Health
MakSPH Environmental Health Graduates Trained to Prevent Disease at Its Source
In most health systems, attention turns to illness after it appears in clinics and hospitals. Environmental Health works earlier, often invisibly, by preventing disease before treatment becomes necessary. At Makerere University School of Public Health (MakSPH), this preventive philosophy shapes the training of students learning to manage health risks at their source, through sanitation systems, safer environments, community engagement, and evidence-based public health action.
This year, as MakSPH presents 29 graduands approved by the Makerere University Senate for the award of the Bachelor of Environmental Health Science (BEHS) degree, four outstanding students graduate with first-class honours. Their journeys, shaped by different personal histories and professional ambitions, provide a clear view of how the School prepares practitioners whose work begins long before patients reach health facilities. Through academic training, field practice, research exposure, and leadership experience, the programme equips graduates to address the environmental and social conditions that determine health outcomes across communities.
Environmental health occupies a distinctive position within public health practice. Rather than focusing primarily on diagnosis or treatment, practitioners work at the intersection of science, policy, and society, addressing risks linked to water and sanitation, food safety, occupational health, climate change, and urbanisation. The discipline demands technical competence alongside communication, systems thinking, and community engagement, capabilities that increasingly define modern public health leadership.
The journeys of Nakulima Bushirah, graduating with a CGPA of 4.58 on February 25, 2026, Mujurani Alphersiiru with 4.44, and Cherop Eric with 4.41, alongside Phillip Acaye, the cohort’s overall best student with a CGPA of 4.63, demonstrate how MakSPH shapes students from varied beginnings into professionals grounded in prevention. Their paths reveal a shared formation that links classroom learning with real-world health challenges and prepares graduates to prevent disease before it occurs.
Bushirah Nakulima’s Turn Toward Prevention
For Bushirah Nakulima, environmental health began during a period of uncertainty. The COVID-19 pandemic repeatedly disrupted her Bachelor of Pharmacy studies at Kampala International University, prompting reflection about the kind of health professional she wanted to become. A conversation with a family friend working in preventive health introduced an alternative path, one focused not on treating illness after onset but on preventing it altogether.
“When I applied to Makerere University in 2022, I was considering two career paths,” she recalled. “I prayed to Allah to guide me toward the best one. When I was admitted to the Bachelor of Environmental Health Science, I accepted it wholeheartedly, and I came to appreciate it even more as I studied.”
Her academic foundation had already demonstrated consistency. She progressed from Melody Junior School in Nansana, where she obtained aggregate eight in 2010, to Shuhada’e Islamic School in Nyamitanga, completing O-Level with 25 aggregates in 2016 and A-Level with 10 points in 2018. Pharmacy initially appeared the logical continuation, yet environmental health offered something broader in scale and impact.
“Environmental Health offered an opportunity to prevent illness and suffering before it occurs,” she explained. “It allows a single intervention, such as WASH or health education, to protect many people at once, and it provides flexibility to work across diverse environments. It offered freedom to operate in various settings, which truly connects with my personality since I love exploration.”
At MakSPH, classroom concepts quickly translated into practice. During her internship at Mukono Municipal Council, she conducted school health education sessions, participated in inspections of markets and abattoirs, and engaged communities facing sanitation challenges. Field exposure deepened her understanding of how environmental conditions directly shape disease patterns, reinforcing prevention as both a scientific and social responsibility.
Leadership further expanded her training. Serving as the 90th Female Guild Representative Councillor (GRC), she represented the School of Public Health in the Student Guild structure, facilitating engagement between students and School leadership on academic and welfare matters. The role strengthened her capacity for representation, negotiation, and collaborative problem-solving, skills central to public health practice, where advocacy and systems engagement are inseparable from technical expertise.
Graduating with a CGPA of 4.58, Bushirah’s research examined roadside vendors’ exposure to air pollution in Kampala, reflecting growing concern about occupational and urban environmental risks. She now plans to pursue advanced training in public health, building on MakSPH’s emphasis on evidence-driven and community-centred practice.
Cherop Eric’s Return to the Classroom
Eric Cherop’s journey into environmental health began not in lecture halls but in community service. Raised in Kapchorwa District, he was shaped by economic hardship and resilience, experiences that informed his commitment to community well-being.
He completed his Primary Leaving Examinations at Chema Primary School, a Universal Primary Education institution, attaining 24 aggregates in 2008. He later joined Sipi Secondary School, where he obtained 37 aggregates at Uganda Certificate of Education in 2012 and continued at the same school for A-Level, earning 8 points at Uganda Advanced Certificate of Education in 2014.
After earning a Diploma in environmental health sciences from Mbale School of Hygiene between 2015 and 2017, he entered public service as an Environmental Health Officer and Community Field Facilitator with Kapchorwa District Local Government. His work included sanitation campaigns, climate resilience initiatives, nutrition education, and household behaviour change programmes. Over time, field experience revealed the limits of practice without deeper theoretical grounding.
“I wanted to understand not only what works in communities, but why it works,” he explains. Enrolling in the BEHS programme at MakSPH in 2022 allowed him to connect practical experience with analytical training. Coursework strengthened competencies in environmental risk assessment, participatory engagement, and data-driven planning. Mentorship reshaped how he interpreted evidence.
“My lecturers helped me move beyond seeing data as numbers,” he said. “I learned to see it as evidence that guides decisions and improves accountability.” Graduating with a CGPA of 4.41, Eric now aims to advance evidence-driven leadership at the intersection of climate change, nutrition, and environmental health, ensuring interventions remain grounded in community realities.
Mujurani Alphersiiru’s Path into Environmental Health
For Mujurani Alphersiiru, Environmental Health arrived at an unexpected moment, when his academic future appeared uncertain. Financial pressures had begun to threaten the continuation of his Bachelor of Nursing Science studies at Kampala International University Western Campus, raising the real possibility that his university education might end prematurely. The turning point came when the government district quota admission list was released, offering him placement at Makerere University under Bunyangabu District and opening an alternative academic pathway he had not previously considered.
At the time, environmental health was unfamiliar to him. “I didn’t know what environmental health was,” he recalls. “But I celebrated because I had reached my dream university.” Orientation sessions and early coursework gradually reframed that uncertainty, revealing a discipline grounded in prevention, systems thinking, and public health policy. What began as an unexpected opportunity soon developed into a clear professional direction.
Serving as class president and 90th Male GRC for the School with Nakulima Bushirah, Mujurani organised student activities, mobilised community outreach initiatives, and advocated for improved learning environments. Balancing leadership responsibilities with academic performance required deliberate discipline and time management.
His educational foundation began at St. Augustine Butiiti Demonstration Primary School in Kyenjojo, where he scored 12 aggregates in 2014. He later attended Pride Secondary School in Mityana, attaining 25 aggregates at O-Level in 2018, before proceeding to Kibiito Secondary School in Bunyangabu, where he obtained 13 points at A-Level in 2021, performance that earned him government sponsorship for university education. At MakSPH, faculty mentorship further strengthened both his academic rigour and commitment to public service.
“Government sponsorship meant responsibility,” Mujurani said. “I had to plan my time carefully while remaining active in school programmes.” Graduating with a CGPA of 4.44, his interests now centre on governance and accountability within health systems, particularly strengthening the implementation of public health policies.
Training Prevention Professionals
Taken together, the three journeys demonstrate how MakSPH’s Environmental Health training converts diverse personal backgrounds into a shared professional orientation centred on prevention. Through interdisciplinary coursework, field placements, research mentorship, and leadership opportunities, students develop competencies that extend beyond technical knowledge to include systems thinking and public engagement.
The BEHS programme, established in 2000 within MakSPH’s Department of Disease Control and Environmental Health, remains the School’s only undergraduate degree and has trained more than 1,000 graduates who now serve across government institutions, non-governmental organisations, academia, and international health programmes. Its continued evolution reflects growing recognition that strengthening health systems requires professionals capable of addressing environmental risks before illness occurs.
The achievements of this year’s graduates, therefore, represent more than academic distinction. They reflect a model of training designed to prepare professionals whose work reduces the need for treatment by preventing disease at its source, reinforcing MakSPH’s role in shaping Uganda’s environmental health workforce.
Makerere University’s School of Public Health (MakSPH) showcased research, training and international partnerships supported through European Union funding during the EU Uganda Research and Study Fair 2026 held at Makerere University.
The fair brought together students, researchers, academics, government representatives and development partners to explore opportunities in education, research, innovation and international collaboration, while celebrating 50 years of partnership between Uganda and the European Union.
Through its exhibition, MakSPH highlighted research and capacity building initiatives addressing public health challenges including infectious diseases, non communicable diseases, health systems, climate change and pandemic preparedness.
18 EU funded projects supported at MakSPH
Prof. Rhoda Wanyenze, Dean of Students, School of Public Health, said the School has benefited from 18 EU funded projects over the past five years, supporting research and training across several areas of public health.
She said the projects have contributed to the training of PhD researchers and the development of research addressing infectious diseases and prevention, non communicable diseases, health systems, climate change and health.
Prof. Wanyenze also highlighted a new five year programme which started in 2021 that is aiming at strengthening capacity for research on pandemic preparedness and response, including outbreaks such as Ebola.
Another programme being undertaken with the Ministry of Health and Karolinska Institute focuses on improving maternal health while also addressing adolescent pregnancy and the health of mothers and children.
She described partnerships as critical to advancing science and innovation, noting that collaboration allows researchers in Africa and Europe to share knowledge and strengthen the impact of research on communities.
Research partnerships strengthen innovation
Prof. Robert Wamala, Director of the Directorate of Research, Innovation and Partnerships at Makerere University, said the exhibition provided an opportunity to showcase EU funded projects across the University.
He noted that the School of Public Health alone has more than 18 such projects, while other colleges also have several EU supported initiatives.
One of the projects showcased was PREPARE TID, a partnership aimed at developing rapid diagnostic technologies for emerging and re emerging infectious diseases.
Prof. Julius Okuni, Associate Professor of Veterinary Pathobiology and Molecular Diagnostics at Makerere University, said the project brings together universities, industries and other organisations from Africa and Europe.
The project is working to develop technologies that can quickly identify pathogens responsible for outbreaks such as Ebola, Rift Valley fever and Crimean Congo haemorrhagic fever.
According to Prof. Okuni, Makerere is involved in field and laboratory work to test and refine the technologies before they can be delivered to end users.
Fair provides platform for research visibility
For researchers at MakSPH, the fair also provided an opportunity to increase the visibility of ongoing research and create new connections with researchers, policymakers and potential funders.
Dr. Raymond Tweheyo, Honorary Lecturer and Senior Research Fellow in the Department of Health Policy, Planning and Management, said such exhibitions allow researchers to share their work and identify others working on related challenges.
He cited the CONNECT for Health project, which focuses on transforming non-communicable disease care in Uganda through collaboration with partners across several countries.
Dr. Tweheyo said exhibitions can help researchers connect with policymakers, civil society organisations and other partners who can contribute to translating research into practical solutions.
Assoc. Prof. Angelina Kakooza Mwesigye, Associate Professor and Child Neurologist at Makerere University College of Health Sciences, also emphasised the importance of exposing young people to international research opportunities.
She said the long standing Uganda Europe partnership provides opportunities for the next generation of researchers to learn, build networks and prepare for future research collaborations.
The School of Public Health’s participation highlighted the role of international partnerships in strengthening research capacity, supporting innovation and developing evidence based responses to Uganda’s public health challenges.
Uganda has strengthened its ability to respond rapidly to Ebola and Marburg outbreaks once cases are confirmed, but delays in frontline detection, health worker exposure, emergency financing bottlenecks and incomplete implementation of lessons from previous outbreaks continue to undermine preparedness, a study has found.
The findings were presented today, October 6, 2026, during a country validation workshop convened by the Meeting Targets and Maintaining Epidemic Control (EPiC) project, to examine lessons from Uganda’s response to filovirus disease outbreaks. The study was undertaken by Makerere University School of Public Health and FHI 360.
Presented by Dr. Steven Kabwama, the synthesis examined Uganda’s experience with recurrent Ebola virus disease (EVD) and Marburg virus disease (MVD) outbreaks between 2000 and 2026, drawing particularly on After-Action Reviews from the 2017 Marburg outbreak and the 2019, 2022 and 2025 Ebola outbreaks. The work seeks to consolidate recurring strengths, weaknesses, innovations and lessons that had previously been documented separately.
Uganda has recorded 12 filovirus outbreaks over the 26-year period, including nine Ebola and three Marburg outbreaks, according to the research team. Among the four outbreaks examined closely were the 2017 Marburg outbreak in Kween and Kapchorwa, the cross-border Ebola outbreak in Kasese in 2019, the multi-district Sudan Ebola virus outbreak in 2022, and the 2025 outbreak whose index case was a health worker.
Strong systems after confirmation
Across the outbreaks reviewed, the synthesis found that Uganda has developed significant capacity to mobilise after laboratory confirmation. National and district task forces and technical response structures are activated quickly, supported by strong laboratory capacity, established coordination mechanisms and increasingly sophisticated surveillance systems.
The country has also built laboratory capacity around the Uganda Virus Research Institute, mobile laboratories, genomic sequencing, sample referral systems and the Results Dispatch System. Digital surveillance tools, Village Health Teams, survivor champions and established national and district coordination structures have further strengthened response capacity.
Detection remains a weak point
However, the findings point to a critical problem before confirmation: recognising a possible outbreak early enough.
For outbreaks originating within Uganda, the synthesis found that the period between a patient’s first presentation and confirmation ranged from nine to 27 days. This the study found is linked to low clinical suspicion and weaknesses in screening. Other recurring challenges included delayed access to emergency financing, infections among health workers, disruptions to essential health services, community mistrust and stigma, and limited follow-through on recommendations from previous After-Action Reviews.
Opening the workshop, the Dean, Prof. Rhoda Wanyenze, said understanding these delays requires going beyond identifying broad weaknesses to examining where response systems fail in practice.
“We can identify a broad challenge such as delayed detection from the literature, but your experience on the ground can help us understand the specific factors that create that challenge,” Prof. Wanyenze said while addressing district health officials from across the country.
“When we begin looking for solutions, we need to be able to target the actual problems rather than simply identifying broad challenges.”
The workshop brought together partners and colleagues from districts, including people directly involved in outbreak response, to validate the synthesis against frontline experience. Prof. Wanyenze noted that published literature, scientific papers and response reports cannot capture every operational reality, making practitioner experience essential to understanding where delays occur and what interventions have worked. Remarks validation workshop
Turning outbreak experience into continuous readiness
Among the priority actions proposed are stronger screening and alert systems for earlier detection; ring-fenced emergency financing and more reliable responder payment systems; routine infection prevention and control training; stronger occupational protection for health workers; continued investment in laboratories and genomic sequencing; and preparedness extending beyond districts traditionally considered outbreak hotspots. The study also recommends stronger community engagement and a formal mechanism to track and finance implementation of recommendations from After-Action Reviews.
Dr. Andrew Acero, Director of the EPiC project at FHI 360’s Uganda Office said the central challenge is ensuring that experience accumulated during successive outbreaks translates into lasting institutional capacity.
“The real value lies in ensuring that what we learn changes what we do. Our findings should inform policy, shape guidelines and training, strengthen systems and ultimately improve practice.”
He noted that preparedness cannot begin only after an emergency has been declared, but must be built through sustained relationships, systems and capacity before outbreaks occur. Remarks validation workshop
The EPiC project is led by FHI 360 with core partners including Right to Care, Palladium and Population Services International.
Uganda’s latest national HIV survey reveals lower viral suppression among adolescents and young adults living with HIV than among older adults, even as the country records substantial improvements in controlling the virus. The findings come from Uganda Population-Based HIV Impact Assessment (UPHIA 2025), a national household survey examining HIV prevalence and whether people living with the virus know their status, receive treatment, and achieve viral suppression.
Releasing the preliminary UPHIA 2025 findings at the Uganda Media Centre on 1 October 2026, Minister of Health Hon. Dr. Chris Baryomunsi called for earlier prevention and testing, particularly among adolescent girls and young women, alongside support for treatment adherence. “We must reach out to the young people, ensure that they have information, they test, take treatment, and adhere to the treatment guidance,” he urged.
Hon. Baryomunsi recalled how fear had discouraged testing during his university years: “I remember when we were at university, we went for testing at the university hospital. We sat there for three hours. Some of us left without even testing because it was scary.” Today, he explained, “even if you test HIV positive, you can be initiated on treatment, and you live normally like the rest of those who don’t have HIV.”
UPHIA 2025 was locally led under the Ministry of Health’s overall leadership, with Makerere University School of Public Health serving as the prime implementer, a role ICAP at Columbia University held in the previous two surveys. The Uganda Bureau of Statistics led sampling, while the Uganda Virus Research Institute and National Health Laboratory and Diagnostic Services led laboratory operations. Regional referral hospitals and local governments supported implementation, and the U.S. government provided US$10 million through PEPFAR, along with technical assistance from the U.S. CDC.
UPHIA collected data from July to September 2025 among people aged 15 and above, including those outside routine treatment services. Of 6,283 eligible households, 94.4% completed interviews. Researchers interviewed 13,801 people and tested 13,477 for HIV.
Testing followed Uganda’s national algorithm, with laboratory confirmation of positive samples, viral-load measurement, and checks for antiretroviral medicines to establish treatment use. Researchers weighted the estimates to account for the sampling design. Participants received counselling and results, and those who tested positive were referred for treatment.
Hon. Baryomunsi thanked participants and their families for welcoming survey staff and contributing their time, information and samples, without which the national evidence would not have been available.
National progress and the youth gap
The survey estimated HIV prevalence, which means the proportion of people living with HIV, at 5.9% among those aged 15 and above, corresponding to about 1.496 million people in this age group nationwide. Prevalence was 7.3% among women and 4.1% among men, ranging from 1.3% in Karamoja to 8% in the South Western region.
Among people aged 15 and above living with HIV, 86% had achieved viral suppression, meaning a low amount of HIV in the blood, measured in UPHIA as fewer than 1,000 copies per millilitre. Suppression stood at 69.3% among adolescents and young adults aged 15–24 living with HIV, compared with 89.9% among those aged 50 and above. These estimates cover people living with HIV regardless of whether they know their status or receive treatment.
HIV prevalence among people aged 15–24 was 1.5%, including 2% among young women and 1% among young men. Among young women, prevalence was 1.3% at ages 15–19 and 2.8% at ages 20–24. These differences support attention to earlier prevention and testing, although they do not establish when infections occurred.
The highest prevalence estimates occurred among middle-aged adults: 15.7% among women aged 40–44 and 11.7% among men aged 45–49. Lower suppression among young people therefore requires attention alongside the higher HIV prevalence among middle-aged adults. Comparing the same age group across both surveys, viral suppression among people aged 15–64 increased from 74.9% in 2020–21 to 86.1% in 2025, while HIV prevalence remained at 5.9%.
Diagnosis and the path to 2030
The treatment results identify diagnosis as the main national gap. Among people aged 15 and above living with HIV, 85.3% knew their status. Of those aware, 99.1% were receiving treatment; among those receiving treatment, 96.5% had achieved suppression.
The 95-95-95 targets aimed for 95% of people living with HIV to know their status, 95% of those diagnosed to receive treatment, and 95% of those receiving treatment to achieve viral suppression by 2025. Among people aged 15 and above, Uganda exceeded the treatment and suppression targets, while diagnosis remained below target. UNAIDS’s Global AIDS Strategy 2026–2031 retains these targets towards ending AIDS as a public health threat by 2030.
According to WHO, viral suppression protects health and helps prevent HIV transmission. Uncontrolled HIV weakens the immune system, increasing the risk of serious illness. With continued treatment as prescribed, sexual transmission risk is negligible when HIV remains suppressed but detectable, and zero when undetectable. The Uganda AIDS Commission estimated over 34,000 new HIV infections in 2025, underscoring the importance of early diagnosis, timely treatment, and sustained suppression alongside other prevention measures.
The demographic stakes are substantial. People aged 15–24 constituted 21.2% of Uganda’s population in the 2024 census. The country’s Fourth National Development Plan, covering 2025–2030, prioritises a healthy, knowledgeable, skilled and productive population and reducing HIV through primary health care. Protecting young people’s health, therefore, supports their participation in education, work, and national development; UPHIA helps identify where services need greater attention.
Turning evidence into action
The study’s conclusions identify three priorities: sustain treatment outcomes, find people unaware of their status, and improve suppression among younger people. Permanent Secretary Dr. Diana Atwine connected the findings to the Ministry’s planning.
“We do believe that these results are a true reflection of what is happening in our country as far as the HIV status is concerned, and we do believe that it will give us a very clear direction and the roadmap that we are going to take in the next five years to target and to get our targets achieved.”
Acting on these priorities requires funding for services and research. Hon. Baryomunsi outlined plans to target resources where needs are greatest, strengthen district services and align partner support with government priorities. Responding to journalists’ questions, he noted the government’s intention to increase domestic funding for the HIV response, including research.
“The HIV/AIDS response, including research and surveys such as this one, has largely been funded by partners in the past. The government of Uganda is committed to allocating more resources from our domestic budget to support the response and research,” he noted.
For the first time in the UPHIA series, the survey assessed selected noncommunicable disease indicators among people aged 15 and above: 15.5% had elevated blood pressure, 24.8% were overweight or obese, and 0.9% had raised random blood glucose. These screening findings align with the Ministry’s integration agenda and Hon. Baryomunsi’s call to bring HIV and chronic care services together to address people’s wider health needs.
Speaking at the release of the preliminary results, U.S. Embassy Chargé d’Affaires Mikael (Mika) Cleverley described UPHIA 2025 as the first Population-Based HIV Impact Assessment worldwide fully led and implemented by the country itself.
“The study was led by Ugandan scientists, Ugandan managers, Ugandan public servants, Ugandan field teams, from design to data collection to analysis. And this is what two decades of focused strategic U.S. foreign investments in the public health sector was meant to produce, is to reinforce Ugandan leadership and Ugandan-led efforts.”
At the survey launch on 29 May 2025, MakSPH Dean Prof. Rhoda Wanyenze highlighted the partnership’s contribution: “The partnership between Makerere University and CDC has not only helped build national capacity in surveillance and epidemiology, but has also strengthened our ability to lead high-quality, large-scale national surveys.”
The Dean added: “After two decades of joint work, we are proud that UPHIA is now a fully Ugandan-led effort. This is critical to the sustainability of the skills and knowledge generation to inform our local response.”
UPHIA 2025 shows how far Uganda’s HIV response has advanced and where gaps remain. As the country works towards ending AIDS as a public health threat by 2030, reaching young people with testing, treatment, and continued care will be essential to extending those gains.
Read the full UPHIA 2025 summary results here:
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