Prof. Barnabas Nawangwe (2nd R) presents a certificate to a participant (R) as Dr. Phyllis Awor (L) and Mr. Tomas Lundström (2nd L) witness on 9th April 2025.
Kampala, 09 April 2025— Makerere University has officially launched the Social Innovation in Health Initiative Community of Practice (SIHICOP)—a new platform designed to connect local health innovators with policymakers, donors, and researchers. The goal: to turn scattered success stories into a powerful, nationwide movement that reimagines healthcare from the ground up.
The launch, held during the 6th National Social Innovation in Health Stakeholders’ Workshop at Hotel Africana in Kampala, drew a dynamic mix of changemakers, health innovators, academics, donors, and government leaders, all rallying around one idea: that equitable, sustainable healthcare must be rooted in communities.
While Uganda has made notable progress, cutting under-five deaths by 66% since 2000, challenges remain. Fifty out of every 1,000 children still die before their fifth birthday. Nearly half suffer from stunting due to malnutrition. In rural areas, pregnant women walk for hours to reach clinics. Across the country, hospitals battle frequent drug shortages.
Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Makerere University’s School of Public Health (MakSPH), emphasized the critical role of social innovation in closing healthcare gaps. “Half of Ugandan children lack basic vaccinations, and 40% face stunting. These challenges demand creative, inclusive solutions co-created with communities,” she said.
“We’ve spent a decade identifying, studying, and strengthening grassroots innovations. Through our six-month fellowship program, we train innovators in monitoring and evaluation, research, communication, impact assessment, and fundraising so their work doesn’t just survive but scales,” she said. “Today, we’re awarding them completion certificates and launching them into a vibrant community of practice.”
Dr. Awor, who is also a Lecturer and Researcher maintains Social Innovation is about solving these real problems with real people. With the support of the Swedish Embassy and the World Health Organization’s TDR program, SIHICOP, she says, will foster peer learning, capacity-building, and scaling of innovations like mobile health platforms and community-based maternal care.
Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Makerere University’s School of Public Health (MakSPH) speaks during the launch.
Since 2017, Uganda’s SIHI hub has supported 30 homegrown innovations, impacting tens of thousands of lives. “We’ve identified 21 standout solutions so far,” Dr. Awor shared. “But if we want them to go national, we need enabling policies.”
Globally, SIHI was founded in 2014 to bring together innovators, communities, policymakers, and academics across the Global South. With 15 hubs, including Uganda’s, SIHI has documented over 200 innovations and 40 case studies that demonstrate the power of grassroots solutions to improve health systems.
Dr. Olaro Charles, Uganda’s Acting Director General of Health Services, acknowledged that bureaucracy often stifles good ideas. “Sometimes, a small change in how you look at a problem can produce the best and most marketable solution,” he said.
He spoke from experience. As a clinician, Dr. Olaro led efforts to curb drug theft and stockouts by tightening distribution and boosting accountability. “It’s not like people walk off with whole boxes,” he explained. “But if you have 300 employees and each takes just one dose… that adds up. We introduced medicine returns, round-the-clock pharmacies, and ward-level audits. At first, there was resistance, but it worked.”
Dr. Olaro Charles, Uganda’s Acting Director General of Health Services, Ministry of Health Uganda speaks to Innovators during the launch of the SIHICOP.
Another one of his most memorable innovations was setting up a neonatal unit for premature babies while he was a Medical Superintendent. “I remember a baby who weighed less than a kilo, barely six months old, and survived. We pushed survival rates to 85%. Eventually, we ran out of space. We began asking ourselves: Where had these children been going before? Previously, these children may have died within the community. These are innovations that create real, tangible impact. And I’m sure many of the things you’re doing here are creating similar results.”
He urged the Fellows to treat their innovations like living systems: “If they survive infant mortality, they’ll live longer. These ideas deserve to grow.”
Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy, spoke with deep conviction about Sweden’s long-standing investment in Uganda’s future. “For decades, Sweden has believed in Uganda’s greatest asset, its people,” he said. “Through Sida, we funded the training of over 500 Makerere staff for PhDs. I didn’t start it. I didn’t train your PhDs. The Swedish taxpayers actually funded the training. Now that wasn’t just investment; it was transformation. It’s one reason Makerere is the powerhouse it is today.”
Lundström also shared a memory that continues to shape his view of development. While inspecting UNICEF projects in Zambia in 1998, he recalled visiting five villages where only one had shown some success. A driver suggested they visit the last village, the 5th. “We went. No one was there. We waited, then a man came running, covered in dirt. He was the village chief,” Lundström recounted. “He said something I’ve never forgotten: ‘Thomas, when the rainy season comes, we can’t take pregnant women to the clinic. Do you know where I can learn to build a bridge’?”
Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy.
“That was different from what I usually hear—‘Can we have some money?’ Real change doesn’t come from handouts. It starts within communities.”
But Lundström warned that international aid is under strain. “We’ve already lost a lot of funding from U.S. and other donors. Ukraine, Sudan—global crises are pulling resources away. We must get creative. We must find new ways to secure resources.”
Still, he was optimistic. “We’re seriously considering continued support for another year. We’re also pushing for deeper collaboration between Makerere and Karolinska Institutet. But it’s up to you too,” he said.
He praised Dr. Phyllis Awor and her team: “What sets them apart is not just competence, but passion. She doesn’t do this because it’s her job; she does it because she believes in it. Because everyone deserves a fair chance, a seat at the table, a bit of hope.”
Makerere University Vice Chancellor, Professor Barnabas Nawangwe, echoed those sentiments, describing the School of Public Health as the university’s “engine of change.” He noted that the School contributes to nearly 30% of all university publications—and brings in 40% of its research funding.
“That’s no accident,” he said. “Public health is critical. Without health, there is no progress. That’s why donors invest in public health issues.”
He described the social innovation initiative as a model for how academia and communities can work together, not just to publish but to transform lives. “When global rankings name Makerere the most community-impactful university, they’re recognizing what happens when scholars step beyond lecture halls. This is what happens when researchers dig deep into the ground to cultivate solutions that transcend national boundaries.
The Vice Chancellor also paid tribute to Sweden’s role in that transformation. “We cannot thank the people of Sweden enough. Their support through Sida trained over 500 of our staff to the PhD level—the largest staff development initiative I’ve seen at any university, anywhere. It came when we needed it most, after the war. That’s why Makerere stands today as a leading research institution in Africa.”
He congratulated the 2024/25 Fellows, praising their inspiring journeys, and commended Dr. Awor and her remarkable team of researchers for achieving what only world-class institutions can: “melding razor-sharp academia with the wisdom of villages, policy muscle with frontline innovations.”
SIHI innovators and researchers in a group photo with the Makerere University Vice Chancellor, Professor Barnabas Nawangwe, Mr. Tomas Lundström, Health Counsellor at the Swedish Embassy and Dr. Phyllis Awor, Director of the SIHI Uganda Hub at Hotel Africana.
Makerere University on 11th November 2025 marked a significant milestone as the Health User Committee (Mak-HUC)—established by the Vice Chancellor in 2022 as part of his strategic mandate to strengthen and oversee the University’s health service delivery—formally handed over its three-year report. The event highlighted the committee’s achievements in guiding, monitoring, and improving Makerere University Health Services, presenting a record of progress that has reshaped confidence, strengthened systems, and expanded care for staff and students.
A Call for Integrated and Sustainable Health Services
The Vice Chancellor Prof. Barnabas Nawangwe emphasized the need for a more integrated, efficient, and sustainable approach to delivering health services for Makerere University staff and students. He noted that while the University does not receive supplies from the National Medical Stores system, its community remains entitled to quality care, urging renewed consideration of how essential services—such as drug access, surgical limits, and special medical cases—can be better supported. He highlighted the importance of practical costing models, especially for extending care to staff dependents, and called for flexibility in managing exceptional cases like complex surgeries or referrals abroad.
Prof. Barnabas Nawangwe.
The Vice Chancellor also underscored the urgent need to modernize the University Hospital, proposing that Makerere begin incrementally establishing a teaching hospital using existing facilities and leveraging expertise of highly qualified consultants the College of Health Sciences (CHS). He reiterated that government budget ceilings remain a major constraint, but encouraged the committee to develop a concept that could be presented to Council and later supported through strategic engagement with the Ministry of Finance, Planning and Economic Development. Throughout his remarks, he applauded the Mak-HUC for its work and reaffirmed that even with the creation of a professional hospital board, the committee must remain central in representing service users.
Aligning Health Services with Sustainable Insurance Models
Prof. Bruce Kirenga the Principal College of Health Sciences responded by clarifying the committee’s efforts to align Makerere’s health services with real insurance models, including cost projections for covering additional family members and encouraging voluntary staff contributions where necessary. He acknowledged the complexity of expanding service coverage—especially in cases of chronic illness or high-cost procedures—but emphasized the committee’s commitment to cautious, sustainable planning. He confirmed that the College is working closely with the Hospital to improve services, attract specialists, and integrate students into the health system, a model that naturally draws academic staff into clinical roles without imposing unrealistic obligations.
Prof. Bruce Kirenga.
Prof. Kirenga also noted the College’s ongoing assessments of facility needs, including dialysis, ICU expansion, and equipment placement, stressing that the ultimate goal is a unified, well-structured health network across the University. He welcomed the Vice Chancellor’s support for transforming existing facilities into a teaching hospital and pledged to refine proposals that reflect both current realities and long-term institutional needs.
Committee Chair Reflects on Three-Year Achievements
Dr. Allen Kabagyenyi, Chair of Mak-HUC, reflected on the three-year journey with gratitude and pride, noting that the committee not only fulfilled its terms of reference but exceeded expectations. She highlighted major gains made under the Vice Chancellor’s support, including transforming the University Hospital into a self-accounting unit—an intervention that unlocked smoother financial management and accelerated service delivery. Dr. Kabagyenyi commended the strong collaboration with the Hospital administration, Human Resources Directorate, and other units, which ensured staffing stability even during institutional transitions.
Dr. Allen Kabagenyi.
She pointed to the expansion of referral partnerships—now totaling 29 health facilities nationwide—as a crucial achievement that guarantees continuity of care for staff and students wherever they are. She also emphasized the committee’s work in guiding policies for specialized treatment and cross-border care, strengthening fraud-prevention systems, and advancing digital transformation through an integrated health information system and the new Makerere University Health Services (MakHS) website. Dr. Kabagyenyi noted that these improvements have directly benefited staff and enhanced the overall quality of care, supported by close collaboration with the College of Health Sciences and access to some of the country’s best consultants. She concluded by underscoring the ongoing need for a comprehensive University Health Policy and expressed deep appreciation to the Vice Chancellor and University Management for their unwavering openness and support—attributes she credited for the committee’s success.
Highlights of Service Growth and Infrastructure Upgrades
The Chief, Makerere University Health Services, Prof. Josaphat Byamugisha, highlighted the significant progress achieved under the Health User Committee’s oversight, noting especially the steady rise in service utilization and renewed confidence among staff and students. He emphasized that trust in the University Hospital has grown organically—built not through advertising, but through improved patient experience, stronger systems, and word of mouth.
Prof. Josaphat Byamugisha.
Prof. Byamugisha pointed to major achievements such as expanded Out-Patient Department (OPD) attendance, better student access to care, enhanced infrastructure including modernized theatres capable of complex procedures, and upgraded laboratories supported through framework agreements that ensure continuous equipment renewal. He noted that specialized clinics, increased inpatient capacity, and expanded referral networks have strengthened the Hospital’s reach and responsiveness. The Hospital is also taking on more research work and clinical training, partnering with units such as optometry, internal medicine, and the Clinical Trials Unit, with new collaborations—like the MasterCard Foundation—driving further growth.
He reaffirmed that the long-term vision of establishing a fully-fledged Makerere University Teaching Hospital is taking shape through coordinated efforts with the College of Health Sciences. Prof. Byamugisha credited the Vice Chancellor’s support for enabling these strides and expressed deep appreciation to all stakeholders contributing to the continued improvement of health services for the entire University community.
Prof. Barnabas Nawangwe (4th Left) and Dr. Allen Kabagenyi (4th Right) pose for a group photo with Mak-HUC Members and officials at the Main Building Entrance.
DICTS Unveils Modular Information System & Health Services Website
The Directorate for ICT Support (DICTS) presented the newly developed Makerere University Integrated Health Management Information System (MakIHMIS), designed around a modular system that streamlines all hospital processes. The platform integrates eight functional modules, including registration, triage, clinician workflows, inventory and medicines management, pharmacy dispensing, laboratory information management, user management, and linkages to both the Academic and Human Resource Management Information Systems ACMIS and e-HRMS respetively. Most of these modules are already active, enabling smooth patient registration, accurate record-keeping, real-time inventory tracking, and seamless access to student and staff data without duplication. Only two modules—land and insurance—remain under development before the system becomes fully end-to-end. The MakHS website on the other hand features information about hospital services, events, research activities, and staff profiles, offering both the university community and the public a centralized and efficient digital gateway to the hospital’s operations.
Prof. Barnabas Nawangwe (4th Left) flanked by Left to Right: Prof. Josaphat Byamugisha, Mr. Juma Katongole, Mr. Victor Watasa, Dr. Allen Kabagenyi, Mr. Samuel Mugabi and Prof. Bruce Kirenga launches the MakIHMIS.
The term of the outgoing committee has officially concluded, and preparations are now underway for the incoming committee to assume its duties and continue advancing the work ahead.
The Ministry of Health and Makerere University in Uganda co-organised the National Annual Communicable and Non-Communicable Diseases (NACNDC) and 19th Joint Scientific Health (JASH) Conference 2025 under the theme: “Unified Action Against Communicable and Non-Communicable Diseases in Uganda“. The conference brought together stakeholders from government ministries and departments, local governments, academia, civil society, the private sector, development partners, professional associations, and communities who deliberated on the important role of coordinated action in addressing Uganda’s growing burden of infectious and non-infectious diseases in an evolving local and global health landscape.
Discussions reaffirmed the need for strengthened multisectoral collaboration and One Health approach that engages all government sectors and clearly defines the role of the private sector. Participants emphasized the importance of an integrated, people-centred model of disease prevention and care model, along with the need to enhance data systems, research, and policy translation. The conference also underscored the urgency of increasing domestic financing and adopting innovative financing mechanisms that broadly support the health system’s capacity to tackle the dual disease burden.
The conference proceedings feature selected abstracts presented during the conference, showcasing a wide range of research, innovations, programmatic solutions and field experiences. The conference offered a unique platform that demonstrated how academia, programme implementers, and policymakers can collaborate to generate and apply evidence for improved health outcomes. The findings shared at the conference and captured in the proceedings will inform national policies and strengthen efforts to prevent and control communicable and non-communicable diseases in Uganda.
Two new studies by researchers at Makerere University School of Public Health (MakSPH) reveal a troubling pattern at the centre of Uganda’s escalating antimicrobial resistance (AMR) crisis, a public health challenge where disease-causing bacteria and other germs stop responding to known medicines meant to kill them, making common infections harder or more expensive to treat.
The studies, conducted in Wakiso and neighbouring districts and recently published in leading scientific journals, examined key drivers of AMR from distinct yet connected perspectives. Together, they expose a health system under strain; shaped by poor-quality medicines circulating in communities, high and often inappropriate antibiotic use in healthcare facilities, and limited public awareness of safe medicine use, conditions now reinforcing one another and accelerating drug resistance.
At the centre, Assoc. Prof. David Musoke, one of the lead researchers on the two studies, and Ms. Bonny Natukunda (Senior Health Educator, Wakiso District) pose with community health workers, district health officials, and facilitators after an AMR workshop in Bukondo, Namayumba Sub-County, on September 22, 2025. Delivered under the NTU–Mak Partnership with Buckinghamshire Healthcare NHS Trust, the week-long workshop trained more than 380 community health workers from Namayumba Sub-County.
According to the Ministry of Health, AMR in Uganda has reached concerning levels. By March 2025, resistant infections were estimated to kill 37,800 people annually, with over 7,000 deaths directly caused by AMR and more than 30,000 linked to infections no longer responding to available treatment. This surge is driven by unrestricted access to antibiotics, weak drug-regulatory enforcement, and widespread misuse of antimicrobials in humans and animals.
The Ministry acknowledges that many patients are treated without diagnostic testing, while low public awareness and weak stewardship across human and veterinary health services continue to fuel microbial resistance. As a result, bacteria that once responded to routine antibiotics now show resistance rates of up to 80 per cent in some cases, undermining treatment outcomes, food safety, and household incomes. It is this challenge that informed the two MakSPH studies.
Part of the study team, led by Assoc. Prof. David Musoke (extreme left), at the recent 10th National AMR Conference in Kampala on November 19, 2025, organised by the Ministry of Health, where they presented evidence from the two studies in Wakiso generated through the NTU–Mak Partnership.
Two Studies, One Warning
Evidence from both studies points to the need for coordinated action to strengthen medicine quality, improve prescribing practices, and build community awareness to preserve the effectiveness of essential treatments. In the first paper, published on October 6, 2025, in the Journal of Pharmaceutical Policy and Practice, researchers led by Associate Professor David Musoke examined how consumers encounter and respond to substandard and falsified medicines for both human and animal use.
Conducted in 2024, the study surveyed 432 community members in Wakiso District, where the Nottingham Trent University – Makerere University(NTU–Mak) Partnership, initiated by NTU’s Prof. Linda Gibson and MakSPH’s Assoc. Prof. Musoke, has implemented community-based health systems programmes for 15 years now. Using a structured household questionnaire, the team assessed knowledge, attitudes, and everyday practices related to medicine use.
NTU’s Prof. Linda Gibson and MakSPH’s Assoc. Prof. David Musoke at the British Academy Equitable Partnerships Workshop on November 20, 2025, reflecting on 15 years of the successful NTU–Mak partnership.
The second study, published on November 21 in the Dovepress Journal of Infection and Drug Resistance, was led by Dr. Bush Herbert Aguma, a pharmacist, health-systems researcher, and Lecturer in the Department of Pharmacy at Makerere University. Working with Assoc. Prof. Musoke and colleagues, the team applied the standardised Global Point Prevalence Survey (GPPS) to examine antibiotic prescribing across three hospitals and five lower-level health centres in Wakiso, Nakaseke, and Butambala. The survey assessed patient demographics, antimicrobial therapy details, and adherence to treatment guidelines to identify gaps requiring improvement.
The surveys were conducted at Entebbe Regional Referral Hospital, Gombe General Hospital, Nakaseke General Hospital, and five lower-level facilities in Wakiso, all part of the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) project at MakSPH implemented through the NTU–Mak Partnership. Alongside the surveys, the partnership has strengthened antimicrobial stewardship in these eight facilities through routine staff training, mentorship, community engagement, and capacity-building in infection prevention and control, microbiology, and detection of substandard and falsified medicines.
“The work was to empower the facility through its Medicines and Therapeutics Committee, which has a sub-committee on antimicrobial stewardship. That committee oversees the process, ensures future surveys are conducted, and can initiate targeted assessments when problems with specific prescriptions arise,” Dr. Herbert Bush Aguma, lead author of the second study, explained.
Dr. Herbert Bush Aguma, explaining the study’s results and impact from his office on December 8, 2025, noted that it has enabled the health facilities to independently track antimicrobial use, identify prescribing gaps, and strengthen stewardship practices.
He added that the programme in the selected facilities for the study went beyond just measuring antimicrobial use, to supporting the facilities develop stewardship plans, strengthening laboratory capacity, and training health workers across human, animal and environmental sectors under a One Health approach. As a result, he stated, facilities can now independently conduct point prevalence surveys, identify prescribing gaps such as inappropriate ceftriaxone use, and advocate for improved diagnostics, while hospitals, Village Health Teams (VHTs), veterinary and environmental officers increasingly address AMR drivers within their settings, leading to significant and lasting impact.
Over the last 15 years, the NTU–Mak Partnership, as part of this work, has trained more than 600 health workers across the human, animal, and environmental sectors in Wakiso, Nakaseke, and Butambala, and equipped over 1,300 community health workers (VHTs) in Wakiso with practical AMR knowledge. University-led programmes, international student competitions, and a 900-member online Community of Practice have further extended its reach. Together, these initiatives demonstrate how sustained community engagement can translate national AMR priorities into real-world impact, offering a model for locally anchored AMR interventions while also supporting the generation of new evidence to strengthen health systems, including the current two studies.
Right: MakSPH student Bridget Ahumuza celebrates a commendation as the 2025 Antibiotic Guardian Health Student of the Year, awarded through the NTU–Mak Partnership for her AMR stewardship advocacy.
What Communities Know, and Don’t Know, About Fake Medicines
In the first study, Assoc. Prof. Musoke and colleagues found that while 83 per cent of respondents had heard of substandard and falsified medicines, only 31 per cent could correctly define the terms, and just seven per cent could accurately identify a falsified product. According to the World Health Organisation (WHO), a global health watchdog, substandard and falsified medicines fail to meet quality standards or deliberately mimic genuine products, often containing the wrong, too little, or no active ingredients. Such medicines put patients at risk of treatment failure, toxicity, and death and accelerate antimicrobial resistance by exposing bacteria to ineffective drug levels.
In Wakiso, the most populous district in Uganda with over 3.3 million people, although over 95 per cent of respondents recognised substandard and falsified medicines as dangerous, many reported having purchased drugs they suspected to be fake: 14 per cent for human and 24 per cent for animal use. To check authenticity, residents relied on advice from health workers or veterinary officers and on buying from trusted outlets. Yet reporting remained extremely low, as only one in four informed a health worker when they suspected a problem, and still, just four per cent had ever reported a case to the National Drug Authority (NDA), mandated to regulate drugs in Uganda.
These patterns reveal a community that recognises the threat of poor-quality medicines but lacks the agency to act. As the study notes, “community members from a range of backgrounds had limited knowledge and poor practices despite commendable attitudes on substandard and falsified medicines… Many respondents reported never having purchased and used substandard and falsified medicines knowingly or unknowingly, although a good number suspected that a medicine they previously purchased had been substandard or falsified.”
Over 50 health managers from 51 healthcare facilities in Wakiso District received certificates at the end of a two-day leadership development training on November 26, 2025, delivered through the NTU–Mak Partnership and Nottingham University Hospitals NHS Trust (NUH) in collaboration with the Wakiso District Local Government and the Ministry of Health. The workshop strengthened leadership capacity across the district health system.
In the second study on antibiotic prescribing, the researchers found high rates of antibiotic use across all eight public facilities. In the three hospitals, 87.2 per cent of inpatients were receiving at least one antibiotic, with ceftriaxone alone, the most commonly prescribed antibiotic in other studies, accounting for nearly one-third of all prescriptions. Most antibiotics were administered prophylactically, especially for obstetric and gynaecological surgeries, which made up 30.7 per cent of all hospital antibiotic use. In lower-level facilities, 60.7 per cent of outpatients received antibiotics, with amoxicillin accounting for 39.1 per cent of all prescriptions. Upper respiratory tract infections, many of them viral, were the leading reason for outpatient antibiotic use.
“Resistance to first-line antimicrobials increases the risk of morbidity and mortality. Unfortunately, the global rise in AMR has not been matched by the development of new antibiotics effective against resistant bacteria,” reads the paper in part. “As a result, healthcare costs are expected to rise, economic productivity will fall due to reduced workforce activity, and global life expectancy could drop by an estimated 1.8 years. This existential threat must be averted to avoid a post-antibiotic era in which even minor infections become fatal.”
In the study on antibiotic prescribing, the researchers found high rates of antibiotic use across all eight public health facilities, with ceftriaxone as the most commonly prescribed antibiotic.
Read together, the two studies provide a ground-level view of how AMR takes root long before a patient reaches a hospital or pharmacy. Poor-quality medicines remain widespread yet poorly understood, while health workers operate under heavy workloads, limited diagnostics, and outdated guidelines that make empirical treatment with antibiotics the default option.
These realities echo the warning delivered by Assoc. Prof. David Musoke, during his keynote address at the 10th National AMR Conference in Kampala on November 19, 2025. Speaking at the event organised by the National One Health Platform, institutionalised in 2016 under the Ministry of Health to coordinate AMR efforts, and held to mark World AMR Awareness Week 2025 under the theme Act Now: Protect Our Present, Secure Our Future, he cautioned that Uganda’s fight against AMR will falter unless communities are placed at the centre of national action.
“One in six bacterial infections globally, and one in five in Africa, are now resistant to available antibiotics,” Dr. Musoke said, citing the latest Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report 2025. “If Uganda is to make real progress, communities must be treated not as recipients of information but as genuine partners in the fight against AMR.”
Assoc. Prof. David Musoke delivers the keynote address at the 10th National AMR Conference in Kampala on November 19, 2025, warning that Uganda’s fight against AMR will stall unless communities are placed at the centre of national action.
What Must Change: Recommendations from the Researchers
To strengthen antimicrobial stewardship, the study on antibiotic prescribing recommends scaling up diagnostic capacity in public facilities so that treatment decisions are based on laboratory evidence rather than broad empirical prescribing, a medical term that means treatment initiated based on a clinician’s “educated guess” and clinical experience, in the absence of a definitive diagnosis or complete information about the specific cause of a disorder. Expanding functional microbiology services, the study says, would reduce reliance on broad-spectrum antibiotics, which accelerates resistance.
The authors also call for strict enforcement of national treatment guidelines, especially in surgical wards where antibiotics are routinely continued longer than clinically required. For them, reducing unnecessary prophylaxis, particularly in obstetric and gynaecological surgery, would go a long way in limiting misuse without compromising patient safety.
They further urge the Ministry of Health to eliminate non-recommended antibiotic combinations from routine use and ensure consistent stock management to prevent missed doses. This, in addition to strengthening Water, Sanitation, and Hygiene (WASH), and Infection-Prevention and Control (IPC) systems, combined with regular stewardship-focused training for prescribers, is highlighted as essential for improving prescribing standards. Finally, they recommend institutionalising routine point prevalence surveys in Uganda to track trends, guide facility-level action, and reinforce accountability for stewardship.
Makerere University students demonstrate proper hand hygiene while engaging residents in an AMR and hygiene awareness outreach in Kamwokya’s informal settlements on April 11, 2025.
On the other hand, to address the widespread circulation of substandard and falsified medicines, the study team call for a nationwide effort to improve public literacy on how to recognise, verify, and report suspicious medical products. The authors also argue that current reporting pathways are largely invisible, leaving most community members unsure of how or where to lodge complaints. Strengthening the National Drug Authority’s visibility and making its reporting mechanisms simple and accessible, in that case, is identified as a critical first step.
They also highlight the need to engage frontline actors, and this includes Village Health Teams, Community Health Extension Workers, veterinary officers, and local leaders, as primary change agents. These trusted community structures, the authors assert, are well-positioned to translate regulatory messages into actionable information than mass-media campaigns alone.
Given the extensive use of suspected counterfeit veterinary medicines, the authors call for strengthened One Health education and a fully integrated communication approach linking human, animal, and plant health risks. They recommend sustained messaging through radio and other local media, supported by community-driven monitoring systems able to empower consumers to act as partners in protecting the medicine supply chain.
Mr. Mathias Sserwanga (extreme right) of Namulonge HCIII in Wakiso district receiving his certificate from Assoc. Prof. David Musoke (2nd right), following a two-day leadership and management training on November 26, 2025, at Makerere University. The programme by MakSPH and partners has helped enhance the capacity of facility in-charges in Wakiso District to improve health service delivery to the people.
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