Health
Philliph Acaye and the Making of Uganda’s Environmental Health Workforce
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.
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.”
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.
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. 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.”
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.
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.
“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.”
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.
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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