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Advancing Evidence-Based and Coordinated Climate Health Action in Uganda

Categories: Health National Adaptation Plan (HNAP), VAA, Country experience, Africa, Climate Resilient Health Systems, Financing, Action Line 1: Surveillance and monitoring, Action Line 2: Evidence-based policy strategy and capacity building, Assessments of climate and health risks and GHG emissions, Climate-transformative leadership and governance, Integrated risks, monitoring, early warning, and GHG emissions tracking, Health systems wide resilience

Country: Uganda

Context

Uganda acknowledges the growing impact of climate change on population health and has taken deliberate steps to understand and address these risks. To assess the extent of vulnerability, the Ministry of Health, in collaboration with Makerere University School of Public Health and the WHO Country Office, conducted a national Climate-Health Vulnerability and Adaptation Assessment (VAA) across 716 health facilities.

The assessment revealed :

  • Widespread exposure to climate-related hazards, particularly among lower-level facilities,
  • Critical gaps in emergency preparedness, workforce capacity, WASH and energy systems, and healthcare waste management.
  • Communities, especially vulnerable groups such as refugees, pregnant women, children, and those with chronic conditions, face compounded risks due to food and water insecurity, vector-borne diseases, and climate-induced displacement.
  • Air pollution, changing weather patterns, and rising temperatures further contribute to respiratory illnesses, malnutrition, and the spread of diseases like malaria and cholera.

These findings informed the development of Uganda’s Health National Adaptation Plan (H-NAP) 2025–2030, which reflects WHO’s Operational Framework for Climate-Resilient and Low Carbon Health Systems. The H-NAP outlines priority actions around:

  • climate transformative leadership and governance,
  • risk monitoring and early warning,
  • a climate-smart health workforce,
  • climate-informed programming,
  • and resilient infrastructure among others;

closely aligning with the Belém Health Action Plan’s adaptation measures and offering a roadmap for strengthening health system resilience in the face of a changing climate.

 

Components of Uganda's Health National Adaptation Plan (HNAP)
Components of Uganda's Health National Adaptation Plan (HNAP)
Credit: Ministry of Health Uganda

Implementation process

Since the launch of the H-NAP (2025-2030) in August 2024, the Ministry of Health has made progress on the following priority actions:

Establishment of a National Climate-Health Coordination Mechanism:

Under Component 1: “Climate Transformative Leadership and Governance” of the H-NAP,

  • the Ministry of Health established a Climate and Health Subcommittee to oversee climate-health adaptation. The subcommittee is comprised of ministries, departments and agencies, development and implementation partners, CSOs, academia and other stakeholders.
  • This subcommittee has collectively developed supporting strategies such as communication, resource mobilization and reporting tools, and is fostering collaboration among climate-health actors in Uganda.
  • The committee convenes on a monthly basis to deliberate on climate-health issues and solutions, promoting integrated and collaborative climate-health action.

 

Integration of Climate Data into Health Information Systems:

Under Component 4: “Integrated risks monitoring, and early warning” of the H-NAP,

  • the Ministry of Health, in collaboration with the Ministry of Water and Environment and Health Information Systems Programme (HISP) Uganda, has taken strides to incorporate climatic variables into Uganda’s DHIS2 to strengthen disease early warning and surveillance.
  • A climate data integration tool has been developed and tested using data from the past 10 years. The tool utilizes precipitation, humidity, heat stress and vegetation index data from global sources including ERA5, CHIRPS and NASA and air quality data from AirQO, Makerere University.
  • Data Sharing Agreements have been signed to facilitate the inclusion of local climate and air quality data in the DHIS2 system.
  • The Climate App currently provides an exploratory visualization and dashboard to demonstrate climate-health data trends.
  • The dashboard ably illustrates trends of malaria cases and climate data and climatic suitability for malaria.

 

Targeted dissemination of H-NAP in climate change hot spot districts

  • Dissemination of the H-NAP has taken place in 26 districts in western, midwestern and southwestern Uganda, areas that experience extreme flooding, landslides and droughts. This exercise involves national Ministry of Health teams meeting the District Health Teams and orienting them on climate change and health and handing out copies of the H-NAP.
  • Hot spot districts in eastern and northern Uganda will be visited in the next quarter.

 

Resource mobilization

  • Concerted efforts are in place to mobilize technical and financial resources to implement the H-NAP. For instance, The Rockefeller Foundation and International Development Research Centre (Canada) have provided seed funding to build capacity for finance mobilization.

In collaboration with WHO and UNDP, processes are underway to access Green Climate Fund financing to implement some of the H-NAP components.

 

Lessons learned

The development and ongoing implementation of Uganda’s Health National Adaptation Plan (H-NAP) can provide valuable insights for countries seeking to strengthen climate change adaptation in the health sector. Key and transferable lessons include:

  • Utilizing WHO Guidelines for conducting the vulnerability & adaptation (V&A) assessment and developing the H-NAP
  • Having a technical proposal to solicit support from both government and development partners
  • Involving academia with the relevant expertise to conduct the V&A and lead the development process
  • Co-developing and co-designing the plan with state and non-state stakeholders
  • Presentation of the draft plan to key health stakeholders, e.g., Technical Working Groups senior management and top management for approval and ownership
  • High-level launch, both nationally and globally, to increase awareness and set the stage to catalyze technical and financial resource mobilization.

In a nutshell, this process underscores the importance of robust coordination, technical guidance, and inclusive engagement, while also revealing critical constraints such as limited access to climate finance and competing demands within the health system. The lessons  offer practical guidance to other countries with similar contexts- particularly those in low-resource settings- facing similar challenges.

 

Challenges

  • Inadequate Access to Climate Finance: Limited initial funding delayed V&A and H-NAP development. Additionally, unlocking climate funding remains a critical barrier for the health sector.
  • Competing Health Priorities: Persistent health challenges such as infectious diseases, maternal, newborn, and child health, and access to health services overshadow climate-health initiatives.
  • Perceptual Disconnect: Globally and locally, climate change is often perceived solely as an environmental issue, limiting health sector engagement in climate-related discourses and policy processes.
  • Lack of Health Sector GHG Baseline: The health sector lacks emissions data, especially on emissions from healthcare waste, which impedes efforts to design mitigation strategies targeted at health facilities.

 

Success factors

  • Use of WHO Guidelines: Adoption of WHO frameworks ensured technical rigor and sectoral alignment.
  • Academic Collaboration: Partnership with Makerere University enhanced the quality of assessments as well as of theco-development and costing.
  • Inclusive Development Approach: Multi-stakeholder engagement fostered ownership, cross-sectoral alignment, and strengthened legitimacy of the H-NAP.
  • Strategic Global Visibility: Participation in COP events and international conferences mobilized support and strengthened Uganda’s profile in global climate-health discourses.
  • Supportive Policy Environment: The Climate Change Act (2021), the National Climate Change Policy (2015), the Nationally Determined Contributions (NDCs 2015 and 2022) and the National Development Plan IV provided a strong policy and legal foundation for integrating climate considerations into health planning.
  • High-Level Leadership Commitment: MoH leadership ensured alignment with national priorities, effective stakeholder coordination, and institutional buy-in.

 

Recommendations

  • Countries should adopt WHO frameworks to guide the development of the V&A and the H-NAP and ensure alignment with global best practices.
  • Collaboration with academic institutions is essential for conducting robust assessments, generating evidence, and supporting policy development.
  • High-level political and technical leadership should be engaged early to champion climate-health priorities.
  • Establishing a multisectoral coordination mechanism improves coherence, resource use, and sustainability of climate-health actions.
  • Building capacity at national and sub-national levels is crucial to conduct V&As, implement adaptation strategies, and mainstream climate considerations.
  • Establishing a baseline for health sector GHG emissions is important to support mitigation efforts.
  • Support and guidance from ATACH and global fora like the World Health Assembly and COPs should be provided regularly to sustain climate health action.
  • ATACH should work closely with UNFCCC Parties and other actors to raise the profile of health in the COP negotiations and processes.

 

Key resources

 

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