative power of immunization. She urged the fellows to stay grounded, stay committed, and embrace the modern, data-driven tools now shaping global health research. In closing, she celebrated their potential to make a global impact and welcomed them formally into a field where their work will shape healthier futures for generations to come.
Prof. Ponsiano Ochama, one of the pioneers from the first cohort, reflected on the journey of the Sewankambo clinical scholarship from its early days in the “cookhouse” to the strong, structured program it has become. He recounted how the scholarship began as a mentorship-driven initiative aimed at nurturing future researchers and how sustained advocacy eventually removed barriers that once limited clinical scholars’ progression.
Prof. Ochama shared the impactful work he and his colleagues have since undertaken—highlighting, for example, a national study on hepatitis B mother-to-child transmission that shaped recent Ministry of Health policy. He encouraged the incoming cohort to embrace the program fully, assuring them that the “cookhouse” experience will transform them into strong, skilled scientists whose work will influence health policy and improve lives across the country.
Dr. Byonanebye Dathan, Deputy Head of the Global Health Security Department, outlined the strong rationale behind the Sewankambo Global Health Security Program, noting Africa’s rising burden of zoonotic and viral hemorrhagic fevers and the continent’s limited capacity for early detection and response. He emphasized that despite competing health priorities—HIV, TB, malaria, maternal health—there remain significant gaps in surveillance systems, workforce capacity, and research preparedness.
The program, he said, is designed to fill these gaps by strengthening research training, developing a skilled outbreak response workforce, and building a network of experts across Africa capable of generating evidence that directly informs policy and improves health systems. Dr. Dathan highlighted the rigorous selection process, the program’s alignment with WHO and national public health frameworks, and its integration of emerging technologies such as AI and machine learning. He affirmed that the fellows will receive structured mentorship, leadership development, and hands-on experience using existing data and real-world outbreak response systems—ensuring that their work leads not only to publications, but to meaningful impact across the continent.
Dr. Francis Kakooza, Acting Head of Global Health Security, traced the remarkable evolution of IDI’s Global Health Security work over the past decade, from its early CDC-funded surveillance efforts in 2015 to its expansion into biosecurity, AMR, epidemic research, policy development, and regional outbreak support. He highlighted IDI’s role in major national initiatives—including COVID-19 response, vaccination rollouts, risk management, lab accreditation, and the establishment of Regional Emergency Operations Centers—as well as its growing continental footprint through partnerships with Africa CDC, Mastercard Foundation, and Resolve to Save Lives.
Dr. Kakooza emphasized that the launch of the Prof. Nelson Sewankambo Global Health Security PhD Program is the culmination of years of investment in strengthening African research capacity and supporting fellows whose work is already shaping policy. He expressed gratitude to all partners, mentors, and leaders who contributed to the program’s development, acknowledged the rigorous selection that yielded five fellows from ten countries, and reaffirmed IDI’s commitment to nurturing a new generation of scientists equipped to protect the continent from infectious disease threats.
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