Participants pose for a group photo at the "Strengthening leadership and management among local government health managers in Wakiso district, Uganda", Project Dissemination Workshop held on 23rd April 2025 in the MakSPH Auditorium.
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.
A joint study between Makerere University School of Public Health (MakSPH) and The Open University, UK, is investigating a possible link between maize cultivation and malaria risk in Uganda, as evidence increasingly points to livelihoods and everyday economic activities as key drivers of transmission of the disease.
The research initiative was advanced during a stakeholders’ workshop held on April 15, 2026, at MakSPH’s Resilient Africa Network in Kololo, where a team led by Assoc. Prof. David Musoke of Makerere University and Dr. Kevin Deane of The Open University presented ongoing and previous findings on the social determinants of malaria. The meeting brought together academics, policymakers, and practitioners to examine how agricultural practices, particularly maize farming, may be shaping malaria patterns in both rural and urban settings in Uganda.
The work builds on a growing body of research linking malaria to economic activity. One such study, led by the two researchers and published in Global Public Health in December 2025, found that livelihood activities such as farming, livestock keeping, and night-time work significantly influence malaria exposure. The study identified agriculture, especially maize cultivation near homes, as a key factor associated with increased mosquito density and heightened infection risk.
Assoc. Prof. David Musoke presents research findings on how livelihoods, including maize cultivation near homes, may influence malaria exposure during a stakeholder workshop at the Resilient Africa Network, Kololo, on April 15, 2026.
At the workshop, Dr. Musoke said the new inquiry reflects a broader shift in how malaria is understood, outlining how livelihoods, particularly agriculture, shape exposure through multiple pathways, from crop production and water use to the timing of daily activities that coincide with peak mosquito biting hours. These patterns, he argued, extend risk beyond what conventional interventions, such as insecticide-treated nets and indoor spraying, are designed to address.
Uganda remains one of the countries most affected by malaria, with the disease accounting for a significant share of outpatient visits, hospital admissions, and deaths. It is consistently ranked among the leading causes of illness and mortality, particularly among children under five and pregnant women. Despite sustained investment in prevention and treatment, including widespread distribution of insecticide-treated nets and indoor residual spraying, transmission remains high in many parts of the country. This persistence has increasingly drawn attention to factors beyond conventional interventions, including the role of livelihoods, environment, and everyday exposure to mosquitoes.
Maize grown close to homes, with damp ground conditions, may increase exposure to malaria in rural communities.
“As researchers, our role is to generate evidence, and that evidence should inform decision-making,” Dr. Musoke said. “We do not work in isolation. What we hear from stakeholders matters. We are bringing together different sectors, disciplines, and institutions because this work is still in progress, and we intend to build it collaboratively. Increasingly, research requires not just academics, but policymakers, implementers, and communities to be part of the process.”
The collaboration with The Open University has been central. Dr. Deane said the idea of examining the relationship between maize and malaria emerged from several years of joint research on social determinants with MakSPH. He pointed to a gap in malaria research, which has largely focused on biomedical and indoor interventions, while overlooking the role of livelihoods and outdoor exposure.
Assoc. Prof. David Musoke (left), Dr. Paul Mulumba (centre), a Health Inspector in Wakiso District, and Dr. Kevin Deane (right) share insights during the workshop at the Resilient Africa Network, Kololo, on April 15, 2026.
“We cannot continue relying solely on bed nets, spraying, and treatment,” Dr. Deane said. “These remain essential, but they are not sufficient for elimination. There is significant outdoor malaria transmission, particularly among adults, and that is linked to how people live and work.”
He added that maize presents a complex case. As one of Uganda’s most widely grown staple crops, it is central to both food security and household income, making it impractical to separate farming from living spaces. This, he said, underscores the need to better understand the relationship and develop responses grounded in evidence and local realities.
Evidence presented during the workshop drew on both community experiences and existing scientific literature. Prior qualitative research by the team found that mosquito populations increase during maize growing seasons, particularly in the evenings. Scientific studies also show that maize pollen can enhance mosquito survival and longevity, potentially increasing their capacity to transmit malaria.
Dr. Kevin Deane of The Open University emphasised the need to move beyond conventional malaria interventions to better understand how livelihoods and everyday activities shape exposure during the stakeholder workshop in Kololo, Kampala, on April 15, 2026.
Previous work in Wakiso district further situates maize within a wider set of risk factors. Findings show that agriculture, including crop production and animal husbandry, can create conditions that support mosquito breeding through stagnant water, water storage practices, and environmental changes. These risks are compounded by outdoor activities in the early morning and evening, when exposure is highest. The research also points to the growing role of urban agriculture, which is bringing crop cultivation and potential mosquito habitats closer to residential spaces, altering traditional patterns of transmission.
Ms. Doreen Nabwire Wamboka, in-charge at Namayumba Epicentre Health Centre III in Wakiso District, said the discussions challenged long-held assumptions that malaria is a “well-understood” condition.
“I used to think malaria had been fully researched, that we already knew what we needed to know,” she noted. “I now see that what has been studied is the conventional side of it. There are emerging factors we have not paid attention to. This work is opening up new ways of thinking, even about things we take for granted, like the crops we grow around our homes. We treat malaria as ordinary, yet it is still one of the most common conditions. Understanding these connections could change how we approach the disease.”
Ms. Doreen Nabwire Wamboka, In-charge at Namayumba Epicentre Health Centre III in Wakiso District, engages in a co-creation session as a fellow participant looks on during the stakeholder workshop in Kololo on April 15, 2026, underscoring the need for collaborative approaches to design interventions to tackle malaria.
The initiative will now combine spatial analysis, entomological studies, and community-based research to better understand how maize cultivation influences malaria risk. It will also involve farmers and other stakeholders in shaping potential interventions, reflecting a broader shift toward co-produced solutions.
The workshop, funded by The Open University, marked an important step in refining this research agenda. As the work progresses, its findings could inform policy and practice not only in Uganda, but also in other malaria-endemic countries where maize is widely cultivated. For now, the research signals a shift from isolated interventions to a more integrated understanding of how livelihoods and environments drive malaria transmission.
Update: Application deadline extended to 30th April 2026
Makerere University School of Public Health (MakSPH) is pleased to announce the Certificate Course in Water, Sanitation and Hygiene (CWASH) – 2026.
This intensive and practical short course is designed to strengthen the knowledge, skills, and attitudes of professionals involved in the planning, implementation, and management of Water, Sanitation and Hygiene (WASH) services. The programme responds to the growing demand for competent WASH practitioners in local government, non-governmental organisations, and the private sector.
Course Highlights
Duration: 8 weeks (01 June – 24 July 2026)
Mode: Day programme (classroom-based learning and field attachment)
Fees:
UGX 900,000 (Ugandans / East African Community)
USD 500 (International participants)
Application deadline:Thursday, 30 April 2026
Who Should Apply?
Practising officers in the WASH sector
Environmental Health workers seeking Continuous Professional Development (CPD)
Applicants with at least UACE (or equivalent) and one year of WASH-related work experience
Attached to this announcement, interested persons will find:
The course flier, providing comprehensive programme details, and
The application form, which should be completed and returned to MakSPH together with the required supporting documents.
For full course details, application procedures, and contact information, please carefully review the attached documents. Eligible and interested applicants are strongly encouraged to apply before the deadline and take advantage of this opportunity to build practical competence in WASH service delivery.
Makerere’s School of Public Health (MakSPH) is expanding faster than it can house itself. It now hosts more than 1,000 students, runs programmes across multiple countries, and anchors a large share of the University’s research output. Yet parts of its operation still spill into rented space, costing over $113,000 a year, because the infrastructure has not kept pace with its growth.
That constraint sits uneasily with the School’s economic weight. Health research accounts for more than half of Makerere University’s academic output, making it one of the University’s most productive engines. As Vice Chancellor Barnabas Nawangwe put it, “An educated population is a healthy population, and an educated and healthy population is a prosperous population.”
Beyond the university, health is not just a social outcome but a driver of economic performance. Healthier populations are more productive, more resilient, and less costly to sustain. Investments in public health, whether in prevention, systems, or infrastructure, raise an economy’s productive capacity, not just improve outcomes.
A construction worker undertakes metal fabrication works at the Makerere University School of Public Health (MakSPH) building site.
Institutions that generate public health knowledge and train professionals are not peripheral to growth; they are part of its foundation.
It is this logic that is shaping how Makerere’s School of Public Health is positioning itself. At its centre is a new, unfinished complex on the University’s main campus, intended to anchor the School’s next phase as a regional hub for research, training, and policy support. But like much of the system it supports, it is being built gradually, in a “build-as-you-go” approach constrained as much by funding realities as by design.
Construction of Phase II of the MakSPH complex is now at an advanced stage, with progress recorded across all sections of the site. As of March 2026, Phase 2B is nearing completion at 98%, while Phase 2A stands at 89%, and Phase 2C at 69%, each tracking close to or slightly ahead of planned targets. Current works are concentrated on interior finishes—including tiling, terrazzo installation, and external rendering—as well as preparations for lift installation, signaling a transition from structural works to final detailing. The project team is working toward a practical completion date of August 31, 2026, with timelines calibrated to align with broader resource flows and implementation considerations.
Six years ago, in February 2020, construction began on what will be the new home of the School of Public Health. The building, a permanent, purpose-built public health facility on Makerere’s main campus, will accommodate a growing student body, provide space for doctoral and postdoctoral fellows, and strengthen the University’s ability to respond to Africa’s most pressing public health challenges.
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, said the construction journey reflects the School’s “ambition, intent, and courage”—a bold step despite limited resources. He was speaking at a public lecture on health financing held at Makerere University on April 9, 2026.
But the ambition behind the project is not modest. “We are not building for today—we are building for the future,” said Professor David Serwadda, reflecting on a decision that shaped the entire construction effort. “We need to build for the next 100 years.”
Professor David Serwadda, Professor Emeritus at Makerere University and Chair of the MakSPH Infrastructure Fundraising Committee, speaks at a public lecture on health financing for Uganda’s future, held on April 9, 2026.
That long view helps explain both the scale of the project and the risks taken to start it. When construction began, the School did not have the full funding. “We started with about a third of the required budget,” Serwadda said.
The approach was not without setbacks. A major grant from USAID, worth over a million dollars, was later withdrawn, midway through the construction, due to the closure of USAID. “We received what is called a ‘Dear John letter,’” he recalled. “At that moment, we felt the situation was a major blow, almost terminal for the project.”
But the project did not stop. It adjusted. “We said, let us continue, piecemeal,’” he said. “Finish the auditorium first, use it, and keep building the rest.”
“We have come a long way as the School of Public Health,” said Professor Rhoda Wanyenze, the Dean. “We are proud of that history, but we also recognize that it comes with responsibility.”
Professor Rhoda Wanyenze, Dean of the Makerere University School of Public Health, speaks at a public lecture on health financing for Uganda’s future, held on April 9, 2026.
She argued that responsibility is no longer confined to Uganda. With ongoing collaborative work in more than 25 African countries currently, the Dean says this is “a responsibility to provide leadership in public health not only in Uganda but across the continent.”
The scale of that growth has been visible from what was once a small training unit in the Faculty of Medicine in the 1950s, which has expanded into 12 academic programmes and more than 1,000 students.
“When I came back for my public health training, we were about 40 students,” she said. “Now, we have more than 1,000.” “Public health is growing and evolving,” Wanyenze said. “And we are doing our best to develop the skills needed for this changing landscape.”
That includes new areas such as health informatics and data science, driven by the digitisation of health systems and the growing role of data in decision-making and AI. The School is already coordinating regional platforms on digital health, linking multiple countries in shared learning and practice.
But this growth has outpaced the physical systems needed to sustain it. For the University leadership, the implications extend beyond infrastructure.
“One of the most effective ways to invest in health in Uganda is to invest properly in Makerere University,” said Vice Chancellor Barnabas Nawangwe. “We must recognize Makerere as a research-led university with a special national role—not fund it like any other institution or department. Makerere is one of the government’s greatest assets. Invest in her, and the returns will exceed expectations.”
Professor Nawangwe hailed Dr. Ramathan Ggoobi, the Permanent Secretary to the Treasury, who delivered a keynote on investing in health for Uganda’s future in view of Vision 2040. “I wish to thank Dr. Ramathan Ggoobi and his team for their personal intervention in allocating resources in next year’s budget to complete the new School of Public Health building. That support is deeply appreciated,” he said.
Vice Chancellor Professor Barnabas Nawangwe speaks at a public lecture on health financing for Uganda’s future on April 9, 2026.
Uganda’s progress in health outcomes is evident, but uneven. Life expectancy has risen significantly from about 50 years in 2000 to roughly 68.8 years in 2024, according to the Permanent Secretary to the Treasury, Ramathan Ggoobi. Yet the gains sit alongside persistent financial strain on households. About 4% of Ugandans still spend more than a quarter of their consumption on healthcare, pushing many into poverty as a result of illness.
For Ggoobi, this points to a structural gap that recurrent government spending alone cannot close. “We must mobilise long-term domestic capital without adding fiscal risk,” he argued, pointing to the need for more sustainable financing mechanisms. Central to this is the gradual design and rollout of a national health insurance scheme. Evidence from countries such as Rwanda, Kenya, and Ghana suggests that well-structured contributory models can expand coverage while reducing catastrophic out-of-pocket spending.
“My Ministry and the School of Public Health must be partners. … Evidence framed in fiscal terms drives policy,” said Ggoobi, stressing the need for locally grounded solutions. “What works in Ghana might not work here. We need a model that fits Uganda.”
Uganda’s current macroeconomic conditions, relatively low inflation, currency stability, and expanding private credit may provide a window to move in that direction.
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