As Makerere University School of Public Health (MakSPH) presents 29 graduands on February 25, 2026, at Makerere University’s 76th Graduation Ceremony, for the conferment of the Bachelor of Environmental Health Science (BEHS) degree, the journey of the cohort’s best student provides a compelling window into both individual resilience and institutional impact. Philliph Acaye, graduating with a CGPA of 4.63, represents more than academic distinction. His story reflects the lived realities that shape many public health professionals in Uganda and shows how rigorous training can transform experience into leadership within health systems.
On the left, Prof. Rhoda Wanyenze, MakSPH Dean, presents Bachelor of Environmental Health Science graduands, who look on in anticipation during Makerere University’s 75th Graduation Ceremony in January 2025.
Education Shaped by Conflict
Acaye was born on October 2, 1993, in Wangduku Village, Palenga Parish, Pajule Sub-County, Pader District in northern Uganda, a region deeply affected by the Lord’s Resistance Army (LRA) insurgency in the early 2000s, where education and security often existed in constant tension. As a child, schooling unfolded alongside displacement and uncertainty, conditions that shaped an entire generation growing up during the conflict.
“Around 2002, before we had fully moved into the IDP camps, we often ran with our parents whenever there were LRA attacks,” he recalls. “But on several occasions, they caught us unaware. During one of the attacks, they abducted me and moved with me for close to seven kilometres, from Wangduku to Pajule Trading Centre in Pader. At first, they said I was too young to be moved with. I was around nine or ten years old. Later, I understood that someone among them personally knew my father and did not want me taken, so he used my age as the reason, and they left me behind.”
Children and families walk at dusk in northern Uganda during the height of the LRA insurgency in 2004, when many travelled nightly to safer shelters to avoid abduction, a reality that shaped the childhood of a generation, including graduates like Philliph Acaye. Photo Credit: UNICEF/Chulho Hyun.
He narrates that several relatives and neighbours, including some of his childhood friends, were not spared, among them an uncle whose whereabouts remain unknown to this day. “If they had gone with me,” Acaye reflects quietly, “I could be dead, or I might not have studied.” The remark sits deep and places his graduation in context, not simply as personal success, but as the outcome of persistence through years when conflict repeatedly disrupted education across northern Uganda.
Between 2002 and 2006, his schooling continued inside Pajule Internally Displaced Persons (IDP) Camp, where families lived in overcrowded settlements and depended largely on relief food. Learning environments were unstable, teachers travelled under risk, and lessons were frequently interrupted by insecurity. Even within the camps, attacks remained possible. Education progressed slowly, but it continued, sustained by families and teachers who insisted that schooling remained essential despite uncertainty.
When communities gradually returned home, Acaye rebuilt his academic track record step by step. He completed Primary Leaving Examinations in 2007 with an aggregate of 19 and was the best pupil at Wangduku Primary School, at a time when enrolment remained low because many families feared returning to villages. He proceeded to Pajule Senior Secondary School, completing O-Level in 2011 with 31 aggregates, and later obtained 10 points at A-Level in 2013 from Kitgum High School.
However, his progression was shaped by consistent recovery after disruption, supported by relatives, teachers, community mentors, and educational assistance from Invisible Children, a post-LRA conflict recovery NGO led locally by Ms. Laker Jolly Okot, which supported his A-Level education.
Professional direction emerged during his training at the Mbale School of Hygiene, where he pursued a Diploma in Environmental Health Science from 2014 to 2016 and graduated with a strong CGPA of 4.4. The diploma opened immediate employment opportunities in community and humanitarian health settings back home, followed by service in local government. Today, he works as a Health Inspector in Kitgum District Local Government, implementing sanitation monitoring, infection prevention activities, and community health interventions. Practical experience strengthened his understanding of public health challenges but also revealed limits in technical depth that he felt required further training.
Training the Public Health Professional
His admission to MakSPH in 2022 through the government diploma-entry sponsorship scheme represented a deliberate academic decision rather than a career reset. He sought broader analytical skills and a stronger grounding in environmental health systems, particularly in areas of surveillance, planning, and evidence-based decision-making.
“I realised some technical aspects were not fully covered at the diploma level. I wanted to understand public health beyond implementation and learn how decisions are justified scientifically,” Acaye explained.
Philliph Acaye supporting COVID-19 screening at Tikao Prison Farm in Orom Sub-County, Kitgum District, in 2022, part of his frontline public health work as a Health Inspector during the pandemic response.
The sponsorship, he observed, transformed that ambition into possibility and remains central to how he understands his academic journey at Makerere University. “I am grateful to the Makerere University selection committee, the MakSPH selection committee, and the Government of Uganda for this opportunity. Opportunities like this are not guaranteed, and I recognise the trust placed in me to undertake and complete the three-year BEHS programme.”
The transition into university study was not seamless, though. His admission had come earlier than planned, and he began coursework without formal study leave while still tied to workplace obligations in Kitgum. Sustained support from district leadership, particularly Dr. Okello Henry Otto, the District Health Officer, eventually enabled him to secure study leave and concentrate fully on academic work. Now with stability came rapid academic improvement, supported by peer learning, faculty mentorship, and a strong curriculum that emphasised analytical reasoning alongside applied practice.
Acaye attributes his transformation to the programme’s academic culture rather than individual brilliance. “The programme helped me realise that what I was doing before was only a surface understanding,” he argued. “I learned to approach public health more deeply.” Exposure to research methods, he revealed, reshaped how he interpreted field experience and encouraged him to submit an abstract to an international academic conference, marking his transition from practitioner to emerging researcher.
For Mr. Abdallah Ali Halage, the MakSPH Coordinator of the BEHS programme, such outcomes reflect intentional design rather than coincidence. He noted that student success is rooted in a training philosophy that combines technical instruction with professional discipline from the moment students enter the programme. According to him, orientation focuses not only on coursework but also on expectations of conduct, independence, and responsibility. “When students join, we brief them on how seriously they must approach their academic journey,” he said. “That grounding helps shape their performance over time.”
Mr. Abdallah Ali Halage, MakSPH Coordinator of the Bachelor of Environmental Health Science programme, delivers remarks during the Heavy Metal project Dissemination Workshop at MakSPH on June 26, 2025.
Mr. Halage argued that while some high-performing students enter through diploma schemes, achievement ultimately depends on commitment and effort rather than background. He cited Acaye’s consistent curiosity and self-motivation as defining traits, noting that strong academic results tend to follow students who actively engage with the learning process.
“I congratulate Philliph and his colleagues upon attaining first-class honours and performing very well academically. Philliph has been hardworking and self-motivated. He has consistently shown a strong interest in his studies, and that commitment has helped him achieve this result. He has been a very good student,” Mr. Halage attested.
He added that the achievement reflects a broader culture within the programme. “Our students are disciplined and independent. Their commitment, together with support from the School management, the College and University leadership, has contributed greatly to their success.”
MakSPH Dean Prof. Rhoda Wanyenze and former Deputy Dean Prof. Elizeus Rutebemberwa join faculty and staff in welcoming incoming students during a MakSPH student orientation on 15 August 2025, reflecting the School’s strong culture of mentorship and academic support that shapes student success.
From Individual Achievement to Institutional Impact
The broader significance of Acaye’s achievement becomes clearer when placed within the evolution of the BEHS programme itself. Established in 2000 within MakSPH’s Department of Disease Control and Environmental Health (DCEH), the programme remains the School’s sole undergraduate degree and was among the earliest environmental health bachelor’s programmes in East Africa. In more than two decades, it has produced over 1,000 graduates, expanding professional capacity beyond diploma-level training and strengthening Uganda and the region’s environmental health workforce across government, non-governmental organisations, educational institutions, and points of entry such as airports and border services.
Mr. Halage explained that the programme helped redefine career pathways within the government of Uganda’s public service structures by introducing degree-level expertise into environmental health roles. Graduates now serve as Environmental Health Officers, Senior Environmental Health Officers, and technical specialists contributing to policy implementation and service delivery across multiple sectors. The academic pathway has also expanded vertically, with postgraduate training opportunities at MakSPH currently enabling graduates to progress into research, teaching, and doctoral-level specialisation, ensuring continuity within the discipline.
Philliph Acaye conducts stream water pollution testing during field training in Kasangati in 2023, applying environmental health surveillance skills central to the Bachelor of Environmental Health Science programme at MakSPH.
A Programme Shaping Regional Practice
The reputation of Makerere University’s Bachelor of Environmental Health Science programme is also increasingly influencing regional institutions. During a strategic benchmarking visit to MakSPH on July 30, 2025, Dr. Ratib Dricile, Dean of the Faculty of Health Sciences at Muni University, described the School of Public Health as a reference point for universities seeking to strengthen environmental health training in the region.
The main reason the delegation visited Makerere University School of Public Health was that Muni University remains a young and growing institution located in north-western Uganda along the borders with the Democratic Republic of Congo and South Sudan, where porous borders contribute to frequent cross-border diseases, many of which are preventable through strong environmental health approaches, Dr. Dricile explained.
Dr. Ratib Dricile (third right), Dean of the Faculty of Health Sciences at Muni University, together with the Muni University delegation, during a benchmarking visit to MakSPH on July 30, 2025, to learn from the School’s Environmental Health training model.
“Makerere University, with over 100 years of institutional experience and 25 years running the Environmental Health programme, was the right place for us to benchmark, particularly in curriculum design, course content, programme structure, and implementation,” he said. “We were impressed by the work being implemented and gained more than we initially expected. By integrating these experiences, we believe the Muni University curriculum can become even stronger. The collaboration will allow us to adopt innovations built on Makerere’s long experience, and we believe that working together with Makerere University will strengthen Muni University institutionally and contribute positively to our university’s growth and ranking.”
It is within this institutional tradition, built over decades of training environmental health professionals across Uganda and the region, that Philliph Acaye’s achievement takes meaning. For him, graduating top of the class remains grounded in practical purpose rather than prestige. He views a first-class degree as an opportunity rather than an endpoint. Recalling guidance from his lecturers, he said strong academic results can open doors but must be followed by demonstrated competence. “A first class helps you get shortlisted,” he said. “After that, you must prove yourself.”
Philliph Acaye (back row) with classmates from the Bachelor of Environmental Health Science programme at MakSPH during their undergraduate training as part of the 2022 intake cohort.
His immediate plans reflect that perspective. He is currently pursuing additional training in Health Services Management at Gulu College of Health Sciences while preparing for postgraduate study in either public health or environmental and occupational health. At the same time, he continues supporting pupils in his community and plans to mobilise resources to provide sanitary pads for girls at his former primary school, an initiative he believes will help reduce school dropout rates in rural areas.
Acaye’s journey, from disrupted schooling in an IDP camp to graduating top of MakSPH’s BEHS programme for the 2022 cohort, reflects the deeper purpose of public health education. As MakSPH presents its newest cohort for graduation this week, his story demonstrates how the programme turns lived experience into professional capacity, strengthening communities and health systems across Uganda and the region, one graduate at a time.
In many low- and middle-income countries, mortality data remains a critical gap in public health planning, often leaving a significant portion of the population “invisible” in official records. In Uganda, where national death registration completeness has historically hovered around a mere 20%, Makerere University Centre for Health and Population Research (MUCHAP) is leading a transformative initiative. By leveraging the infrastructure of the Health and Demographic Surveillance System (HDSS), MUCHAP has demonstrated how academic research frameworks can be integrated into national systems to strengthen Civil Registration and Vital Statistics (CRVS).
A Bridge between research and governance
The core of this success lies in the collaboration between Makerere University’s infrastructure and government agencies, specifically the National Identification and Registration Authority (NIRA). This partnership, supported by the Uganda National Public Health Institute (UNPHI) and international partners like the Bloomberg Philanthropies Data for Health Initiative at the CDC Foundation, aimed at aligning local death recording practices with the legal requirements of the Registration of Persons Act (ROPA) 2015.
By utilizing the existing MUCHAP Iganga Mayuge HDSS platform, which has monitored births and deaths in the Iganga and Mayuge districts since 2005, the project demonstrated the use of a decentralized notification process. This model utilises Village Health Teams (VHTs) who already serve as HDSS scouts and part of the Ministry of Health systems as official death notifiers. These VHTs assist households in completing official NIRA notification forms at the household/community level, which are then verified by local leaders and submitted to District Registration Offices.
Impact: From 20% to over 70% completeness
The results of this collaboration have been profound. In the pilot sub counties in the districts of Iganga and Mayuge, death registration completeness reached 73–79%, a dramatic improvement over the prevailing national estimates. During the study period, 2,992 deaths were officially registered within the national CRVS system.
Key drivers of this success included:
Reduced barriers: Decentralization brought the registration process closer to home, with an average travel distance of only 4–5 km for notification, compared to the significant distances previously required to reach district offices.
Cost savings: Families reported that the community-based process eliminated unofficial fees and high transportation costs, facilitating essential cultural and legal tasks like property inheritance and appointing heirs.
Advanced surveillance: The project proved that local health personnel could successfully conduct verbal autopsies (VA) in non-HDSS settings, providing critical data on causes of death that were previously unavailable for home-based deaths.
Sustainability and future potential
The MUCHAP-IMHDSS model is designed for long-term sustainability and national scalability. By embedding these tasks within the routine activities of VHTs and local leaders, the process becomes streamlined and cost-effective over time. The project also highlights that community sensitization is vital to maintaining trust and ensuring high participation rates, particularly in rural areas.
Looking forward, this initiative serves as a scalable blueprint for the rest of Uganda and other low-resource settings. Future engagements are expected to focus on:
National scale-up: Applying the lessons learned from Iganga and Mayuge to the entire country to close the mortality surveillance data gap.
Integration with health systems: Linking the CRVS data with broader health information systems to enhance pandemic preparedness and routine public health actions.
Regional leadership: Aligning with the Africa CDC’s initiative to strengthen mortality surveillance across the continent, positioning Uganda’s university-led model as a regional gold standard.
The HDSS-CRVS integration Project Leader Dr. Dan Kajungu who is the Executive Director of MUCHAP emphasised that “through this work, Makerere University has again proved that academic infrastructure is not just for research, but a vital engine for building resilient national governance and health systems”. This work was disseminated at the 2026 CRVS Research Forum in Bangkok, Thailand and can be accessed at https://shorturl.at/8JLTd
Dan Kajungu Msc PhD is the Executive Director MUCHAP
World Malaria Day 2026: Makerere scientists have found the countdown clock for when Ugandan children will die from malaria: The question is whether anyone is listening
On a day when the world declares it can and must end malaria, new research from Eastern Uganda shows climate change is working against us and that the evidence to fight back exists right here at home
Special Feature | World Malaria Day, 25 April 2026
By Health and Science Correspondent
Today, 25 April 2026, Uganda joins the rest of the world in marking World Malaria Day under the global theme: “Driven to End Malaria: Now We Can. Now We Must.” It is a rallying cry rooted in genuine optimism. Since 2000, 2.3 billion malaria cases and 14 million deaths have been averted globally. Forty-seven countries have been certified malaria-free, and between 2000 and 2024, the number of malaria-endemic countries fell sharply from 108 to 80.
Uganda is not one of those success stories, not yet. Malaria is endemic in 96% of Uganda, accounting for 29.1% of outpatient visits and 39.5% of hospital admissions, with over 17,556 estimated malaria deaths annually, the highest burden falling on children under five years of age. And on this World Malaria Day, a new alarm has been sounded from the heart of one of Uganda’s most malaria-burdened communities, not by foreign researchers, not by a distant global health organisation, but by scientists at Makerere University, drawing on two decades of data they have collected in the villages of Iganga and Mayuge in Eastern Uganda.
Their message is urgent: climate change is silently and measurably worsening Uganda’s malaria crisis. But this is the equally important half of the story. They have now identified the precise conditions under which children die, and exactly how long in advance those deaths can be predicted. Uganda has, for the first time, a scientifically validated early warning system for climate-driven malaria mortality. Whether the country chooses to use it is now a question of political will, not scientific capacity.
The study and the platform that made it possible
Published in BMC Public Health in August 2025, the study — “Climate-driven malaria mortality among children in malaria-endemic areas of Uganda” — was led by Dan Kajungu of Makerere University‘s Centre for Health and Population Research (MUCHAP). It analysed 14 years of weekly malaria death data from January 2008 to December 2022 matched against climate variables, using a sophisticated time-series statistical approach called the Distributed Lag Non-linear Model.
The data came from the Iganga Mayuge Health and Demographic Surveillance Site (IMHDSS), the population research platform that Makerere University has operated continuously since 2005. The IMHDSS population cohort collects data from 65 villages located within an area of 155 square kilometres, monitoring a population of close to 100,000 people. The site has 23 health facilities, including two general hospitals, and a bimodal tropical climate with rainfall seasons from March to May and September to November.
What makes the IMHDSS extraordinary and what made this study possible is its method of capturing deaths. Rather than relying on hospital registers that miss the majority of rural deaths, malaria deaths were identified using verbal autopsies and the InterVA algorithm, a probabilistic tool that uses verbal autopsy questionnaires and Bayesian statistical techniques to estimate the probabilities of various causes of death based on signs and symptoms reported by bereaved families. Three different WHO verbal autopsy tools are used, tailored for neonates, children, and adults respectively.
In other words, when a child dies in a village in Iganga, the IMHDSS knows about it. It interviews the family. It determines why the child died. And it has been doing this, without interruption, for twenty years. The result is a dataset that is both scientifically rare and profoundly Ugandan, generated here, about us, by our own researchers.
A total of 858 malaria-related deaths were recorded in the Iganga-Mayuge districts between 2008 and 2022. Of these, 53% were among males and 47% females. The vast majority, about 73% occurred among children under five years of age, while the fewest deaths occurred among those aged 15 to 49 years. Males exhibited higher mortality proportions across all age groups, except among the elderly.
Eight hundred and fifty-eight deaths. Each one a child or adult with a name, a family, a community. Each one counted.
The finding that changes everything: Uganda now has a malaria early warning system
The scientific heart of this study, the finding that every health planner, every district malaria coordinator, and every Minister of Health in Uganda should understand is this: the researchers have identified the exact temperature and rainfall thresholds at which malaria deaths among children rise, and how many weeks in advance those deaths can be predicted.
The study found an increased mortality risk across all ages at a lag of 11 to 12 weeks following exposure to rainfall above 646 mm. Higher risks of malaria mortality were also observed at a lag of 5 to 11 weeks when temperatures ranged between 25.2°C and 29.9°C. Critically, the relative risk of malaria mortality in children under five years and children aged between 5 and 14 years was more sensitive to temperature than to rainfall.
Read that again, slowly. When temperatures in Eastern Uganda climb into the range of 25.2°C to 29.9°C, children begin dying of malaria five to eleven weeks later. When extreme rainfall events exceed 646 mm, deaths rise eleven to twelve weeks after that exposure. Uganda’s meteorological service measures temperature and rainfall continuously. Uganda’s health system manages malaria interventions. These two systems have never been formally connected, but the science to connect them now exists.
This is what a malaria early warning system looks like. Not a foreign technology imported at great expense. Not a satellite system requiring international expertise to interpret. A Ugandan scientific finding, produced from Ugandan data, that tells Ugandan health authorities: when you see these weather conditions, stock your health centres, distribute your bed nets, deploy your community health workers, and prepare, because the deaths are coming in six to twelve weeks if you do not act.
On this World Malaria Day, when the global community declares that ending malaria is now possible, Uganda has precisely this tool in its hands. The only question is whether it will use it.
Climate change is not a future threat, it is already killing children
The global theme for World Malaria Day 2026 carries urgency partly because climate change, conflict, and humanitarian crises continue to drive malaria resurgence and disrupt essential services. The Makerere study puts specific, local flesh on that global warning.
Malaria is climate-sensitive, changes in temperature, rainfall patterns, and relative humidity affect the dynamics and intensity of malaria transmission by influencing the habitats of mosquitoes and parasites and their biological growth cycle. Climate remains an indirect cause of malaria mortality by affecting parasite development during periods of high rainfall and temperatures, leading to increased transmission, morbidity, and severe malaria outcomes.
The malaria parasite Plasmodium falciparum, the species responsible for almost all malaria deaths in Uganda requires specific temperature ranges to complete its development inside the Anopheles mosquito. Too cold, and development slows or stops. Too hot, and it also stops. But within the range that Eastern Uganda increasingly inhabits, and will inhabit more frequently as global temperatures rise, the parasite thrives, multiplies, and kills.
The World Malaria Report 2025 warns that drug resistance is now confirmed in four African countries including Uganda, where artemisinin partial resistance has been detected. Insecticide resistance to pyrethroids – the main chemical on bed nets is now confirmed in 48 out of 53 reporting countries. As the tools Uganda currently relies on including bed nets, indoor spraying, artemisinin-based drugs face mounting biological resistance, the importance of climate-informed prevention strategies grows exponentially. Deploying interventions at exactly the right time, guided by weather data, becomes not just efficient but essential.
The children most at risk: a finding that demands a policy response
Among the study’s most striking findings is the specific vulnerability of school-age boys. A group almost entirely absent from Uganda’s current malaria prevention architecture.
Male children aged between 5 and 14 years were found to be more vulnerable to temperature-related malaria mortality compared to females in that age group and compared to children under five years. Rainfall did not have a significant association with malaria mortality in children.
Uganda’s National Malaria Control Programme, like most in sub-Saharan Africa, has historically concentrated resources on two priority groups: children under five and pregnant women. These groups are undeniably vulnerable and deserve protection. But this study shows that school-age boys are dying from temperature-driven malaria at rates that demand their inclusion in prevention strategies.
School-aged children between 5 and 14 years have higher malaria prevalence, with 70% carrying the malaria parasite asymptomatically in high transmission settings. They carry the parasite silently, sustaining transmission in their communities, and they die when temperatures rise, particularly the boys, who in rural Uganda spend more time outdoors, sleep less consistently under nets, and receive less parental health supervision than their sisters as they grow older.
The study’s area is itself among the most heavily burdened in Uganda. The Iganga-Mayuge area has a malaria prevalence rate of 39.4% in children under five years old, making it one of the areas in Uganda most severely impacted by malaria, and the disease is the leading cause of mortality in children there. In such a high-transmission setting, the combination of asymptomatic carriage, temperature-driven transmission spikes, and inadequate prevention coverage for school-age children is a formula for preventable death.
On World Malaria Day 2026, as Uganda declares its commitment to ending malaria, the national malaria strategy must be updated to reflect this evidence. School-based distribution of insecticide-treated nets, school health programmes that include malaria education and early symptom recognition, and targeted community outreach for families with boys aged 5 to 14 are not optional additions, they are evidence-based necessities.
The platform: Makerere‘s IMHDSS as a national asset for malaria elimination
None of the findings in this study would have been possible without the IMHDSS and on World Malaria Day, it is worth being explicit about what that platform represents for Uganda’s future.
The IMHDSS platform has measured various indicators about coverage and uptake of national interventions including the coverage and utilisation of immunisation and vaccines, mosquito nets for malaria vector control, household income improvement, and family planning, and other behaviour change interventions at community level, strengthening the evaluation of burden of disease at the subnational level.
For malaria specifically, the IMHDSS has now produced the most granular mortality data in Uganda’s history capturing not just how many children die, but exactly which weather conditions preceded those deaths, which sex and age group is most vulnerable, and what the biological and epidemiological mechanisms are that connect climate to the grave. This is the kind of intelligence that a National Malaria Control Programme needs to move from reactive crisis management to proactive, evidence-driven prevention.
Scarcity of quality data remains a key development bottleneck in low and middle-income countries, and the Iganga-Mayuge HDSS represents a Makerere University platform for research and research training with a population-based cohort that longitudinally generates data for evidence-based decisions and policy.
Uganda’s malaria elimination goal, to bring mortality to zero will not be achieved by effort and goodwill alone. It requires data. It requires the kind of longitudinal, community-level, cause-of-death data that only a platform like the IMHDSS can generate. And it requires the institutional will to connect that data to the decisions that determine whether children live or die.
What must happen now
The global call on World Malaria Day 2026 is clear: “Now We Can. Now We Must.” For Uganda, the Makerere climate-malaria study translates that call into three specific and achievable actions.
First, the Ministry of Health and Uganda National Meteorological Authority must establish a formal, operational malaria early warning system. One that uses real-time weather monitoring to trigger predetermined health system responses when temperature and rainfall thresholds identified by this research are breached. The science is ready. The infrastructure for meteorological monitoring exists. What is needed is the institutional bridge between them.
Second, Uganda’s National Malaria Control Programme must extend its prevention focus to include school-age children, particularly boys aged 5 to 14, in all high-transmission areas. Bed net campaigns must reach schools, not just health centres and antenatal clinics. Community health workers must be equipped to identify and treat malaria in this age group as a priority.
Third, and most fundamentally, the Government of Uganda must formally recognise and domestically resource the IMHDSS as national public health infrastructure. The 2024 global malaria funding of US$3.9 billion was less than half of the US$9.3 billion target, leaving a projected shortfall of US$5.4 billion that leaves the response dangerously under-resourced. In a world where international health financing is under historic pressure, Uganda cannot afford to have its most powerful evidence-generation platform dependent entirely on foreign philanthropy. The IMHDSS is a Ugandan asset. It must be funded as one.
Today, children in Iganga and Mayuge are alive who might not be, because the research generated by the IMHDSS informed the malaria interventions that reached their communities. Today, Makerere scientists have given Uganda a tool, a climate-based early warning system for malaria deaths that no other country in East Africa currently possesses.
Now we can. Now we must.
The evidence is there. The science is done. The only thing Uganda needs now is the will to act on it.
“Climate-driven malaria mortality among children in malaria-endemic areas of Uganda” is published open-access in BMC Public Health, Volume 25, Article 2825, August 2025. Full text available at: https://link.springer.com/article/10.1186/s12889-025-23678-0
The Iganga Mayuge Health and Demographic Surveillance Site (IMHDSS) is operated by MUCHAP, Makerere University. Contact: info@muchap.mak.ac.ug or dkajungu@muchap.mak.ac.ug| Tel: +256 772 207127 (Dr. Dan Kajungu)
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.
Law2 weeks ago
General1 week ago
General3 days ago
Health2 weeks ago
General2 weeks ago