At a glance
CDC began working in Uganda in 1991 and established a country office in 2000. CDC works with the Ministry of Health (MOH) and other partners to deliver evidence-based health services to prevent, control, and treat HIV. CDC also supports tuberculosis (TB) and malaria control efforts, and maternal and child health services, including vaccination. CDC works with partners to strengthen Uganda’s capacity to prevent, detect, and respond to public health threats.
Overview
CDC established an office in Uganda in 2000. CDC works closely with the Ministry of Health (MOH) and partner organizations to address the following public health areas:
- Laboratory Systems Strengthening
- Workforce Development
- Emergency response
- HIV
- TB
- Malaria
Global health security
Strategic focus
CDC works with the MOH and local partners to support activities across the 11 technical areas outlined in the Global Health Security Agenda (GHSA). CDC in Uganda focuses on strengthening the country's public health systems across the following core areas:
Laboratory systems strengthening
CDC began supporting the MOH in 2003 to build a robust laboratory network with greater diagnostic capacity. This network aims to provide efficient and effective diagnostic and surveillance services for prompt and accurate results. These results help to inform clinical decisions, outbreak response, policies, and programs. Ugandan laboratories experience fewer adverse safety incidents and higher confidence in laboratory services due to increased quality, lower wait times for patients, and enhanced interactions with clinicians.
Key achievements
- CDC supported development of Uganda's first national health laboratory services policy in 2009 and national strategic plans for 2010-2015 and 2016-2022.
- In July 2023, over 40 laboratories in Uganda were internationally accredited, compared to only seven in 2015.
Workforce development
CDC partnered with the MOH and Makerere University School of Public Health to establish a Field Epidemiology Training Program (FETP) in 2015. Participants strengthen their skills in data collection and translation of data into evidence-based action. The program consists of three levels of training: frontline, intermediate, and advanced. Uganda’s FETP-Advanced, also known as the Public Health Fellowship Program, is the only field epidemiology training program in Africa that enrolls post-master’s degree fellows.
Key achievements
As of December 2023, the FETP has graduated 94 fellows from the advanced program and 651 trainees from Intermediate and Frontline FETPs across 118 districts and cities. Building on the success of the FETP, CDC started the Uganda Public Health Fellowship Program-Laboratory Leadership Program (PHFP-LLP) in 2023 —a two-year part-time in-service competency-based training that focuses on laboratory leadership and management skills.
FETP fellows have investigated and supported the control of 220 public health emergencies, conducted more than 300 epidemiologic, surveillance and quality improvement projects and published 107 manuscripts in peer-reviewed journals.
Emergency response
Uganda’s Public Health Emergency Operations Center (PHEOC) was established in 2014 with support from CDC. The PHEOC serves as a hub for coordinating preparedness, response, and recovery from public health emergencies.
Throughout the COVID-19 pandemic, CDC worked with local partners to prevent the spread of disease across borders and within health facilities, support emergency operations, and promote COVID-19 vaccines, laboratory efforts, disease surveillance, and workforce capacities.
Key achievements
In its first year, the LLP supported over 10 outbreak investigations through laboratory coordination and sample management activities in support of holistic epi-surveillance interventions. Since 2014, the CDC-supported PHEOC responded to more than 430 events, including outbreaks of COVID-19, yellow fever, Ebola, Marburg, Rift Valley fever, Crimean Congo hemorrhagic fever, influenza, measles, cholera, typhoid, meningitis, and anthrax.
HIV and TB
Strategic focus
Through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), CDC partners with Uganda to build a robust national HIV and TB response. CDC efforts include:
- Finding more people living with HIV (PLHIV)
- Linking and maintaining PLHIV to antiretroviral therapy (ART)
- Scaling up viral load testing to monitor for viral suppression
- Supporting TB diagnosis, preventive therapy, and treatment among PLHIV
- Reducing new HIV infections through disease surveillance
- Preventing mother-to-child transmission
- Supporting efforts to reduce HIV through voluntary medical male circumcision
- Peer-based programs for key populations
- DREAMS program
- Preventing gender-based violence
- Increasing access and uptake of PrEP
- Providing cervical cancer screening for women living with HIV
Key achievements
- More than 769,666 men, women, and children living with HIV in Uganda received ART in 2023.
- Despite the COVID-19 pandemic, HIV treatment outcomes continued to improve with viral load suppression rates reaching over 96% in 2023.
- Nearly 67,000 people living with higher risk of HIV started PrEP in CDC-supported regions.
- In 2023, over 74,843 eligible PLHIVs received TB preventive therapy, of which 96% completed TB preventive therapy. The "100 Day" TB preventive therapy campaign contributed to an 80% reduction in TB incidence and 90% reduction in TB-related deaths.
- More than 250,000 voluntary medical male circumcisions were performed in 2022 by CDC partners, which prevented over 12,000 new HIV infections.
- Increased the number of HIV clinics offering cervical cancer screening from 11 to 1,511. CDC reached 299,640 women (106 percent of the annual target) and 75 percent of all age-eligible women in 2 years.
Strengthening healthcare through ECHO
The platform has been pivotal in providing training and knowledge exchange on HIV, TB clinical care, and emergency responses during pandemics. Many districts have seen increased clinical management among virally suppressed people living with HIV due to this enhanced support. Uganda plans to expand the ECHO platform to most health facilities in the country, revolutionizing healthcare delivery and empowering healthcare workers at all levels with expert knowledge and support.
Malaria
Strategic focus
Under the U.S. President's Malaria Initiative (PMI), CDC assigned a resident advisor to support malaria prevention and control activities in Uganda. Through PMI, CDC helps to:
- Provide long-lasting insecticide-treated nets and indoor residual spray (IRS).
- Prevent malaria during pregnancy.
- Strengthen diagnostics and case management.
- Conduct operational research, surveillance, monitoring, and evaluation.
Key achievements
- Through the PMI, CDC helped distribute 2.5 million bed nets, 3 million malaria rapid diagnostic tests, and 2 million artemisinin-based combination therapies in 2023.
- In 2023, an indoor residual spray campaign that covered 774,173 structures helped protect 3 million people from malaria.
- Since PMI was launched in Uganda in 2006, malaria prevalence decreased by 78% and all-cause child mortality decreased by 53% among children under 5 years old.
Immunization
Uganda introduced the hepatitis B birth dose vaccine into its immunization schedule in 2023.
Success story spotlight
Journey of laboratory accreditation
Since 2009, CDC has been collaborating with the MOH to establish a robust laboratory network capable of providing accurate and timely diagnostic results. Through PEPFAR funding, CDC has supported the implementation of the Strengthening Laboratory Management Towards Accreditation (SLMTA) program, resulting in significant improvements in laboratory quality management systems and international accreditation.
The SLMTA program was initially piloted in 19 laboratories, including hospitals and healthcare facilities across Uganda. Witnessing the positive impact on quality results and reduced errors, MOH expanded SLMTA into a national program in 2010. The initiative aimed to enhance laboratory quality management systems at all levels by implementing continuous improvement measures and deploying auditors, assessors, and mentors for HIV-related tests.
As a result of these efforts, at least 150 public laboratories have successfully implemented SLMTA. Of these 71 have achieved international accreditation standards for providing timely, accurate, and reliable test results. These accredited laboratories are strategically located across different geographical areas, including public laboratory hubs that serve as centers of excellence within their catchment areas.
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