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Inside Uganda’s Silent AMR Crisis: Counterfeit Drugs, Antibiotic Overuse, and What Wakiso’s Evidence Reveals

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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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John Okeya

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82% Stressed: Uncovering the Hidden Mental Health Burden Among Kampala’s Taxi Drivers

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Commuter minibuses to various destinations in one of Kampala's Taxi Parks. Photo: Katumba Badru. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.

A new study by Dr. Linda Kyomuhendo Jovia, a medical doctor and graduate of the Master of Public Health programme at Makerere University School of Public Health, has found high levels of psychological distress among minibus taxi drivers operating in Kampala’s major taxi parks. In a cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, nearly two-thirds screened positive for symptoms of depression (65.6%), while anxiety affected more than 70%, and stress an estimated 82%. The findings point to a largely overlooked occupational health concern within the city’s informal transport sector, where long working hours, economic pressure, poor sleep, and prior road accidents were associated with higher levels of mental strain.

Before sunrise settles over Kampala, Old Taxi Park is already awake. White minibuses marked with the blue stripe of Uganda’s public service taxis sit jammed bumper to bumper, their noses pointed toward narrow exits that will soon release them into the city’s traffic. Dust clings to the windows. Torn seats peek through sliding doors. Diesel hangs low in the air. Conductors slap the metal sides of vans and shout destinations into the morning.

“Kireka! Banda! Bweyogerere!” The calls overlap until they become a steady roar.

New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
An infographic showing sample characteristics that frame occupational exposure of taxi drivers in Kampala.

Passengers squeeze through narrow corridors between vehicles where there was never meant to be walking space. Hawkers weave through the crowd with trays of roasted maize and boiled eggs. Somewhere, a small radio crackles. Nearby, two conductors argue over whose turn it is to load passengers. This scene is how Kampala wakes, in diesel fumes, shouted destinations, and the quiet urgency of people trying to earn a living before the traffic tightens its grip on the day.

Handwritten route boards fixed to the taxis signal their destinations: Masaka “A” Stage, Kaguta Road, Nakawa, Namirembe, Ntinda, Gayaza, Nansana, and Entebbe, guiding passengers through the organised chaos of the park. Behind every steering wheel sits someone doing the arithmetic of survival. Drivers wake before dawn to secure a place in the queue. For many, sleep is short, interrupted, and rarely restorative. The day stretches across long hours of traffic, uncertain earnings, rent, school fees, and taxi levies, including annual payments of about UGX 720,000. Passengers today mean dinner tonight. Yet inside the noise of the taxi parks, another story has remained largely invisible.

Across Uganda, an estimated 400,000 taxis move millions of passengers every day, forming the backbone of the country’s informal transport system. But almost nothing is known about the psychological toll on the drivers who keep it running.

That gap is what drew Dr. Kyomuhendo into Kampala’s taxi parks. What she uncovered were levels of depression, anxiety, and stress far higher than many had imagined.

A Medical Doctor Turning Toward Public Health

Born on 23 July 1994 to Mr. Muhigwa Lawrence and Ms. Kataito Jacqueline, Dr. Kyomuhendo grew up in Hoima District in western Uganda. Her early education took her from St. Christina Nursery School to Budo Junior School before she continued to Trinity College Nabbingo and later Mount Saint Mary’s College Namagunga for Advanced Level, where she studied Biology, Chemistry, and Mathematics.

In 2014, she earned a government scholarship through the Public Universities Joint Admissions Board and enrolled for a Bachelor of Medicine and Bachelor of Surgery at Busitema University, graduating in 2019.

During her medical internship at Masaka Regional Referral Hospital, she began noticing a troubling pattern in the cases arriving at the wards: road traffic injuries, complications of chronic diseases, severe malaria in children, and obstetric emergencies that might have been prevented with earlier intervention. Many of the crises doctors were treating, she realized, had begun long before patients reached the hospital. “They were symptoms of deeper problems,” she recalls.

Public health offered a way to investigate those underlying causes. In 2022, she enrolled in the Master of Public Health Distance programme at Makerere University School of Public Health, where students are trained to examine health problems not only at the bedside but across entire populations. Guided by Associate Professor Lynn Atuyambe, a respected scholar in Community Health and Behavioural Sciences at MakSPH, and Dr Juliet Kiguli, Senior Lecturer and public health anthropologist, the student’s work benefited from strong academic stewardship.

Dr. Linda Kyomuhendo after her graduation. Photo montage recreated by Author. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
Dr. Linda Kyomuhendo after her graduation. Photo montage recreated by Author.

Uganda’s road transport system is dominated by motorcycles and 14-seater minibus taxis. About 15,000 operate in the Kampala Metropolitan Area alone.

These drivers navigate congested roads, pollution, erratic traffic patterns, and long working hours. Their workday often begins before dawn and stretches deep into the evening.

“They are important in Uganda’s transport industry,” Kyomuhendo said. “Yet they seem to be overlooked in our society.”

While commuting through Kampala during her studies, she began to notice the lives of taxi drivers. Arguments between passengers and conductors were common. When tensions rose, someone would eventually mutter the same question in Luganda.

“Oba abasajja ba takisi baabaki?” loosely to mean, ‘What is wrong with taxi men?’

The question lingered, and in June 2024, social media campaigns marking Men’s Mental Health Awareness Month pushed her to think about the issue differently. What if the behaviour many passengers dismissed as impatience or aggression was linked to something deeper? To her, taxi drivers seemed an unlikely but revealing group to study.

“They carry the responsibility for passengers’ lives every day,” she says. “Yet very little attention is paid to their own well-being.”

An illustrative photo of the researcher, Dr. Linda Kyomuhendo, with a taxi driver, one of the respondents in her research. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
An illustrative photo of the researcher, Dr. Linda Kyomuhendo, with a taxi driver, one of the respondents in her research.

For instance, Kampala City Authority (KCCA) documents that between 2019 and 2024, geolocated crash data reveal a dangerous road environment in which Kampala’s taxi drivers operate daily. A total of 1,878 vulnerable road users, including pedestrians, motorcyclists, and cyclists, were killed in crashes involving motor vehicles, with buses and minibuses linked to 281 deaths, most of them pedestrians (147) and motorcycle occupants (131). Fatalities were heavily concentrated along major corridors such as Jinja Road, Kibuye–Natete Road, Bombo Road, and Ggaba Road, while for pedestrians, the most dangerous segments included Gayaza Roundabout (Kalerwe) and Kyebando Police Post along the Northern Bypass and Entebbe Road, where fatality densities reached 27–28 deaths per kilometer. These patterns highlight the high-risk traffic environments in which taxi drivers work, specifically busy arterial roads and bypass intersections where pedestrians, boda bodas, and public transport vehicles compete for space. These conditions contribute to the broader pressures that shape drivers’ safety, well-being, and mental health.

Research in the taxi parks

Her dissertation set out to answer two questions: how common are depression, anxiety, and stress among taxi drivers in Kampala, and what factors contribute to them? The study surveyed 422 male drivers across seven major taxi parks: Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete, using a multistage sampling approach designed to ensure representation across the city’s transport hubs.

Participants completed structured interviews on socio-demographic, occupational, lifestyle, use of habit-forming substances, medical, and environmental factors. Mental well-being was assessed using the Depression Anxiety Stress Scale (DASS-21), a widely used screening tool in mental health research.

The data were analysed using statistical models that allowed Kyomuhendo to examine how occupational conditions, lifestyle factors, and health status interacted to shape mental well-being.

The study reflected the epidemiological training embedded in MakSPH’s Master of Public Health programmes, where students are encouraged to investigate real-world health challenges through evidence-based research.

Conducting interviews inside the taxi parks meant stepping into one of the most unpredictable environments in the city. “The atmosphere was survival for the fittest,” Kyomuhendo recalls.

An infographic showing the burden of depression at a glance. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
An infographic showing the burden of depression at a glance.

Stories behind the statistics

The fieldwork brought moments that stayed with her long after the questionnaires were completed. One driver laughed when asked how he coped with stress. “I don’t drink or smoke,” he said, suggesting that multiple relationships were his way of managing the emotional strain of the job.

The answer was not in the questionnaire, and they both laughed. Yet the moment captured something deeper about life in the taxi parks: humour often hides exhaustion.

Another driver told her he had spent years buying herbal medicine for a hernia that never healed. Every month, he spent close to 100,000 shillings, hoping the treatment would eventually work. She advised him to seek hospital care, a conversation that stayed with her.

“Sometimes people spend far more trying to manage a problem than it would cost to treat it properly,” she explains.

An infographic illustrating occupational exposure among taxi drivers in Kampala. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
An infographic illustrating occupational exposure among taxi drivers in Kampala.

When the data were analysed, nearly two-thirds of the drivers screened positive for symptoms of depression. More than 70 percent had symptoms of anxiety, and over 80 percent reported levels of stress. The psychological burden was far heavier than most people had assumed.

Several factors stood out. Drivers who had experienced road accidents in the previous year were significantly more likely to report depression. Chronic medical conditions and a family history of mental illness also increased the risk.

Sleep deprivation emerged as one of the most important predictors. Drivers who consistently slept fewer than seven hours per night were far more likely to report anxiety and stress. Also, economic security mattered. Drivers who owned their vehicles were substantially less likely to experience anxiety compared to those who rented taxis or paid daily remittance fees to vehicle owners. In other words, psychological distress followed the same lines as economic pressure.

More than a transport problem, and the silence around men’s mental health

The implications extend beyond the drivers themselves, she observed. Mental health affects concentration, reaction time, and decision-making. All abilities that are critical for safe driving in a city known for congestion, unpredictable traffic, and frequent road hazards, including flooding, among others.

“If drivers are anxious or sleep-deprived,” Kyomuhendo explains, “there is a risk they may struggle to follow traffic rules or respond quickly to hazards.”

In a transport system that carries millions of passengers daily, the well-being of drivers becomes a matter of public safety. The findings suggest that mental health among taxi drivers should be treated as both an occupational health issue and a transport policy concern.

During interviews, Kyomuhendo noticed another pattern. Few drivers openly described themselves as depressed or anxious. Instead, stress appeared through jokes, casual references to alcohol or relationships, or long pauses followed by silence.

Men’s mental health remains a difficult subject in many communities. “Men’s mental health is a serious public health issue that should not be ignored,” she says.

Breaking the stigma will require awareness campaigns, stronger occupational protections, and greater attention from both health authorities and transport regulators, she proposes.

An infographic showing sample characteristics that frame occupational exposure of taxi drivers in Kampala. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
An infographic showing sample characteristics that frame occupational exposure of taxi drivers in Kampala.

A different way of seeing the city?

This research also changed how Kyomuhendo sees Kampala. Where passengers notice congestion or impatience, she now sees the pressures shaping the people behind the wheel. “It made me appreciate the men who show up every day and work hard despite their struggles,” she says.

One driver confided in her about the pressures of the job. “People will not help you unless they know the problems you are facing,” he said.

The city and its drivers

By late afternoon, the taxi parks are as crowded as they were in the morning. Conductors still shout destinations into the traffic. Engines idle in long rows of white vans waiting for passengers. Drivers lean against steering wheels, hoping the next arrival will finally fill the vehicle.

The city keeps moving because they do. Most passengers step into these taxis thinking only about where they are going—work, home, school, or the market. Few stop to consider the pressures carried by the people behind the wheel.

Taxi conductors marshal passengers and load commuter minibuses on a Kampala street. Photo: Katumba Badru. New study by Dr. Linda Kyomuhendo Jovia, medical doctor and Master of Public Health graduate Makerere University School of Public Health, Kampala Uganda, East Africa, cross-sectional survey of 422 drivers across Old, New, Kisenyi, Usafi, Namirembe, Nakawa, and Nateete parks, symptoms of depression (65.6%), anxiety affected more than 70%, and stress an estimated 82%, March 2026.
Taxi conductors marshal passengers and load commuter minibuses on a Kampala street. Photo: Katumba Badru.

Yet Kyomuhendo’s research suggests that beneath the noise of the taxi parks and those car hoots on the streets lies something far quieter and far less visible: a level of stress, anxiety, and depression that touches not only the drivers themselves but also the safety of the passengers they carry and the communities they serve.

Each morning, the vans will still line up bumper-to-bumper. Conductors will still shout destinations into the traffic. Kampala will still climb inside and move.

If nearly half a million taxis keep Uganda moving every day, who is protecting the minds of the people behind the wheel?

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Davidson Ndyabahika

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Makerere Graduation Underscores Investment in Africa’s Public Health Capacity

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PhD Graduates from the School of Public Health and College of Health Sciences with Professor Christopher Garimoi Orach (Rear) at the 76th Graduation Ceremony. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH). Commencement Speaker-Dr. Margaret J. Kigozi, Makerere University Endowment Fund Chairperson. 25th February 2026, Freedom Square, Kampala Uganda, East Africa.

KAMPALA, 25 February 2026 — Higher education must move beyond awarding degrees to producing solutions for national and global crises, speakers said on Wednesday as Makerere University continued its 76th Graduation Ceremony, positioning universities as central actors in strengthening Africa’s public health capacity.

Addressing graduands on Wednesday, February 25, 2026, at Freedom Square, national leaders and university officials framed graduation not as a ceremonial endpoint but as an investment in workforce readiness, research leadership, and evidence-driven governance, particularly at a time when health systems across the continent face growing pressure from pandemics, demographic change, and climate-related risks.

The message resonated strongly through presentations from Makerere University School of Public Health (MakSPH) and Makerere University College of Health Sciences (MakCHS), whose graduates enter professional service amid renewed global attention to health system resilience, scientific leadership, and locally generated research.

Delivering the commencement address on Day Two of Makerere University’s 76th Graduation Ceremony, Dr. Margaret Blick Kigozi, Board Chairperson of the Makerere University Endowment Fund, reflected on her graduation in 1976 during a period of national uncertainty under then-Chancellor President Idi Amin. She recalled leaving Uganda soon after with her young family, carrying “little more than education, values, and hope,” an experience she used to frame lessons on resilience, purpose, and responsibility in uncertain times.

Dr. Maggie Kigozi, (C) in the Chancellor’s Procession during the Mak 76th Graduation Ceremony. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH). Commencement Speaker-Dr. Margaret J. Kigozi, Makerere University Endowment Fund Chairperson. 25th February 2026, Freedom Square, Kampala Uganda, East Africa.
Dr. Maggie Kigozi, (C) in the Chancellor’s Procession during the Mak 76th Graduation Ceremony.

Challenging graduates to rethink professional success, she reminded those entering health and life sciences that their training carries extraordinary influence.

“Power does not make you important; it makes you responsible,” she said. “You will decide who is listened to and who is dismissed, who waits and who is rushed through, who feels safe and who feels small. Your education has trained you to ask better questions, but your humanity must guide the answers. Behind every chart, every case, every experiment, there is life, and life deserves care, patience, and dignity.”

Throughout the ceremony, speakers returned to a common refrain: societies increasingly depend on evidence, and universities must produce professionals capable of translating knowledge into policy, practice, and community impact.

Across the four-day congregation, the University will award 9,295 degrees and diplomas, including 2,503 Master’s degrees, 6,343 Bachelor’s degrees, 206 Postgraduate Diplomas, and 30 Diplomas. But beyond the numbers, speakers repeatedly returned to a central question on how higher education can translate academic growth into national development and health security.

On day two, graduands were presented from the College of Natural Sciences, the College of Veterinary Medicine, Animal Resources and Biosecurity, the College of Health Sciences, and the MakSPH, the latter positioned squarely within Africa’s ongoing struggle to expand its pool of trained epidemiologists, health systems researchers, and policy leaders.

Vice Chancellor Prof. Barnabas Nawangwe noted that Africa averages just 80 researchers per million people, compared to a global average of 1,081, warning that the human resource gap remains substantial.

“Today the School of Public Health presents graduands joining the field at a time when Africa faces a critical shortage of highly trained public health leaders,” he said.

Vice Chancellor Prof. Barnabas Nawangwe speaks during the graduation ceremony. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH). Commencement Speaker-Dr. Margaret J. Kigozi, Makerere University Endowment Fund Chairperson. 25th February 2026, Freedom Square, Kampala Uganda, East Africa.
Vice Chancellor Prof. Barnabas Nawangwe speaks during the graduation ceremony.

The School of Public Health presented seven PhD candidates: Aber Harriet Odonga, Komakech Henry, Lubogo David, Nakisita Olivia, Namukose Samalie, Ntaro Moses, and Osuret Jimmy. It also graduated 195 Master’s students and 29 Bachelor of Environmental Health Science graduates, including four first-class honours recipients led by Phillip Acaye with a CGPA of 4.63.

Their research spans maternal and child health, epidemic preparedness, sanitation behaviour change, nutrition systems integration, and injury prevention, areas increasingly recognised as foundational to national development rather than peripheral health concerns.

University Chancellor Dr. Crispus Kiyonga emphasized that research must move beyond academic publication into policy and implementation.

“Research plays a very vital role in the development of any community,” he said, linking university scholarship directly to Uganda’s national development agenda.

University Chancellor Dr. Crispus Kiyonga confers a Doctorate Degree upon one of the graduands last week. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH). Commencement Speaker-Dr. Margaret J. Kigozi, Makerere University Endowment Fund Chairperson. 25th February 2026, Freedom Square, Kampala Uganda, East Africa.
University Chancellor Dr. Crispus Kiyonga confers a Doctorate Degree upon one of the graduands last week.

For public health education, that responsibility carries particular urgency. The COVID-19 pandemic, recurring disease outbreaks, and climate-linked health risks have exposed how deeply national stability depends on scientific capacity.

The chancellor hailed the Government of Uganda for committing UGX 30 billion through the Makerere University Research and Innovations Fund (MakRIF).

Mak Urged on More PhDs

Representing the First Lady and Minister of Education and Sports, State Minister Dr. Joyce Kaducu Moriku described doctoral training as central to Uganda’s research ambitions, noting government efforts to expand funding and modernize higher education systems.

State Minister Dr. Joyce Kaducu Moriku during the 76th Mak Graduation Ceremony last week. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH). Commencement Speaker-Dr. Margaret J. Kigozi, Makerere University Endowment Fund Chairperson. 25th February 2026, Freedom Square, Kampala Uganda, East Africa.
State Minister Dr. Joyce Kaducu Moriku during the 76th Mak Graduation Ceremony last week.

“Universities must produce more PhDs to strengthen the national research agenda,” she said, adding that competence-based reforms aim to align training more closely with societal needs.

“More PhDs also mean the university is growing in academic leadership and an increase in research. So, keep the numbers growing, especially in Science, Technology, and Engineering,” she added.

The 213 PhDs conferred this year, a record, signal more than institutional expansion but a response to structural deficits.

Africa bears approximately 25% of the global disease burden but produces a disproportionately small share of global health research. The continent’s research density remains far below global averages. In this context, each doctoral graduate becomes not merely an academic achievement but a strategic asset.

A University Responding to Its Moment

For the School of Public Health, the graduation reflects a broader evolution in how public health training is conceived. Rather than focusing solely on the treatment of disease, the field increasingly addresses systems, sanitation, nutrition, behavioural change, surveillance, prevention, and climate change, areas where research directly shapes everyday life.

Recent MakSPH-led initiatives, including national HIV impact surveys and digital health system expansion, demonstrate how academic institutions increasingly function as implementation partners to the government rather than observers.

Over the past five years, MakSPH has supported the national scale-up of electronic medical records through the CDC-funded Monitoring and Evaluation Technical Support (MakSPH-METs) programme, and led the Third Uganda Population-Based HIV Impact Assessment (UPHIA 2024–2025), the first fully Ugandan-implemented national survey of its kind.

Launched in 2020, the METs program has supported the nationwide scale-up of UgandaEMR+, transitioning thousands of facilities to secure electronic medical records and deploying critical ICT infrastructure. In March 2026, these systems will be formally transitioned to the Ministry of Health, reflecting sustainable national ownership.

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Davidson Ndyabahika

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Three MakSPH Faculty Honoured with Makerere University Research Excellence Awards 2026

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A photo collage of top researchers from the Makerere University School of Public Health L-R: Dr. David Musoke, Assoc. Prof. Peter Waiswa and Juliana Namutundu. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.

KAMPALA—Three faculty members from Makerere University School of Public Health (MakSPH) have been recognised at the Makerere University Vice-Chancellor’s Research Excellence Awards 2026, highlighting the School’s expanding contribution to research leadership, scientific productivity, and policy-relevant scholarship across Africa.

Associate Professor Peter Kyobe Waiswa, Associate Professor David Musoke, and Juliana Namutundu received honours during the University’s 76th Graduation Ceremony at Freedom Square, where Makerere celebrated scholars whose work has demonstrated exceptional research achievement and impact beyond academia.

Associate Professor Peter Kyobe Waiswa holds a #Mak76thGrad Book during the graduation ceremony last week. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.
Associate Professor Peter Kyobe Waiswa holds a #Mak76thGrad Book during the graduation ceremony last week.

The annual awards, coordinated by the Directorate of Research, Innovation and Partnerships (DRIP), recognise faculty and staff whose scholarly output and leadership advance Makerere University’s ambition to become a research-led institution.

“This recognition celebrates sustained excellence in research productivity and contributions to knowledge that advance both national and global discourse,” Vice-Chancellor Prof. Barnabas Nawangwe said. “We are strengthening a culture where research does not remain confined to journals but translates into solutions for society.”

Among the university’s top researchers was Assoc. Prof. Peter Kyobe Waiswa, a health systems scientist whose work focuses on maternal, newborn, and child health. Waiswa ranked among Makerere’s overall top researchers after publishing 43 peer-reviewed papers in 2025, tying with three-time award winner Prof. Moses Kamya of the School of Medicine in the College of Health Sciences.

His research examines how health systems function at their most fragile moments, including childbirth, early life, and community-level care, addressing questions of equity, service delivery, and health system performance across Africa.

Also recognised was Dr. David Musoke, an Associate Professor of Disease Control, whose 25 publications earned distinction among senior career researchers. His work spans environmental health, community health systems, and implementation research, areas increasingly viewed as critical to preventing disease before it reaches hospitals.

Dr. David Musoke, Associate Professor of Disease Control at MakSPH, receives a plaque recognising his scholarly work from Hon Balaam Barugahara Ateenyi, Minister of State for Youth and Children Affairs, during the Mak Convocation luncheon. Looking on are Prof Buyinza Mukadasi, Academic Registrar; Dr Diana Atwiine, Permanent Secretary, Ministry of Health; Convocation Chairperson Mr George Turyamureeba Mugabi; and NRM National Youth Chairperson Mr Collins Tanga. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.
Dr. David Musoke, Associate Professor of Disease Control at MakSPH, receives a plaque recognising his scholarly work from Hon Balaam Barugahara Ateenyi, Minister of State for Youth and Children Affairs, during the Mak Convocation luncheon. Looking on are Prof Buyinza Mukadasi, Academic Registrar; Dr Diana Atwiine, Permanent Secretary, Ministry of Health; Convocation Chairperson Mr George Turyamureeba Mugabi; and NRM National Youth Chairperson Mr Collins Tanga.

In the early-career category, Juliana Namutundu received recognition for emerging research leadership, reflecting Makerere’s effort to nurture the next generation of African scholars.

Together, the awards underscored MakSPH’s growing influence within Makerere’s research ecosystem, particularly in fields linking science directly to population wellbeing.

Juliana Namutundu received recognition for emerging research leadership under the early-career category. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.
Juliana Namutundu received recognition for emerging research leadership under the early-career category.

The Research Excellence Awards were established to encourage publication in high-impact journals while reinforcing Makerere’s ambition to become a globally competitive research university. Nominations are reviewed by the Board of Research and Graduate Training, chaired by Deputy Vice-Chancellor (Academic Affairs) Prof. Sarah Ssali.

Awardees were honoured during a graduation luncheon organised by the Makerere University Convocation, the institution’s alumni and staff association, which described the event as a celebration of “excellence and inspiring impact.”

The ceremony also recognised forms of scholarship extending beyond traditional academic publishing.

Dr. Geofrey Musinguzi, a research associate at the School of Public Health, was honoured for his book My Journey with Rectal Cancer, an account of diagnosis, treatment, and recovery that blends personal testimony with public health advocacy.

Diagnosed at age 44 while a visiting scholar at the University of Antwerp in Belgium, Musinguzi sought medical care after experiencing persistent symptoms, including rectal bleeding and back pain. His treatment involved surgeries, chemotherapy, radiotherapy, and a year living with a colostomy bag.

Dr. Geofrey Musinguzi, a research associate at the School of Public Health, was honoured for his book. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.
Dr. Geofrey Musinguzi, a research associate at the School of Public Health, was honoured for his book.

Rather than keeping the experience private, he documented it publicly to challenge cancer stigma and encourage early screening. The book, launched at the School of Public Health in August 2024, highlights how lived experience can shape public health awareness alongside scientific research.

The recognition reflects a broader understanding of research impact, one that includes scholarship capable of influencing behaviour as well as policy.

Awardees pose with their plaques at the ceremony. 76th Graduation Ceremony, Day 2, School of Public Health (MakSPH) Vice Chancellors Research Excellence Awards. 25th February 2026, Makerere University, Kampala Uganda, East Africa.
Awardees pose with their plaques at the ceremony.

Makerere’s emphasis on research excellence comes as African universities face increasing pressure to produce locally grounded evidence while competing globally for visibility and funding. For MakSPH, whose work spans disease surveillance, environmental health, and health systems research, publication output increasingly serves as both academic currency and development infrastructure.

“These awards are part of our broader effort to position Makerere as a truly research-led institution,” Nawangwe said, adding that scholarship must remain aligned with national and regional priorities.

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Davidson Ndyabahika

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