Uganda: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

There is evidence of a national AMR plan for the surveillance, detection, and reporting of priority AMR pathogens. Uganda has implemented the Second Antimicrobial Resistance National Action Plan (2024/25–2028/29), which outlines strategic objectives including surveillance, detection, and reporting of AMR pathogens ¹. The plan adopts a One Health approach and includes a dedicated strategic objective (Objective 4) to strengthen surveillance and research (pages 28–29) ². Section 4.2.4 (page 28) details the development of a national AMR surveillance system and integration with global platforms such as GLASS ³. Timely reporting and data dissemination through national and international channels are addressed under section 4.4.1 (page 29) ⁴. This builds on the previous AMR National Action Plan (2018–2023), which also included surveillance and reporting as key pillars ⁵.

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

Uganda has a national laboratory system that performs Antimicrobial Susceptibility Testing (AST) for WHO priority AMR pathogens. The Antimicrobial Resistance National Action Plan (2024/25–2028/29) confirms the existence of a national laboratory network supporting AMR surveillance and diagnostics ⁶. However, the individual 7+1 WHO priority AMR pathogens are not explicitly listed. Additional evidence from the National Situation of Antimicrobial Resistance and Consumption Analysis (2016–2018) shows that Uganda conducted AST for several WHO priority pathogens, including Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Salmonella spp., but not all 7+1 pathogens are confirmed ⁷. No further details were found in the Ministry of Health’s Data Observatory ⁸ or in WHO GLASS ⁹.

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence that the government of Uganda conducts environmental detection or surveillance activities for antimicrobial residues or AMR organisms. The Antimicrobial Resistance National Action Plan (2024/25–2028/29) includes references to environmental health and mentions sectors such as waste management, soil, and water, but does not provide specific information on surveillance or detection activities for antimicrobial residues or AMR organisms in the environment ¹⁰. The 2025 edition of the Tracking AMR Country Self-Assessment Survey (TrACSS) confirms that Uganda participates in multisectoral AMR monitoring, including the environment sector, but does not detail any environmental surveillance activities for AMR organisms or residues ¹¹. The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) does not include Uganda in its environmental surveillance reporting ¹². No additional information was found in the Ministry of Health’s Data Observatory or the National Environment Management Authority (NEMA) websites ^{13 14}.

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

There is national legislation in place in Uganda requiring prescriptions for antibiotic use for humans ¹⁵. The National Drug Policy and Authority Act (Statute No. 13 of 1993), consolidated in 2023, states that no person shall sell by retail any classified drug otherwise than in accordance with a prescription given by a duly qualified medical practitioner, dentist, or veterinary surgeon ¹⁶. Classified drugs include antibiotics, which are regulated under this provision. The Act is implemented by the National Drug Authority under the Ministry of Health. The Antimicrobial Resistance National Action Plan (2018–2023) acknowledged the need to increase compliance with this regulation and included actions to sensitize private providers about the law ¹⁷. The Second Antimicrobial Resistance National Action Plan (2024/25–2028/29) continues to emphasize prescription-only access to antibiotics and highlights enforcement and public awareness as priorities ¹⁸. The National Antimicrobial Stewardship Manual (2025) reinforces the legal framework by promoting rational antibiotic use and outlining stewardship responsibilities for health workers and institutions ¹⁹. However, there is evidence of gaps in enforcement. Parliamentary discussions in March 2025 noted that while strong laws exist, enforcement remains a major challenge, and legislators called for stronger measures to ensure prescriptions remain the responsibility of qualified prescribers ²⁰. This aligns with the continued prioritization of enforcement in the new AMR action plan ²¹. Studies also report high rates of inappropriate antibiotic prescribing in outpatient settings, indicating challenges in adherence to prescription guidelines ²².

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 0

There is no national legislation or regulation in Uganda that specifically requires prescriptions for antibiotic use in animals. The National Drug Policy and Authority Act, issued by the Parliament of Uganda as Statute No. 13 of 1993 and currently in force, defines “dispense” as the supply of a medicine or poison “on and in accordance with a prescription duly given by a duly qualified medical practitioner, dentist or veterinary surgeon,” and includes drugs used for animals under its definition of “drug” (Part I, Section 1). However, the Act does not establish a separate regulatory framework or enforcement mechanism specifically for veterinary prescriptions ²³. The Antimicrobial Resistance National Action Plan (2018–2023) and the Second Antimicrobial Resistance National Action Plan (2024/25–2028/29) both acknowledge the use of antibiotics in animals and the need for stewardship, but do not reference any binding legal requirement for veterinary prescriptions ²⁴²⁵. The 2023 Uganda Clinical Guidelines and the 2025 National Antimicrobial Stewardship Manual focus on human health and do not address veterinary prescription practices ²⁶²⁷. The 2023–2025 Infection Prevention and Control Plan for the Agricultural Sector discusses risks associated with antibiotic use in animals and AMR, but does not mention any legal requirement for prescriptions ²⁸.

1.2.1a Laws/plans on zoonotic disease

Score: 100

There is national strategy documentation in Uganda addressing zoonotic disease prioritization, detection, and reporting. The Uganda One Health Strategic Plan (2018–2022), issued by the One Health Platform under the coordination of the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Uganda Wildlife Authority, and Ministry of Water and Environment, outlines a multisectoral approach to managing zoonotic diseases and other public health threats. Section 3.2 (pages 8–9) identifies seven priority zoonotic diseases—anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, trypanosomiasis, plague, and rabies—and describes strategies for their surveillance, prevention, and control, including intersectoral coordination and early detection mechanisms ²⁹. The plan also references the need for timely information sharing and reporting between sectors, particularly during outbreaks, and emphasizes the role of the National One Health Platform in coordinating these efforts (pages 17–18) ³⁰. The National One Health Training Manual (2022), published by the Ministry of Agriculture, Animal Industry and Fisheries, reinforces the strategic focus on zoonotic disease detection and reporting. Section 2.1 (pages 6–7) outlines the institutional roles of key ministries and agencies in zoonotic disease surveillance and response, and describes coordination mechanisms under the National One Health Platform, including joint outbreak investigations and information sharing protocols ³¹. Uganda also participates in the One Health Joint Plan of Action (2022–2026), a global initiative coordinated by WHO, FAO, WOAH, and UNEP, which supports national-level implementation of zoonotic disease strategies ³². The Joint External Evaluation for Uganda, conducted in June 2017, confirms that Uganda has a multisectoral coordination mechanism in place for zoonotic disease detection and response, and highlights the existence of a national One Health platform ³³. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ³⁴³⁵.

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 100

There is evidence of national strategy documents in Uganda that include measures for risk identification and reduction for zoonotic disease spillover events from animals to humans. The Uganda One Health Strategic Plan (2018–2022), issued by the One Health Platform under the coordination of the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Uganda Wildlife Authority, and Ministry of Water and Environment, outlines a multisectoral approach to zoonotic disease prevention and control. Section 3.2 (pages 8–9) identifies seven priority zoonotic diseases and describes surveillance, early detection, and response strategies. Section 4.2 (page 16) specifically highlights the need to “strengthen prevention, preparedness and response to zoonotic diseases, antimicrobial resistance and biosecurity threats,” including through risk identification and mitigation at the human-animal-environment interface ³⁶. The National One Health Training Manual (2022), published by the Ministry of Agriculture, Animal Industry and Fisheries, further elaborates on institutional roles in early detection, risk assessment, and intersectoral coordination. Section 2.1 (pages 6–7) outlines the responsibilities of key ministries in identifying and managing zoonotic risks, including through joint outbreak investigations and risk communication protocols ³⁷. Uganda’s participation in the One Health Joint Plan of Action (2022–2026), coordinated by WHO, FAO, WOAH, and UNEP, supports national-level implementation of spillover prevention strategies by promoting integrated surveillance, ecosystem health monitoring, and risk reduction measures under Action Track 3: “Reducing the risks from emerging and re-emerging zoonotic epidemics” ³⁸. The Joint External Evaluation for Uganda, conducted in June 2017, confirms that Uganda has a multisectoral coordination mechanism in place for zoonotic disease detection and response, and highlights the existence of a national One Health platform ³⁹. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ⁴⁰⁴¹.

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 0

There is insufficient evidence that Uganda currently has national legislation, plans, or guidelines that comprehensively account for the surveillance and control of multiple zoonotic pathogens of public health concern ^{42 43 44}. The Uganda One Health Strategic Plan (2018–2022) identified seven priority zoonotic diseases and mentioned mechanisms such as passive syndromic surveillance through the Integrated Disease Surveillance and Response (IDSR) strategy, as well as ministry-specific response plans and guidelines for prioritized zoonoses ⁴⁵. However, the plan did not provide detailed operational guidance for surveillance and control, and it acknowledged limited resources for implementing effective interventions ⁴⁶. The Animal Diseases Act provides a legal framework for controlling epizootic diseases, including some zoonoses, but it does not outline integrated surveillance or multi-pathogen control strategies ⁴⁷. Recent reviews and studies confirm that Uganda’s surveillance systems for zoonotic diseases remain largely sector-specific, with limited interoperability and coordination across human, animal, and environmental health sectors ^{48 49}. Although Uganda has developed technical documents such as case definitions for priority animal diseases (2023) and an Infection Prevention and Control Plan for the agricultural sector (2023–2025), these are sectoral and do not constitute a comprehensive national framework for multi-pathogen zoonotic surveillance and control ^{50 51}.

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

There is a multi-sectoral coordinating mechanism dedicated to zoonotic disease that functions across ministries in Uganda. The Zoonotic Disease Coordination Office (ZDCO) serves as the secretariat of the National One Health Platform and coordinates the implementation of One Health activities across the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Uganda Wildlife Authority, and Ministry of Water and Environment. This structure was formalized through a memorandum of understanding signed by the four ministries in 2016 and is described in the Uganda One Health Strategic Plan (2018–2022), which outlines the ZDCO’s role in coordinating zoonotic disease prevention, detection, and response (Section 4.1, page 15) ⁵². The ZDCO operates under the supervision of the One Health Technical Working Group and is responsible for facilitating inter-ministerial collaboration, information sharing, and joint outbreak investigations. The Joint External Evaluation for Uganda, conducted in June 2017, confirms the existence of a functional One Health coordination mechanism and highlights the ZDCO as a key structure supporting multisectoral collaboration for zoonotic disease control ⁵³. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ⁵⁴⁵⁵.

1.2.1e Presence of One Health strategic plan

Score: 100

Uganda has a One Health strategic plan in place, although it is out of date. The Uganda One Health Strategic Plan 2018-2022 was published in January 2018 by the Ministry of Health, Ministry of Agriculture (MoH), Animal Industry and Fisheries (MAAIF), Ministry of Water and Environment (MWE) and Uganda Wildlife Authority (UWA).⁵⁶

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

There is evidence that Uganda has a national mechanism for owners of livestock to conduct and report on disease surveillance to a central government agency. The Animal Diseases Act, issued by the Parliament of Uganda as Chapter 38 of 2000 and amended by Act 26 of 2006, establishes mandatory reporting requirements for livestock owners. Part II, Section 2 of the Act states that any person having in their possession or charge any animal affected with or suspected of being affected with a disease must, as soon as possible, keep the animal separate and report the case to a veterinary officer or inspecting officer ⁵⁷. The Act defines “disease” to include a wide range of zoonotic and epizootic conditions such as anthrax, foot and mouth disease, rabies, and tuberculosis ⁵⁸. The Department of Animal Health under the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) is responsible for implementing this legislation and for conducting surveillance, collecting and disseminating epidemiological data, and coordinating disease control strategies ⁵⁹. The Veterinary Diagnostics and Epidemiology Division within the department supports field and laboratory investigations and shares findings with relevant authorities ⁶⁰. The Ministry also operates a digital reporting mechanism through the Event Mobile Application (EMA-i), developed in collaboration with the Food and Agriculture Organization (FAO), which enables real-time disease reporting from field officers and animal health workers to MAAIF. Reports are submitted digitally and shared with decision-makers to improve coordination and response, and the system includes a mapping component that visualizes the location and epidemiological details of disease events ⁶¹. However, the Livestock Services Portal (https://livestock.agriculture.go.ug) primarily facilitates licensing and certification services and does not currently include a public-facing interface for livestock owners to directly report disease events or access surveillance dashboards ⁶². The Joint External Evaluation for Uganda, conducted in June 2017, confirms that Uganda has a legal framework for animal disease reporting and surveillance, although it notes that enforcement and compliance mechanisms at the local level remain limited ⁶³. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ⁶⁴⁶⁵.

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no sufficient evidence that suggests there is legislation and/or regulations that safeguard the confidentiality of information generated through surveillance activities for animals (for owners). The Animal Diseases Act, Chapter 38 of 2000, amended by Act 26 of 2006, outlines responsibilities for disease reporting and control but does not include provisions related to the confidentiality of surveillance data concerning livestock owners ⁶⁶. The Data Protection and Privacy Act, enacted by the Parliament of Uganda as Act 9 of 2019, regulates the collection, processing, and disclosure of personal data, but it applies specifically to identifiable personal data of individuals and does not explicitly address data generated through animal health surveillance systems or the confidentiality of livestock owner information ⁶⁷. The Uganda Health Data Access, Sharing and Use Guidelines, issued by the Ministry of Health, focus on human health data and confidentiality protections but do not extend to animal health surveillance ⁶⁸. The One Health Strategic Plan (2018–2022), developed jointly by the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, and other stakeholders, outlines coordination mechanisms for zoonotic disease surveillance but does not mention confidentiality protections for animal surveillance data ⁶⁹. The Joint External Evaluation for Uganda, conducted in June 2017, does not reference any legal or regulatory framework for safeguarding the confidentiality of animal surveillance data ⁷⁰. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ⁷¹⁷².

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

There is insufficient evidence that Uganda conducts surveillance of zoonotic disease in wildlife, poultry, and livestock. The Department of Animal Health under the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) is tasked with conducting surveillance and disseminating epidemiological data on animal diseases and vectors, and its Veterinary Diagnostics and Epidemiology Division is responsible for field and laboratory investigations ⁷³. However, the website and official publications do not provide specific evidence of surveillance activities being carried out, such as reports, datasets, or documented outcomes. The National Technical Guidelines for Integrated Disease Surveillance and Response (IDSR), Third Edition, published in September 2021, state that Uganda applies a One Health approach and includes zoonotic disease surveillance across sectors (Section 5, p. 10), but do not provide details on implementation or coverage of wildlife, poultry, or livestock surveillance ⁷⁴. The Guidelines for Infection Prevention and Appropriate Antimicrobial Use in Animal Sector: Poultry Farming (2020) outline recommended practices for disease monitoring and reporting in poultry farms (Sections 2.2.6–2.2.7), but do not confirm that these practices are systematically implemented nationwide ⁷⁵. The One Health Strategic Plan (2018–2022) notes that the Uganda Wildlife Authority has officers responsible for zoonotic disease surveillance in parks and protected areas, but does not specify which animals or diseases are monitored or how surveillance is conducted (p. 17) ⁷⁶. The Joint External Evaluation (JEE) for Uganda, conducted in June 2017, acknowledges the existence of surveillance systems but does not provide evidence of operational surveillance in wildlife, poultry, or livestock ⁷⁷. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ⁷⁸⁷⁹.

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is evidence that Uganda has a mechanism for reporting notifiable animal diseases to the World Organisation for Animal Health (WOAH). The Department of Animal Health under the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) is mandated to “establish and operationalize collaborative mechanisms with national, regional and international research and other related organizations on animal disease and vector control matters,” which includes Uganda’s obligations as a WOAH member country ⁸⁰. Uganda also participated in the WOAH Performance of Veterinary Services (PVS) Laboratory Mission in 2015. The mission report confirms that Uganda had mechanisms in place for surveillance and reporting of transboundary animal diseases (TADs), zoonoses, and food safety concerns, and that these were being used to guide system-wide reforms ⁸¹. Although the specific reporting interface is not publicly detailed, Uganda’s participation in the PVS process and its stated international collaboration mandate provide evidence of an operational reporting mechanism.

1.2.4a Number of veterinarians per 100,000 people

Score: 3.11

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 0

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is insufficient evidence that the national plan on zoonotic disease or other legislation, regulations, or plans includes detailed mechanisms for working with the private sector in controlling or responding to zoonoses. The Uganda One Health Strategic Plan (2018–2022), issued by the One Health Platform under the coordination of the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Uganda Wildlife Authority, and Ministry of Water and Environment, acknowledges the role of the private sector in zoonotic disease prevention and response. It states that “the private sector will be engaged to play an advisory function and contribute to policy and development of response plans, guidelines, manuals and protocols; dissemination of information on disease prevention measures; conduct One Health related trainings for their staff and to provide budgetary and other support” (p. 16) ⁸². However, the plan does not specify how this engagement is operationalized, which private sector actors are involved, or what formal mechanisms exist to ensure their participation. The National One Health Training Manual (2022), developed by the Ministry of Agriculture, Animal Industry and Fisheries, also identifies the private sector as a stakeholder in surveillance and response, but does not describe implementation structures or coordination mechanisms ⁸³. The World Health Organization's Joint External Evaluation activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ⁸⁴⁸⁵.

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 50

There is some evidence that Uganda has established a national inventory of dangerous pathogens, but insufficient evidence that this record includes details on inventory management systems within facilities. A peer-reviewed article by Byarugaba et al., titled “Establishment of a National Inventory of Dangerous Pathogens in the Republic of Uganda” (Health Security, 2019), describes efforts to create a national inventory to identify and track facilities handling high-risk pathogens ⁸⁶. However, the paper does not confirm whether the inventory is regularly updated within the past five years or whether it includes detailed inventory management systems. The WHO Joint External Evaluation (JEE) for Uganda (2023) does not mention a comprehensive inventory system ⁸⁷. Uganda has also piloted the WHO Global Guidance Framework for the Responsible Use of the Life Sciences, which includes governance of dual-use research and biorisk mitigation, but this does not constitute a full national inventory system ⁸⁸. The National Drug Authority has strengthened regulatory capacity, but there is no indication that these efforts include pathogen inventory systems ⁸⁹. Uganda has not submitted Confidence Building Measures under the Biological Weapons Convention since 1996 ⁹⁰. No relevant legislation was found in the VERTIC database ⁹¹.

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is no sufficient evidence that suggests Uganda has in place legislation and/or regulations related to biosecurity which address requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed. The Joint External Evaluation for Uganda, conducted in October 2023, does not reference any comprehensive national legislation that addresses these specific requirements ⁹²⁹³. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ⁹⁴⁹⁵. Uganda has taken steps to pilot the WHO Global Guidance Framework for the Responsible Use of the Life Sciences, which includes governance of dual-use research and biorisk mitigation, but this initiative does not yet constitute enforceable legislation ⁹⁶. The Uganda One Health Strategic Plan (2018–2022) identifies biosecurity as a priority area but does not outline specific legal or regulatory mechanisms for containment, operational practices, or cybersecurity ⁹⁷. The Forensic and Scientific Analytical Services Bill, reintroduced in July 2025, proposes oversight of forensic laboratories and data protection, but it does not explicitly address biosecurity in facilities handling especially dangerous pathogens ⁹⁸. Uganda has not submitted Confidence Building Measures under the Biological Weapons Convention since 1996 ⁹⁹. No relevant legislation or policy was found in the VERTIC database ¹⁰⁰.

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is insufficient evidence to suggest there is an established agency (or agencies) specifically designated for the enforcement of biosecurity legislation and regulations in Uganda. There is no publicly available documentation confirming a legally mandated agency responsible for enforcement of biosecurity legislation on the websites of the Ministry of Health or the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) ¹⁰¹¹⁰². The 2017 Joint External Evaluation (JEE) for Uganda highlighted the need to expedite the enactment of biosecurity legislation and designate a national competent authority for biosafety and biosecurity ¹⁰³. A Joint External Evaluation was also conducted in 2023, but the report is not available as per the WHO website ¹⁰⁴¹⁰⁵. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁰⁶. No further evidence is available on the VERTIC database ¹⁰⁷.

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no sufficient evidence that suggests Uganda has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities. The Joint External Evaluation for Uganda, conducted in October 2023, does not mention any national strategy or implementation plan for pathogen inventory consolidation ¹⁰⁸¹⁰⁹. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹¹⁰¹¹¹. The Uganda Antimicrobial Resistance National Action Plan (2018–2023) outlines strategic interventions for laboratory integration and biosecurity, but does not include provisions for consolidating pathogen inventories ¹¹². The Uganda One Health Strategic Plan (2018–2022) identifies biosecurity as a priority area but does not reference consolidation of facilities ¹¹³. The Central Public Health Laboratories (CPHL), which oversee laboratory coordination, do not publicly report any consolidation efforts ¹¹⁴. The Uganda National Council for Science and Technology (UNCST) maintains oversight of research and material transfer, but there is no indication of a national consolidation policy ¹¹⁵. Uganda has not submitted Confidence Building Measures under the Biological Weapons Convention since 1996 ¹¹⁶. No relevant legislation or policy was found in the VERTIC database ¹¹⁷.

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 100

There is evidence to suggest there is in-country capacity in Uganda to conduct Polymerase Chain Reaction (PCR)–based diagnostic testing for anthrax and Ebola, which would preclude culturing a live pathogen. The Uganda Virus Research Institute (UVRI), as the national reference laboratory for viral diagnostics, is mandated to conduct surveillance and diagnostics for viral diseases, including Ebola virus, and has PCR capabilities for high-risk pathogens. This is confirmed in the UVRI Strategic and Development Plan 2020/21–2024/25, which outlines the institute’s role in molecular diagnostics and its capacity to conduct confirmatory testing for viral hemorrhagic fevers ¹¹⁸. The WHO Response Plan for the Ebola Virus Disease Outbreak in Uganda (September 2022–February 2023) confirms that UVRI conducted PCR-based confirmation of Ebola virus cases during the outbreak, including the Sudan strain, and that laboratory capacity for viral hemorrhagic fever detection had been expanded ¹¹⁹. The WHO Rapid Risk Assessment on anthrax in Uganda, published in June 2025, also confirms that Uganda has the capacity to detect anthrax cases using PCR-based methods ¹²⁰. These capacities are further supported by Uganda’s participation in regional laboratory networks and its role in the East African Community’s laboratory strengthening initiatives ^121122123.

1.3.2a Biosecurity training using a standardised, required approach

Score: 0

There is no sufficient evidence that suggests Uganda requires biosecurity training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. The Joint External Evaluation for Uganda, conducted in 2023, does not provide a downloadable report or summary that confirms the existence of such a national requirement ¹²⁴¹²⁵. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹²⁶¹²⁷. Uganda has implemented several biosecurity-related training initiatives, including a Bio-Safety and Bio-Security Leadership Skills Training held at the Uganda Virus Research Institute (UVRI) in March 2021, which covered laboratory safety, PPE use, engineering controls, and risk management ¹²⁸. However, this training was project-specific and not part of a standardized national curriculum. Uganda’s National Biosafety and Biosecurity Coordination Office, under the Ministry of Health, developed a Biorisk Management (BRM) training program in 2015, which includes a curriculum with basic, technical, and management tracks ¹²⁹. While this program represents a structured approach, there is no evidence that it is mandatory for all personnel working with especially dangerous pathogens or that it is implemented nationally across all relevant sectors. Uganda has not submitted Confidence Building Measures under the Biological Weapons Convention since 1996 ¹³⁰. No relevant legislation or policy was found in the VERTIC database ¹³¹.

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no sufficient evidence that Ugandan regulations or licensing requirements mandate drug testing, background checks, or psychological or mental fitness assessments for security and other personnel who have access to especially dangerous pathogens, toxins, or biological materials with pandemic potential. The Occupational Safety and Health Act, issued by the Parliament of Uganda as Act 9 of 2006, outlines general provisions for workplace safety and health, including physical and mental elements affecting health, but does not include specific requirements for personnel screening related to access to high-risk biological materials ¹³². The Joint External Evaluation for Uganda, conducted in 2023, does not provide a downloadable report or summary that confirms the existence of personnel vetting procedures ¹³³¹³⁴. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹³⁵¹³⁶. No relevant information is available from the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Central Public Health Laboratories, or the Ministry of Defence and Veterans Affairs ^137138139140. Uganda remains a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁴¹. No further evidence is available on the VERTIC database either ¹⁴².

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is no sufficient evidence that suggests Uganda has publicly available national regulations specifically addressing the safe and secure transport of infectious substances, including Categories A and B. The Occupational Safety and Health Act, issued by the Parliament of Uganda as Act 9 of 2006, outlines general provisions for workplace safety and health but does not mention the transport of infectious substances ¹⁴³. The Uganda Public Health Act of 1935 also does not contain provisions related to the classification or handling of infectious substances during transport. No relevant information is available on the websites of the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, or the Ministry of Works and Transport ^144145146. The Joint External Evaluation for Uganda, conducted in October 2023, does not reference national transport regulations for infectious substances ¹⁴⁷¹⁴⁸. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹⁴⁹¹⁵⁰. While Uganda follows international guidance such as the WHO’s regulations for the transport of infectious substances, there is no indication that these have been formally adopted into national law or regulation ¹⁵¹. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁵². No further information is available on the VERTIC database or the Ministry of Defence website ¹⁵³¹⁵⁴.

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is no sufficient evidence that suggests Uganda has legislation and/or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. The National Technical Guidelines for Integrated Disease Surveillance and Response – Third Edition, published by the Ministry of Health in 2021, includes provisions for cross-border surveillance and coordination at points of entry (see Section 3.3.2), but it does not establish legal or regulatory mechanisms for controlling the transfer or screening of end-users for high-risk biological materials ¹⁵⁵. The Customs and Excise Act, issued by the Parliament of Uganda as Chapter 335 and commenced on 1 July 1977, governs customs operations and import/export procedures but does not include provisions specific to biological materials or end-user screening ¹⁵⁶. No relevant legislation or regulatory framework is available from the Ministry of Health, Ministry of Agriculture, Animal Industry and Fisheries, Ministry of Defence and Veterans Affairs, or the Ministry of Trade, Industry and Cooperatives ^157158159160. The Joint External Evaluation for Uganda, conducted in 2023, does not reference any such legal instruments ¹⁶¹¹⁶². The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹⁶³¹⁶⁴. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁶⁵. No further evidence is available on the VERTIC database ¹⁶⁶.

1.4.1a Biosafety laws/regulations

Score: 0

There is no sufficient evidence that Uganda has enacted national biosafety legislation or regulations. While the country has taken steps to strengthen biosafety and biosecurity governance—such as participating in the WHO pilot of the Global Guidance Framework for the Responsible Use of the Life Sciences—these efforts remain in the planning and roadmap development phase and do not constitute formal legislation or enforceable regulations ¹⁶⁷. The Uganda National Academy of Sciences has published policy recommendations and assessments on biosafety and biosecurity, including The Scope of Biosafety and Biosecurity in Uganda, which outlines strategic priorities and gaps in governance, but these documents are advisory in nature and not legally binding ¹⁶⁸. No relevant legislation is referenced in the Joint External Evaluation for Uganda, conducted in 2023 ¹⁶⁹¹⁷⁰. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹⁷¹¹⁷². No evidence of such laws is available on the websites of the Ministry of Health, Ministry of Agriculture, or Central Public Health Laboratories ^173174175. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁷⁶. No further information is available on the VERTIC database ¹⁷⁷.

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is no sufficient evidence that Uganda has an established agency specifically responsible for the enforcement of biosafety legislation and regulations. The WHO report on responsible use of the life sciences confirms that the Office of the Prime Minister has been tasked with coordinating Uganda’s participation in the WHO pilot of the Global Guidance Framework for the Responsible Use of the Life Sciences, including intersectoral coordination and stakeholder engagement. However, this role is limited to strategic planning and does not constitute a legally mandated enforcement mechanism ¹⁷⁸. The Uganda National Council for Science and Technology (UNCST) has been assigned technical leadership in the domestication and operationalization of the framework, but its role is not defined in law as an enforcement authority ¹⁷⁹. No legislation reviewed on the Uganda Legal Information Institute (ULII) database defines enforcement responsibilities for biosafety governance ¹⁸⁰. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ¹⁸¹. No further evidence is available from the Ministry of Agriculture, Central Public Health Laboratories, or the VERTIC database ^182183184.

1.4.2a Biosafety training using a standardised, required approach

Score: 0

There is insufficient evidence that Uganda requires biosafety training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. The 2017 Joint External Evaluation for Uganda states that biosafety and biosecurity training is received annually by all health laboratory workers as a national requirement, and that a common training curriculum is available within the human health sector and has been harmonized for use by all sectors ¹⁸⁵. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ¹⁸⁶¹⁸⁷. However, the 2017 report does not specify whether the training is standardized across all relevant sectors or whether it includes a train-the-trainer component ¹⁸⁸. The WHO Laboratory Biosafety Manual (4th edition) outlines international best practices and encourages countries to implement biosafety programme management, including training and curriculum development, but does not confirm Uganda’s adoption of these practices ¹⁸⁹¹⁹⁰. Uganda has piloted the WHO Global Guidance Framework for the Responsible Use of the Life Sciences, which includes governance of biosafety and biosecurity, but the framework does not specify standardized training requirements for personnel handling high-risk biological materials ¹⁹¹.

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no evidence that Uganda has conducted a formal assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential, or other forms of dual-use research. The 2017 Joint External Evaluation (JEE) does not reference such an assessment, nor do the websites of the Ministry of Health, Ministry of Agriculture, or Ministry of Science, Technology and Innovation provide any publicly available documentation on this topic ^{192193194195196}. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996, which would typically include disclosures of dual-use research activities ¹⁹⁷. No further evidence is available on the VERTIC database or the Ministry of Defence website ¹⁹⁸¹⁹⁹.

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no evidence that suggests Uganda has legislation and/or regulation requiring oversight of research involving especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual-use research. The 2017 Joint External Evaluation (JEE) does not reference any such legal framework, and no relevant legislation is available through the Ministry of Health, Ministry of Agriculture, or Ministry of Science, Technology and Innovation ^{200201202203204}. While Uganda has participated in the WHO pilot of the Global Guidance Framework for the Responsible Use of the Life Sciences, which promotes governance of dual-use research, this initiative is advisory and not legally binding ²⁰⁵. The Uganda National Council for Science and Technology (UNCST) is involved in coordinating research and ethics oversight, but there is no publicly available evidence that it enforces specific legal requirements for dual-use or high-risk biological research ²⁰⁶. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ²⁰⁷. No further evidence is available on the VERTIC database or the Ministry of Defence website ²⁰⁸²⁰⁹.

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 100

There is evidence to suggest that Uganda has an agency responsible for oversight of research involving especially dangerous pathogens, toxins, pathogens with pandemic potential, and/or other dual-use research. The Uganda National Council for Science and Technology (UNCST) is mandated under the Uganda National Council for Science and Technology Act, Cap 209, to oversee and coordinate research and development activities in Uganda. Section 4 of the Act assigns UNCST the role of acting as a clearing house for research information and coordinating scientific activities across sectors, while Section 5 empowers it to establish specialized committees for oversight purposes ²¹⁰. The UNCST’s 2016 “Research Registration and Clearance Policy and Guidelines” further outlines its role in reviewing research protocols for scientific merit, safety, and ethical appropriateness, and in issuing national-level research permits ²¹¹. The Multi-Sectoral Biosafety Committee under UNCST is responsible for reviewing applications involving genetically engineered materials and dangerous pathogens, as outlined in the Genetic Engineering Regulatory Act, 2018 ²¹². The National Research Information Management System (NRIMS), operated by UNCST, facilitates regulatory oversight of clinical and high-risk research in collaboration with national regulatory agencies and Research Ethics Committees ²¹³. Uganda piloted the WHO Global Guidance Framework for the Responsible Use of the Life Sciences from August 2023 to July 2024, which includes governance of dual-use research of concern (DURC), but the pilot report notes limited awareness and no formalized national DURC policy ²¹⁴. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ²¹⁵. No further evidence is available from the Ministry of Agriculture, Ministry of Defence, Central Public Health Laboratories, or the VERTIC database ^216217218.

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no evidence that suggests Uganda has legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold. No relevant legal or regulatory provisions are available through the Ministry of Health, Ministry of Agriculture, Ministry of Defence, Ministry of Science, Technology and Innovation, or the Ministry of Works and Transport ^{219220221222223}. The 2017 Joint External Evaluation (JEE) for Uganda does not mention any such requirement ²²⁴. Uganda is a party to the Biological Weapons Convention but has not submitted Confidence Building Measures since 1996 ²²⁵. No further evidence is available on the VERTIC database ²²⁶.

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

There is no evidence that suggests official foot-and-mouth disease (FMD) vaccination figures for livestock in Uganda are publicly available through the World Organisation for Animal Health (WOAH, formerly OIE) database. A search of the WOAH’s World Animal Health Information System (WAHIS) platform does not return publicly accessible or up-to-date vaccination data specific to FMD in Uganda. Additionally, no such figures are available on the websites of the Ministry of Agriculture, Animal Industry and Fisheries, the Ministry of Health, or the Uganda Bureau of Statistics ^227228229. The 2017 Joint External Evaluation (JEE) and the One Health Strategic Plan (2018–2022) also do not include publicly reported FMD vaccination statistics ²³⁰²³¹. Uganda is a member of WOAH and reports disease outbreaks, but vaccination data for FMD is not consistently published or accessible through the WAHIS interface ²³².

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

There is sufficient evidence that Uganda has a national immunization strategy or plan that includes a plan to ensure equitable distribution and strategies specifically aimed at overcoming socioeconomic inequalities, geography, cultural/linguistic differences, and gender barriers to vaccination. The National Immunisation Strategy (NIS) 2024–2028, published by the Ministry of Health, replaces the previous comprehensive Multi-Year Plan and outlines detailed operational guidance for immunisation services. It includes provisions for equitable access to vaccines regardless of location, belief, or lifestyle, and emphasizes reaching underserved populations ²³³. The strategy specifically addresses barriers related to geography, gender, and socioeconomic status through targeted outreach and service delivery models ²³⁴. The Ministry of Health Strategic Plan 2020/21–2024/25 also prioritizes immunisation equity and includes gender budgeting and outreach to vulnerable groups ²³⁵. The Uganda Learning Hub for Immunisation Equity conducted a rapid assessment in 2023–2024 identifying barriers such as poor infrastructure, language differences, and gender-related access issues, and recommended tailored interventions ²³⁶. The Zero-Dose Landscape Report by Gavi documents Uganda’s efforts to reach zero-dose and under-immunized children in urban slums, refugee settlements, and remote rural areas ²³⁷. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ²³⁸²³⁹.

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 100

There is sufficient evidence that Uganda’s national immunization strategy includes measures to address vaccine hesitancy and build public trust in vaccines. The National Immunisation Strategy (NIS) 2024–2028 outlines community engagement and communication as key components of immunisation delivery, emphasizing the need to build trust through culturally appropriate messaging and local leadership involvement: “Community engagement and communication are key components of immunisation delivery. Building trust through culturally appropriate messaging and local leadership involvement is essential” (Chapter 8: Communication and Advocacy) ²⁴⁰. The strategy includes plans to train health workers in interpersonal communication and to use mass media and community dialogues to counter misinformation and promote vaccine confidence: “Health workers will be trained in interpersonal communication skills and supported to engage communities through mass media, community dialogues, and other platforms to counter misinformation and promote vaccine confidence” (Chapter 51: Information, Education, Communication & Dissemination) ²⁴¹. The Uganda Learning Hub for Immunisation Equity’s 2024 rapid assessment highlights persistent vaccine hesitancy in certain districts and recommends targeted community engagement strategies to address it: “Persistent vaccine hesitancy was reported in Wakiso, Kasese, and Mubende districts. Recommendations include targeted community engagement strategies to address misinformation and build trust” (Section 4.4: Barriers to reaching ZDC and UIC) ²⁴². The Uganda Zero-Dose Landscape report by Gavi identifies vaccine hesitancy as a barrier to coverage and describes efforts to improve public trust through local partnerships and tailored messaging: “Vaccine hesitancy is a barrier to coverage. Efforts to improve public trust include local partnerships and tailored messaging to address community-specific concerns” (Section: Immunization Context) ²⁴³. The Ministry of Health’s Routine Immunisation Q&A booklet also addresses common concerns and misconceptions about vaccines, including safety, side effects, and myths about infertility, aiming to reassure caregivers and promote informed decision-making: “Vaccines do not cause infertility but provide protection to the recipient against immunisable killer diseases” and “All vaccines are SAFE, EFFECTIVE and FREE” (Questions 21 and 14) ²⁴⁴.

1.6.1e National advisory group for immunization strategy/plan

Score: 100

There is sufficient evidence that Uganda has a national advisory group that provides technical guidance and advice on the immunization strategy/plan to government. The National Immunisation Strategy (NIS) 2024–2028 identifies the Uganda National Immunisation Technical Advisory Group (UNITAG) as a key governance structure responsible for providing evidence-based recommendations to the Ministry of Health on immunisation policies and strategies. The strategy states: “The Uganda National Immunisation Technical Advisory Group (UNITAG) provides independent, evidence-based advice to the Ministry of Health on immunisation policy and strategy” (Table 4: Immunisation Governance Structures, page 53) ²⁴⁵. The WHO Africa Regional Office confirms that Uganda has an operational NITAG and hosted a capacity-building workshop for NITAGs in February 2023, which included UNITAG members ²⁴⁶. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ²⁴⁷²⁴⁸.

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is no sufficient evidence that suggests Uganda has a national immunization programme for influenza. The National Immunisation Strategy (NIS) 2024–2028 does not include influenza in the routine vaccination schedule or in the list of priority vaccines for introduction ²⁴⁹. The Ministry of Health’s UNEPI Immunization Guidelines and the national routine immunisation schedule list vaccines for diseases such as measles, polio, HPV, and rotavirus, but do not mention influenza ²⁵⁰²⁵¹. The National Medical Stores vaccine delivery schedules and vaccine lists also do not include influenza vaccines among the distributed immunisation supplies ²⁵². The WHO/UNICEF Joint Reporting Form on Immunization (JRF) confirms that Uganda does not have a national policy for seasonal influenza vaccination and does not report coverage data for influenza vaccines ²⁵³. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ²⁵⁴²⁵⁵.

1.7.1a Strategy/plan for resilience of health system

Score: 100

There is sufficient evidence that Uganda has a strategy to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patterns pose, including the threat of infectious diseases. The Health-National Adaptation Plan (H-NAP), published by the Ministry of Health in August 2024, states: “This H-NAP should be used to mobilize the required technical and financial resources. This effort should be replicated at the sub-national level to ensure we build a climate-resilient health system” (page 1) ²⁵⁶. It includes actions to address climate-sensitive diseases such as malaria, cholera, and respiratory infections, and outlines plans for surveillance, early warning systems, and infrastructure strengthening (Chapter 4: Adaptation Actions, pages 17–22) ²⁵⁷. The 2024 National State of the Environment Report by NEMA highlights: “Outbreak of diseases such as malaria, dengue fever, water borne diseases like cholera and dysentery… are associated with floods and respiratory diseases associated with droughts” (Chapter 3: Climate Change and Health Impacts) ²⁵⁸. The 3rd Health Promotion and Disease Prevention Conference organized by the Ministry of Health in October 2024 included a session titled “Climate change & Health: Role of Community Health Workers,” which discussed “Adaptation interventions that build health system resilience” and “Role of community health workers contributing to adaptation and health system resilience” ²⁵⁹. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary ²⁶⁰²⁶¹.

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 50

There is some evidence that Uganda’s national laboratory system has the capacity to conduct diagnostic tests for at least 5 of the 10 WHO-defined core tests, although the specific tests are not publicly listed. The 2017 Joint External Evaluation (JEE) for Uganda assigns a score of 4 to indicator D.1.1, which assesses laboratory testing capacity for detection of priority diseases ²⁶². The JEE report mentions that Uganda has well-established reference laboratories, including the Uganda Virus Research Institute (UVRI), the National Tuberculosis Reference Laboratory, the Central Public Health Laboratories (CPHL), and the National Animal Disease Diagnostic and Epidemiology Centre ²⁶³. However, there is no publicly available documentation from the Ministry of Health, Ministry of Agriculture, or the CPHL website that confirms which of the WHO core tests are conducted ^264265266. The Uganda National Health Laboratory Hub and Sample Transport Network Guidelines emphasize the importance of quality laboratory services and specimen transport but do not specify diagnostic test capacity ²⁶⁷.

2.1.1b Plan to conduct testing during a public health emergency

Score: 50

There is evidence that Uganda has disease-specific plans for conducting testing during public health emergencies, but there is insufficient evidence that a comprehensive national plan exists which includes considerations for testing for novel pathogens, scaling capacity, and defining goals for testing ^{268 269 270 271}. The COVID-19 Preparedness and Response Plan (2020) outlined testing goals, laboratory capacity expansion, and sample transport systems, but these provisions were specific to COVID-19 and do not constitute a general national testing strategy ²⁷². Similarly, Uganda’s Ebola preparedness documentation and HIV Country Operational Plan include targeted testing strategies for those diseases ^{273 274}. Recent Mpox situation reports (2024–2025) mention laboratory testing and case confirmation but do not provide a national testing framework applicable to novel pathogens or broader emergencies ^{275 276}. No evidence was found of a publicly available multi-hazard testing strategy from the Ministry of Health or other official sources ^{277 278}.

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

There is sufficient evidence that Uganda has a national laboratory that serves as a reference facility which is accredited. The Uganda National Health Laboratory and Diagnostic Services (NHLDS), under the Ministry of Health, includes the Central Public Health Laboratories (CPHL), which is accredited to ISO 15189:2022 standards by the South African National Accreditation System (SANAS). The official CPHL website states that NHLDS successfully passed reassessment for ISO 9001:2015 and ISO 15189:2022, reaffirming its leadership in quality and diagnostic standards, and confirms that reference laboratories and facilities across the country were evaluated by SANAS. It also notes that 68 laboratories are accredited by SANAS and that the scope of accreditation was expanded to include genomics testing ²⁷⁹. The Ministry of Health’s Strategic Plan for Laboratory Services (2016–2020) identifies CPHL as the national reference laboratory and outlines its role in quality assurance and coordination of the national laboratory network: “CPHL is the national reference laboratory responsible for coordinating the national laboratory network and ensuring quality assurance across all levels” (Chapter 2: Strategic Framework, page 22) ²⁸⁰.

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

There is sufficient evidence that Uganda has a national laboratory that serves as a reference facility which is subject to external quality assurance review. The Central Public Health Laboratories (CPHL), under the Uganda National Health Laboratory and Diagnostic Services (NHLDS), participates in external quality assessment (EQA) programs. The NHLDS website states: “CPHL is mandated to provide stewardship for the National Health Laboratory Network… Laboratory Quality Services include Lab EQA Assessments” (Section: Laboratory Services) ²⁸¹. The Ministry of Health’s publication CPHL Final Edited.pdf confirms that “External Quality Assessment in Uganda [helps] laboratories evaluate their levels of performance through proficiency testing” and that “the Ministry has invested significantly in revitalizing the national laboratory network… [including] establishment of external quality assessment schemes” (page 3) ²⁸². Uganda has also adopted the WHO Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA), which includes external audits and evaluations. The SLIPTA guide outlines that “laboratories are assessed using a standardized checklist and scored to determine their level of compliance with ISO 15189 standards” (Section 2.2: Assessment Process) ²⁸³.

2.2.1a Nationwide specimen transport system

Score: 100

There is sufficient evidence that Uganda has a nationwide specimen transport system. The Central Public Health Laboratories (CPHL), under the Uganda National Health Laboratory and Diagnostic Services (NHLDS), coordinates the Uganda National Sample and Results Transport Network (NSRTN), which links Health Centre IIIs and IVs, General Hospitals, Regional Referral Hospitals, and National Reference Laboratories through a hub-and-spoke model ²⁸⁴. The official guidelines for the Uganda National Health Laboratory Hub and Sample Transport Network state: “In order for the Hub to support lower sites, there should be a functional means of sample movement from the lower sites to the Hub and to reference laboratories” (page iii) ²⁸⁵. The system includes a fleet of motorcycles and vehicles operated by trained riders who visit 4–8 facilities per day to collect specimens and deliver results ²⁸⁶. A Ministry of Health case study confirms: “By March 2016, there were 100 Hubs operational, serving 2500 health facilities, representing 90% coverage in Uganda” and that “Testing Turn Around Time (TAT) improved for Early Infant Diagnosis (EID) of HIV from 69 days… to 14 days” (pages 11, 28) ²⁸⁷. The Ministry of Health’s National Medical Equipment Management Guidelines (2024) also emphasize the importance of standardized logistics and transport mechanisms for laboratory services, stating: “The guidelines… ensure equipment quality, standardization and equitable access to healthcare services” (Section: Overview) ²⁸⁸.

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 100

There is sufficient evidence that Uganda has a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak. The Multihazard Preparedness and Response Framework for Public Health Emergencies (2023) outlines laboratory support mechanisms during emergencies. Section 4.8 states: “Laboratory support to response includes activation of additional testing capacity through public and private sector laboratories, including rapid authorization and deployment protocols” (page 44) ²⁸⁹. The COVID-19 Preparedness and Response Laboratory Manual (2020) describes procedures for scaling up testing capacity, including training, accreditation, and mobilization of laboratories: “The MoH plans to scale up this further by establishing Port Health Facilities with laboratories for surveillance” and “Support Laboratory Accreditation” (pages 17–18) ²⁹⁰. The Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP) confirms that the government implemented rapid laboratory expansion measures during the pandemic, including procurement and deployment of equipment and reagents to support outbreak laboratory network readiness ²⁹¹. The WHO Joint External Evaluation conducted in October 2023 is listed as “conducted” on the WHO JEE activities page, and a WHO AFRO news article summarizing the exercise commends Uganda’s laboratory system and emergency preparedness, though no detailed report is available ²⁹²²⁹³.

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

Uganda conducts ongoing event-based surveillance (EBS) and indicator-based surveillance (IBS) for notifiable and novel infectious diseases, but there is no evidence that data are analyzed on a daily basis. The Ministry of Health publishes weekly epidemiological bulletins that include sections titled “Indicator and Event Based Surveillance,” “Suspected cases of Epidemic Prone Diseases,” and “Weekly cases of diseases/conditions targeted for elimination or eradication,” providing weekly analysis of suspected and confirmed cases of epidemic-prone diseases ²⁹⁴. The National Technical Guidelines for Integrated Disease Surveillance and Response (IDSR), third edition, describe the use of electronic IDSR (eIDSR) for real-time reporting and analysis of priority diseases and public health events, but do not explicitly confirm daily analysis ²⁹⁵.

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is sufficient evidence that Uganda has a mechanism for reporting notifiable diseases to the WHO within the set timeline. The Ministry of Health implements the Integrated Disease Surveillance and Response (IDSR) strategy, which is aligned with the International Health Regulations (IHR 2005). The third edition of Uganda’s National Technical Guidelines for IDSR states: “To strengthen national capacity for early detection, complete recording, timely reporting, use of electronic tools, regular analysis and prompt feedback of IDSR priority diseases, events and conditions at all levels” (Section 4: IDSR and IHR 2005, page 8) ²⁹⁶. The guidelines also specify that “Electronic IDSR (eIDSR) is a platform to enhance real-time surveillance” and that “reporting to WHO, as required (IHR 2005), is part of the surveillance framework” (Section 8: Electronic IDSR, page 11) ²⁹⁷. The WHO Regional Office for Africa confirms that Uganda launched the third edition of the IDSR guidelines in September 2021, which includes “event-based disease surveillance, community-based surveillance, one health approach, cross-border surveillance, and electronic IDSR to improve disease surveillance in Uganda at all levels” ²⁹⁸. The WHO Joint External Evaluation conducted in 2023 confirms that Uganda coordinated its IHR core capacity assessment through the Office of the Prime Minister and the Ministry of Health, but does not explicitly mention the designation of an IHR National Focal Point ²⁹⁹³⁰⁰.

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is sufficient publicly available evidence that the Ugandan government operates an electronic reporting surveillance system at both the national and sub-national levels. The Ministry of Health uses the electronic Integrated Disease Surveillance and Response system (eIDSR), implemented through the District Health Information Software 2 (DHIS2) platform. Uganda’s National Technical Guidelines for Integrated Disease Surveillance and Response state: “Electronic IDSR (eIDSR) is a platform to enhance real-time surveillance and reporting of priority diseases, events and conditions at all levels” (Section 8, page 11) and confirm that “districts use the eIDSR platform for reporting and analysis of surveillance data” (Annex 1D, page 94) ³⁰¹. Additionally, the Health Information and Digital Health Strategic Plan 2020/21–2024/25 outlines DHIS2 as “the national electronic health information system” and confirms that it is “implemented in all districts to support timely and complete reporting of health data” (Chapter 2.4, page 10) ³⁰².

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 50

Uganda operates a real-time electronic reporting surveillance system that collects laboratory data, but there is insufficient publicly available evidence that the system can disaggregate and analyze data by variables such as age or ethnicity beyond what is stated in strategic plans. The Ministry of Health implements the electronic Integrated Disease Surveillance and Response (eIDSR) system through the DHIS2 platform. The DHIS2 Integration Overview confirms that one of the objectives of eIDSR is to integrate case epidemiology data with laboratory results and translate these into public health actions ³⁰³. The National Technical Guidelines for Integrated Disease Surveillance and Response, third edition, describe the use of laboratory data in real-time surveillance through eIDSR ³⁰⁴. The Health Information and Digital Health Strategic Plan (2020/21–2024/25) mentions that analytic platforms and dashboards were designed to include age and sex disaggregation ³⁰⁵. However, there is no publicly available evidence demonstrating that these disaggregation features are operational in the surveillance system or that ethnicity-based disaggregation is supported.

2.3.3a National wastewater surveillance programme or initiative

Score: 100

There is evidence that Uganda has ongoing wastewater or environmental surveillance programmes at the national level.

Environmental surveillance (ES), the monitoring of polioviruses in environmental specimens contaminated with human faeces, is more sensitive than AFP surveillance and was started in Uganda in May 2017 at four sites in the populous districts of Kampala and Wakiso in central Uganda.³⁰⁶ As of 2023, these have increased to 12 (2020, 2 sites; 2021, 2 sites; and 2022, 4 sites) across the country.

In 2021, the Ministry of Health declared polio a public health emergency in Uganda following confirmation of positive laboratory tests from environmental samples in Kampala.³⁰⁷

Support for integration of polioviruses environmental surveillance with other wastewater pathogens saw the region collaborate with partners in the Mpox wastewater surveillance project in Democratic Republic of Congo and the European Union Health Emergency Preparedness and Response Authority (HERA) wastewater project in AFRO that seeks to support Countries and development partners have clear guidance on minimum capacity need and investment requirements to establish and sustain a credible wastewater and environmental surveillance programme. This resulted in four pilot countries (Democratic Republic of Congo, Senegal, Uganda, and Zambia) being supported in selecting priority pathogens based on local context and public health significance, feasibility, acceptability, and how best to integrate with existing surveillance and response systems, as well as multi-target wastewater and Environmental surveillance. Scoping visits were conducted in the four pilot countries where the WHO prioritisation tool was applied to help countries select priority pathogens. Microplanning was conducted for its implementation, after which budgets were drawn up, and implementation is planned for 2026.³⁰⁸ However, there is no evidence on whether this has been implemented yet, whether it is national/sub-national, or whether it is expected to be long-running.

2.4.1a Common usage of electronic health records

Score: 50

There is sufficient publicly available evidence that electronic health records (EHRs) are used in Uganda, but there is no evidence that they are commonly in use nationwide. The Ministry of Health has published the Guidelines for the Implementation of the Electronic Medical Records System (EMRS), which aim to standardize EMR deployment across Uganda’s health system. The guidelines confirm that EMRS is part of the national health information architecture and is designed to be interoperable with other Ministry of Health systems, including for referrals, commodity tracking, reporting, analytics, and surveillance ³⁰⁹. However, the guidelines also note that implementation is being carried out in a phased approach and that significant investment in infrastructure is still required to scale the system nationally ³¹⁰.
The Stre@mline platform, a locally developed EHR system, has been operational in two hospitals in southwestern Uganda since at least 2018. It is tailored to low-resource settings, operates without internet access, and includes features such as medication inventory management and patient safety tools. As of 2018, it had served over 60,000 patients, with plans to expand ³¹¹. However, there is no publicly available evidence that Stre@mline or other EHR platforms have been scaled nationally or adopted across the majority of health facilities.
A 2024 Ministry of Health report confirms that Uganda’s EMR rollout accelerated between 2022 and 2024, expanding from 23 to 69 facilities, including all 16 regional referral hospitals and most general hospitals. The report also notes that the preferred platform, eAFYA, supports offline functionality and integration with laboratory and pharmacy systems. Despite this progress, the report emphasizes that full national coverage has not yet been achieved and that further expansion to Health Center IVs and IIIs is still underway ³¹².

2.4.1b Public health system access to individual electronic health records

Score: 0

There is insufficient publicly available evidence that the national public health system in Uganda currently has access to electronic health records (EHRs) of individuals for centralized public health use. The Guidelines for the Implementation of the Electronic Medical Records System (EMRS) confirm that EMRS is part of the national health information architecture and is designed to be interoperable with other Ministry of Health systems, including for referrals, commodity tracking, reporting, analytics, and surveillance ³¹³. However, the guidelines do not state that individual-level EHRs are accessible to the national public health system at present.
The Health Sector Digitization Bulletin outlines the phased deployment of EMRs across health facilities and confirms integration efforts between EMRs and systems such as the Facility Registry, Client Registry, and DHIS2 ³¹⁴. It also notes the development of a Shared Health Record to enable data exchange among EMRs, but this system is still under development and not yet operational ³¹⁵.
The Health Information and Digital Health Strategic Plan 2020/21–2024/25 sets out the goal of achieving interoperability and access to patient-level data for improved health system performance, but it describes these as future objectives rather than current capabilities ³¹⁶.

2.4.1c Existence of data standards for health record data comparability

Score: 100

There is sufficient publicly available evidence that Uganda has adopted data standards to ensure data is comparable. The Uganda Health Information Exchange and Interoperability Guidelines, issued by the Ministry of Health in January 2023, explicitly outline the use of international standards including HL7 (Health Level Seven), FHIR (Fast Healthcare Interoperability Resources), and ISO/IEC 11179 for metadata registries. These standards are applied to messaging, vocabulary, and communication protocols to enable consistent and interoperable health data exchange across systems (Section A, pages 6–11) ³¹⁷.

The Uganda Health Information and Digital Health Strategic Plan 2020/21–2024/25 confirms the country’s commitment to implementing standardized data systems and interoperability frameworks aligned with global norms. It states that “the Ministry of Health will adopt international standards such as HL7, FHIR, and ISO to ensure interoperability and comparability of health data” (Chapter 3, Strategic Direction) ³¹⁸.

Uganda is also listed in the WHO Global Digital Health Monitor, which tracks countries’ progress in adopting digital health maturity indicators, including standards and interoperability. Uganda is categorized under Phase 3, indicating that standards for data exchange, transmission, messaging, and privacy have been published and disseminated under government leadership ³¹⁹.

2.4.2a Data sharing mechanisms

Score: 0

There is insufficient publicly available evidence of fully operationalized mechanisms for routine data sharing between Uganda’s ministries responsible for animal, human, and wildlife surveillance. The Uganda One Health Strategic Plan (2018–2022) emphasizes multisectoral collaboration and outlines governance structures for coordination among the Ministry of Health (MoH), Ministry of Agriculture, Animal Industry and Fisheries (MAAIF), Uganda Wildlife Authority (UWA), and Ministry of Water and Environment (MWE) ³²⁰. However, the plan and related documents do not provide evidence of functional, ongoing data-sharing systems for surveillance activities such as mosquito or brucellosis monitoring.
Recent initiatives, such as the piloting of the Surveillance and Information Sharing Operational Tool (SIS OT) by FAO, WHO, and OIE, aim to strengthen multisectoral information exchange for zoonotic disease surveillance ³²¹. Additionally, Uganda’s multisectoral review of surveillance systems under the USAID Infectious Disease Detection and Surveillance project identified gaps in interoperability and noted that existing electronic systems in human health (DHIS2, eIDSR) are not integrated with animal or environmental surveillance platforms ³²². These efforts indicate progress toward coordination but do not confirm established, operational mechanisms for routine data sharing.

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

Uganda makes de-identified health surveillance data on infectious diseases publicly available through weekly epidemiological bulletins published by the Ministry of Health. These bulletins provide aggregated data on suspected and confirmed cases of epidemic-prone diseases, reporting completeness and timeliness, and updates on event-based and indicator-based surveillance. For example, the Weekly Epidemiological Bulletin – Week 48, 2024 includes sections on suspected cases of epidemic-prone diseases, maternal and perinatal death surveillance, influenza and viral hemorrhagic fever surveillance, and point-of-entry monitoring ³²³. Similar bulletins for other weeks in 2024 and 2025 are also accessible on the Ministry of Health’s Knowledge Management Portal ³²⁴³²⁵. These reports demonstrate that Uganda regularly publishes de-identified surveillance data in a structured format for public access.

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is sufficient publicly available evidence of legislation and regulations in Uganda that safeguard the confidentiality of identifiable health information for individuals, including that generated through health surveillance activities. The Health Service Commission Act, 2001, issued by the Parliament of Uganda, states under Section 5 that “a health worker shall respect the confidentiality of information relating to a patient and his or her family; such information shall not be disclosed to anyone without the patient’s or appropriate guardian’s consent except where it is in the best interest of the patient” ³²⁶.

The HIV and AIDS Prevention and Control Act, 2014, issued by the Uganda AIDS Commission, mandates confidentiality of HIV-related health information and prohibits unauthorized disclosure of an individual’s HIV status, except under specific legal or medical circumstances ³²⁷.

The Patients’ Charter, adopted by the Ministry of Health in 2009, affirms the right to privacy and confidentiality during consultation and treatment. Section 1 of the Charter outlines that “every patient has the right to confidentiality of information relating to their health status and medical records” ³²⁸.

The Data Protection and Privacy Act, 2019, issued by the Parliament of Uganda, provides broader protections for personal data, including health status and medical records. Section 9 of the Act prohibits the collection or processing of special personal data—such as health information—without the individual’s consent, unless required by law ³²⁹.

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

There is sufficient publicly available evidence of legislation and regulations in Uganda that safeguard the confidentiality of identifiable health information for individuals, including mention of protections from cyber attacks. The Data Protection and Privacy Act, 2019, issued by the Parliament of Uganda, includes provisions under Sections 20–23 that require data controllers and processors to implement appropriate security measures to protect personal data, including health information, from unauthorized access, loss, or destruction. Section 23 specifically mandates notification of data security breaches to the Authority and affected individuals, which implicitly covers cyber threats such as ransomware attacks ³³⁰.

Additionally, the National Information Security Framework (NISF), developed by the National Information Technology Authority–Uganda (NITA-U), outlines baseline security controls for government institutions, including those handling health data. The framework includes standards for securing critical information infrastructure and mandates risk management practices to mitigate cyber threats, including malware and ransomware ³³¹.

The National Cybersecurity Strategy, published by the Ministry of ICT and National Guidance, identifies protection of critical infrastructure and personal data as a strategic priority. It outlines tasks such as threat preparedness, incident response, and the development of a robust cybersecurity ecosystem to defend against cyber attacks targeting sensitive data, including health surveillance systems ³³².

2.4.5a Cooperative commitments or agreements within regions

Score: 50

Uganda has made formal commitments to share surveillance data during public health emergencies.

According to the Africa Centres for Diseases Control and Prevention, Uganda is one of 12 countries that have joined together in collaboration to respond, prevent and control disease outbreaks, especially the recent monkeypox outbreaks, which includes "data-sharing mechanisms". It is unclear whether this is just for one or multiple diseases, and there is no evidence of any implementation of mechanisms yet ³³³. Uganda is also a member of the East Africa Public Health Laboratory Network Project, a World Bank funded project whose aim is to "to establish a network of efficient, high quality, accessible public health laboratories for the diagnosis and surveillance of Tuberculosis and other communicable diseases". This includes the East African Integrated Disease Surveillance Network, which aims to harmonize "integrated disease surveillance systems in the region"^{334 335}.

Searches of the East African Community (EAC) platforms, including the East African Integrated Disease Surveillance Network (EAIDSNet), and Uganda’s Ministry of Health and Central Public Health Laboratories websites show systems for cross-border collaboration and harmonization of surveillance protocols, but do not confirm formal commitments to share data during active emergencies for diseases other than Mpox ^336337338339.

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is evidence that Uganda has a national system to provide support at the sub-national level for contact tracing, but most documented activities are linked to active outbreak response rather than a fully institutionalized preparedness system ^{340 341 342}. During the 2024 mpox outbreak, the Ministry of Health, with WHO support, trained district-level responders in five districts on electronic surveillance tools for contact tracing and deployed Go.Data to strengthen systematic follow-up and case investigation ³⁴³. Similar support was provided during the 2022 Ebola outbreak, where national and district rapid response teams were mobilized, and contact tracing was coordinated through the Public Health Emergency Operations Centre (PHEOC) ³⁴⁴.

Uganda’s Integrated Disease Surveillance and Response (IDSR) guidelines (third edition) outline roles for case investigation and contact tracing at district level and emphasize training and supervision as part of preparedness ³⁴⁵. Additionally, the National Multi-Hazard Preparedness and Response Framework (2023) and the second National Action Plan for Health Security (NAPHS II, 2024–2029) include strategic actions to strengthen sub-national capacity for outbreak response, including contact tracing, through training, logistics, and digital tools ^{346 347}. However, the available evidence does not clearly demonstrate that these measures are fully operationalized outside of active emergencies, as most examples are reactive.

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is no evidence that the country provides comprehensive wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support such as paycheck protection or job security. The Employment Act, 2006, issued by the Parliament of Uganda, provides under Section 41 that employees who are unable to work due to circumstances beyond their control may be entitled to wages during absence, but this applies only to employees with at least three months of continuous service and does not explicitly cover quarantine or isolation due to public health emergencies ³⁴⁸. The Occupational Safety and Health Act, 2006, issued by the Parliament of Uganda, allows employers to implement workplace safety measures, including alternative suitable employment and protective arrangements for vulnerable workers, but does not mandate economic support or job protection during quarantine or isolation ³⁴⁹.

During the COVID-19 pandemic, the government implemented temporary social protection measures with support from the World Bank, including cash-for-work programs, subsidies for essential utilities, and expansion of the senior citizen grant to additional districts. These measures were part of the Uganda COVID-19 Economic Crisis and Recovery Development Policy Financing initiative, which aimed to protect vulnerable populations and stimulate economic recovery ³⁵⁰. However, there is no evidence that these measures have been institutionalized or extended beyond the COVID-19 emergency period ³⁵¹.

Health system strengthening strategies launched in 2024 by the Ministry of Health and the World Health Organization focus on improving access to medical services for vulnerable populations, including refugees and migrants. The Refugee and Migrant Health System Review Report, launched in October 2024, outlines plans to expand access to essential medical resources and improve health worker capacities, but does not mention economic support for isolation or quarantine ³⁵².

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is no publicly available evidence of a formal joint plan or cooperative agreement between the public health system and border control authorities in Uganda that is maintained in preparation for future public health emergencies. During the 2018 Ebola outbreak, Uganda implemented screening measures at points of entry (PoEs), including training volunteers and deploying infrared thermometers at border crossings and refugee reception centers, coordinated by a PoE committee under the Ministry of Health ³⁵³. During the COVID-19 pandemic, Uganda strengthened surveillance at PoEs and deployed teams to manage border screening and cross-border monitoring, particularly along transnational roads ³⁵⁴. These interventions demonstrate coordination between the public health system and border control authorities during emergencies.

However, there is no evidence of a standing joint plan or cooperative agreement that outlines roles, responsibilities, and procedures for coordination between the Ministry of Health and the Directorate of Citizenship and Immigration Control in advance of future public health emergencies. The Multihazard Preparedness and Response Framework for Public Health Emergencies, published by the Ministry of Health in 2023, outlines coordination structures and response protocols, including roles for PoEs and border health surveillance, but does not reference a formalized agreement with immigration authorities or border control agencies ³⁵⁵. Similarly, the 2021 Uganda Multi-Sectoral Self-Assessment Report confirms that coordination at PoEs has improved during active emergencies, but does not identify a pre-existing joint plan or legal framework for sustained collaboration ³⁵⁶.

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

There is evidence that the country has an applied epidemiology training program (such as FETP) available in country, but no evidence that resources are provided by the government to send citizens to another country to participate in applied epidemiology training programs. Uganda’s Field Epidemiology Training Program (FETP), established in partnership with the Ministry of Health and Makerere University School of Public Health, includes three levels of training: frontline, intermediate, and advanced ³⁵⁷. The advanced level, also known as the Public Health Fellowship Program, is the only FETP in Africa that enrolls post-master’s degree fellows ³⁵⁸. As of December 2023, the program had graduated 94 fellows from the advanced level and 651 trainees from the intermediate and frontline levels across 118 districts and cities ³⁵⁹. There is no evidence that the Ugandan government provides resources for citizens to participate in applied epidemiology training programs outside the country ^360361362.

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is evidence that the available field epidemiology training programs in Uganda are explicitly inclusive of animal health professionals and that a specific animal health field epidemiology training program is offered. The 2017 Joint External Evaluation for Uganda confirms that veterinarians are integrated into the Field Epidemiology Training Program (FETP), which includes opportunities for cross-sector training and collaboration between human and animal health professionals ³⁶³. In addition, Uganda is one of the countries implementing the In-Service Applied Veterinary Epidemiology Training (ISAVET) program, launched by the Food and Agriculture Organization (FAO) and the Institute for Infectious Animal Diseases (IIAD). The ISAVET program is a four-month frontline field epidemiology training specifically designed for veterinary professionals and has been conducted in Uganda since 2019 ^364365366. The latest WHO Joint External Evaluation was conducted in 2023. The WHO JEE activities page lists the event as "conducted," but does not provide a downloadable report or summary as provided for other countries ³⁶⁷, ³⁶⁸.

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 100

There is evidence that the country has at least 1 trained field epidemiologist per 200,000 people. As of December 2023, Uganda’s Field Epidemiology Training Program (FETP), operated by the Ministry of Health in partnership with CDC and Makerere University School of Public Health, had graduated 94 fellows from the advanced level and 651 trainees from the intermediate and frontline levels ³⁶⁹. This totals 745 trained field epidemiologists. With a population of approximately 48 million in 2024, this equates to roughly 1 trained field epidemiologist per 64,000 people, which exceeds the threshold of 1 per 200,000 ³⁷⁰.

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 33.33

There is evidence that Uganda has disease-specific public health emergency response plans, but there is no evidence of an overarching national plan that addresses planning for multiple communicable diseases with epidemic or pandemic potential ^{371372373374375}. Uganda has developed plans such as the COVID-19 Preparedness and Response Plan (2020) and the HIV Country Operational Plan (2017), which outline strategies for those specific diseases ³⁷⁶³⁷⁷. Academic literature references a National Multi-Hazard Emergency Preparedness and Response Plan (NMEPRP), but the document is not publicly available, and its contents cannot be verified ³⁷⁸. Uganda launched its second National Action Plan for Health Security (NAPHS II) for 2024–2029, described as a strategic plan to strengthen health security, but the full text is also not publicly available ³⁷⁹. The 2010 National Policy for Disaster Preparedness and Management includes general references to pandemics but does not constitute an operational response plan ³⁸⁰. No overarching emergency response plan is referenced in the 2017 Joint External Evaluation or available on the Ministry of Health website ³⁸¹.

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is no evidence that Uganda has an overarching national public health emergency response plan that is publicly available and addresses planning for multiple communicable diseases with epidemic or pandemic potential. While Uganda launched its second National Action Plan for Health Security (NAPHS II) in December 2024, the full text of the plan is not publicly available, so it cannot be verified for content ³⁸². Other referenced documents, such as the National Multi-Hazard Emergency Preparedness and Response Plan and the 2010 National Policy for Disaster Preparedness and Management, are either not accessible or do not constitute an operational response plan ^383384385. Therefore, it is not possible to confirm that an overarching plan exists or has been updated in the last three years.

3.1.1c One health principles by covering multiple threat types

Score: 0

There is no evidence that Uganda has an overarching national public health emergency response plan that is publicly available and can be verified to follow One Health principles by covering multiple threat types such as antimicrobial resistance, zoonotic disease spillover, biological accidents, or deliberate acts. While Uganda launched its second National Action Plan for Health Security (NAPHS II) in December 2024, the full text of the plan is not publicly available, so its content cannot be assessed ³⁸⁶. Other referenced documents, such as the National Multi-Hazard Emergency Preparedness and Response Plan and the 2010 National Policy for Disaster Preparedness and Management, are either not accessible or do not provide sufficient detail to confirm One Health integration ^{387 388 389}. Therefore, it is not possible to verify that an overarching plan exists or that it incorporates One Health principles.

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is no sufficient evidence that Uganda’s overarching national public health emergency response plan includes consideration of health equity or mechanisms for identifying and considering the needs of vulnerable populations. The National Action Plan for Health Security (NAPHS II) 2024–2029, launched by the Office of the Prime Minister and Ministry of Health, is described as a strategic plan aligned with the National Development Plan IV and aims to strengthen Uganda’s capacity to respond to public health emergencies ³⁹⁰. However, the full text of NAPHS II is not publicly available, and the launch statement does not mention health equity or specific mechanisms for identifying vulnerable populations ³⁹¹. The WHO Uganda Annual Report 2024 highlights achievements in emergency response and health system strengthening, but does not reference equity or targeted strategies for vulnerable groups in the context of NAPHS II ³⁹². The Ministry of Health’s National Community Health Strategy (2024) includes provisions for vulnerable and marginalized populations ³⁹³, and the Ministry of Gender, Labour and Social Development maintains a monitoring system for orphans and vulnerable children ³⁹⁴, but these are not part of the overarching emergency response plan and therefore do not meet the criteria for this indicator. No further evidence was found on the websites of the Ministry of Health ³⁹⁵, Office of the Prime Minister ³⁹⁶, National Planning Authority ³⁹⁷, Ministry of Gender, Labour and Social Development ³⁹⁸, or Ministry of Local Government ³⁹⁹.

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is no evidence that the country has a specific mechanism(s) for engaging with the private sector to assist with outbreak emergency preparedness and response. No such mechanism is referenced in the 2017 Joint External Evaluation (JEE), the Ministry of Health website, or the Office of the Prime Minister’s disaster preparedness portal ^400401402. Uganda’s 2010 National Policy for Disaster Preparedness and Management includes a section on private sector engagement, stating that “there is need to ensure that the private sector integrates disaster management programmes into their action plans,” but it does not outline a formal mechanism for engagement ⁴⁰³. While recent statements from the Ministry of Health acknowledge the role of private sector actors in the health system more broadly, particularly under the One Health approach, these references are general and do not describe structured or institutionalized mechanisms for outbreak preparedness or response ⁴⁰⁴.

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 100

There is evidence that Uganda has policies, plans, and guidelines in place to implement non-pharmaceutical interventions (NPIs) during epidemics or pandemics for more than one disease. The COVID-19 Preparedness and Response Plan (2020–2021) includes extensive NPI measures such as lockdowns, curfews, school closures, social distancing, hand hygiene, and community engagement strategies ⁴⁰⁵. The plan outlines implementation pillars including risk communication, social mobilization, and continuity of essential health services, and was developed through a multi-sectoral approach involving the National Task Force and Public Health Emergency Operations Centre ⁴⁰⁶.

Additionally, the National Guidelines for Management of COVID-19 (2020) provide detailed protocols for screening, triage, infection prevention and control (IPC), isolation, and safe and dignified burials ⁴⁰⁷. These guidelines include annexes on community triage algorithms and home isolation protocols, which are applicable across various settings.

Uganda’s National Response Plan for Ebola Virus Disease (2022) also includes NPI measures such as case isolation, IPC, safe burials, mental health and psychosocial support, and risk communication ⁴⁰⁸. The plan builds on lessons learned from previous outbreaks and emphasizes a people-centered response coordinated through district and national task forces.

The Consolidated Guidelines for Prevention and Treatment of HIV in Uganda include behavioral interventions such as condom promotion, voluntary male circumcision, and targeted outreach for key populations ⁴⁰⁹. While these are disease-specific, they demonstrate structured NPI planning.

No further evidence of a cross-cutting NPI framework applicable to multiple diseases was found on the websites of the Ministry of Health ⁴¹⁰, Office of the Prime Minister ⁴¹¹, or the National Emergency Coordination and Operations Centre ⁴¹².

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is evidence that the country has activated its national emergency response plan for an infectious disease outbreak in the past year, but no evidence that it has completed a national-level biological threat-focused exercise in the same period. In August 2024, the Ministry of Health of Uganda confirmed an outbreak of mpox and activated emergency response mechanisms, including surveillance, contact tracing, and isolation of confirmed cases. The Ministry of Health Press Statement dated 6 September 2024 states that “emergency response mechanisms were activated,” including deployment of rapid response teams, contact tracing for 49 individuals, and use of the National Isolation Facility in Entebbe ⁴¹³. The WHO Uganda National Mpox Situation Report #001 further confirms that “this marks 29 days of responding to the Mpox outbreak,” indicating sustained national-level coordination ⁴¹⁴. However, there is no public evidence that Uganda has conducted a national-level biological threat simulation exercise, either independently or in collaboration with WHO, in the past year. No such activity is referenced on the WHO Simulation Exercise Portal, the Ministry of Health website, or the National Emergency Coordination and Operations Centre ^415416417.

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 50

There is evidence that the country has identified a list of gaps and best practices in response, but there is no evidence of a developed plan to improve response capabilities. In March 2025, the Ministry of Health of Uganda, with support from the World Health Organization, conducted an Intra-Action Review (IAR) of the ongoing mpox outbreak response ⁴¹⁸. The IAR aimed to reflect on the response, identify operational gaps and best practices, and refine strategies to improve outbreak management and reduce health and socioeconomic impacts. According to the WHO report, the IAR discussions highlighted challenges such as fragmented data management, overlapping mandates, and resource gaps, and recommended strengthening coordination mechanisms, expanding technical guidance, and institutionalizing real-time partner tracking ⁴¹⁹. The broader response included activation of the National Public Health Emergency Operations Centre, deployment of 61 national and 432 district rapid response teams, and coordination through District Task Forces and Regional Emergency Operations Centres ⁴²⁰. However, no formal improvement plan or IAR report has been published to date, and no specific activities have been publicly documented as direct outcomes of the IAR. No further evidence was found on the Ministry of Health website ⁴²¹ or the WHO Strategic Partnership Portal ⁴²².

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that the country in the past year has undergone a national-level biological threat-focused exercise that has included private sector representatives. While Uganda has conducted strategic planning workshops and stakeholder engagements related to tuberculosis, leprosy, and malaria control in 2024 and 2025, these activities were not biological threat-focused simulation exercises and did not explicitly include private sector participation. For example, the National Strategic Plan for Tuberculosis and Leprosy Control 2020/21–2024/25, developed by the Ministry of Health, outlines multisectoral coordination and monitoring frameworks but does not reference simulation exercises or private sector involvement in emergency preparedness activities ⁴²³. Similarly, the Malaria Reduction and Elimination Strategic Plan 2021–2025 provides a framework for intervention scale-up involving various stakeholders, but does not mention biological threat simulations or private sector engagement in such exercises ⁴²⁴. A 2024 performance review meeting for the TB and Leprosy Program convened 68 participants from the Ministry of Health, WHO, donors, and implementing partners, but the private sector was only referenced in general terms and not as participants in a biological threat-focused exercise ⁴²⁵. No further evidence is available on the WHO Strategic Partnership Portal, the Ministry of Health website, the Department of Disaster Preparedness and Management National Emergency Coordination and Operations Centre, or WHO's Simulation Exercise portal ^426427428429.

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

There is evidence that the country has in place an Emergency Operations Center (EOC). Uganda established a Public Health Emergency Operations Centre (PHEOC) in 2013 under the Ministry of Health to coordinate responses to public health threats, including disease outbreaks, natural disasters, and other emergencies. According to the Ministry of Health’s official brochure, the PHEOC was created to serve as the central incident management hub for public health emergencies, enabling the Ministry to implement the Incident Management System (IMS) and coordinate multi-agency responses ⁴³⁰. The brochure outlines that the PHEOC provides physical space for subject matter experts, real-time information analysis, and communication infrastructure to support emergency response operations ⁴³¹. The PHEOC is also responsible for issuing daily situation reports and coordinating with the National Task Force during emergencies.

The PHEOC continues to function as a central hub for emergency preparedness and response, and its capacity has been strengthened through initiatives such as the AVoHC-SURGE training conducted in 2024. This training, supported by WHO and Africa CDC, aimed to enhance national and sub-national emergency response capabilities by building a deployable workforce and improving coordination between national and regional actors ⁴³².

Additionally, Uganda has established 12 Regional Emergency Operations Centres (REOCs) to support decentralized coordination. These REOCs are integrated into the national emergency response framework and are responsible for localized incident management, logistics coordination, and information flow. The Mbale Regional EOC, for example, has been active in disaster response, including during the 2022 floods that affected multiple districts in eastern Uganda ⁴³³. The REOCs are referenced in Uganda’s Multihazard Preparedness and Response Framework for Public Health Emergencies, which outlines their role in surge capacity, coordination, and continuity of essential services during emergencies ⁴³⁴.

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is evidence that Uganda’s Emergency Operations Center (EOC) conducts simulation exercises for public health emergency scenarios, but there is no publicly available evidence that it is required to do so annually. In July 2025, Uganda conducted a full-scale simulation exercise in Jinja City to test the deployment and operational readiness of its National Emergency Medical Team (nEMT) in response to a simulated Ebola outbreak. The exercise was coordinated by the Ministry of Health with support from WHO and other partners and included infection prevention and control, logistics, and inter-agency coordination ⁴³⁵.
Additionally, published literature indicates that between 2014 and 2021, Uganda completed 21 simulation exercises through its Public Health Emergency Operations Center (PHEOC), demonstrating a strong history of conducting drills ⁴³⁶. However, neither the Multihazard Preparedness and Response Framework for Public Health Emergencies nor the Office of the Prime Minister’s disaster preparedness documentation specifies a mandatory annual requirement for these drills ⁴³⁷⁴³⁸.

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no public evidence to show that the Emergency Operations Center (EOC) has conducted within the last year a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency/scenario. In July 2025, Uganda conducted a full-scale simulation exercise in Jinja City to test the operational readiness of its National Emergency Medical Team (nEMT) in response to a simulated Ebola outbreak. The exercise was coordinated by the Ministry of Health and WHO under the INITIATE² project and included detection, investigation, and response components ⁴³⁹. However, there is no publicly available evidence indicating that the response was activated within 120 minutes of scenario identification.

Uganda has also strengthened its emergency response capacity through the AVoHC-SURGE training conducted in 2024. This training, led by the World Health Organization and supported by the Foreign, Commonwealth & Development Office, involved 78 multidisciplinary responders and emphasized rapid response coordination, outbreak investigation, and inter-agency collaboration ⁴⁴⁰. While the training focused on improving response speed and coordination, no specific documentation confirms activation within 120 minutes of emergency identification.

The latest Joint External Evaluation for Uganda, conducted in October 2023, commended the country for having one of the best emergency preparedness and response systems in Africa. However, the WHO JEE activities page lists the event as "conducted" without providing a downloadable report or summary, and no specific evidence of activation timelines is available ^{441 442}.

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 100

There is public evidence that public health, animal health, and national security authorities have carried out an exercise to respond to a potential deliberate biological event. In 2025, Uganda conducted a multisectoral AVoHC-SURGE training coordinated by the Ministry of Health and the World Health Organization. The training included participants from the Ministry of Health, Ministry of Agriculture, Ministry of Internal Affairs, Uganda Defence Forces, and local government authorities. It involved scenario-based simulations and rapid deployment exercises designed to strengthen national coordination and response to public health emergencies, including deliberate biological threats ⁴⁴³.

Additionally, Uganda’s National Counterterrorism Centre (NCTC), established in 2013 by presidential directive, coordinates inter-agency counterterrorism operations and training, including biological threats. The NCTC brings together national security agencies and has been praised for strengthening inter-agency coordination and preparedness ⁴⁴⁴.

The 2023 Joint External Evaluation for Uganda, conducted in October 2023, involved multisectoral stakeholders and assessed Uganda’s capacity to respond to deliberate biological events. However, the report is not publicly available, and no specific SOPs or MOUs were found in the public domain ^{445 446}.

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

Uganda has a national framework that includes a section on risk communication intended for use during public health emergencies. The Multihazard Preparedness and Response Framework for Public Health Emergencies (2023) outlines risk and crisis communication as a core component of emergency response (Section 4.5) and includes provisions for risk communication and social mobilization (Section 4.10) ⁴⁴⁷. While the framework does not provide detailed operational guidance on tailoring messages for populations with different communication needs, such as language or geographic barriers, its inclusion of risk communication as part of emergency planning meets the requirement for this indicator. Other documents, such as the Ebola Virus Disease Response Plan (2022) and the IDSR guidelines, reference communication and community engagement but are either disease-specific or lack comprehensive operational detail ⁴⁴⁸⁴⁴⁹.

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 0

There is no sufficient public evidence that the risk communication plan, or other legislation, regulation, or strategy document used to guide national public health response, outlines how messages will reach populations and sectors with different communications needs. While the Uganda National Response Plan for Ebola Virus Disease Outbreak (2022) includes references to local language messaging and outreach to vulnerable groups, it is disease-specific and does not represent a general national risk communication strategy ⁴⁵⁰. The National Technical Guidelines for Integrated Disease Surveillance and Response (2021) mention community engagement and culturally appropriate communication, but do not provide detailed operational guidance on how messages will be tailored to different languages, geographic areas, or hard-to-reach populations ⁴⁵¹.

No additional evidence was found on the websites of the Ministry of Health, the Office of the Prime Minister, or the Department of Disaster Preparedness and Management National Emergency Coordination and Operations Centre to suggest the existence of a general risk communication plan addressing differentiated communication needs ^{452 453 454}.

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is no sufficient public evidence that the risk communication plan, or other legislation, regulation or strategy document used to guide national public health response, designates a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. The Uganda National Response Plan for Ebola Virus Disease Outbreak (2022) outlines a risk communication strategy coordinated by the Ministry of Health and involving media engagement and community leaders, but it does not identify a specific spokesperson role ⁴⁵⁵. The National Technical Guidelines for Integrated Disease Surveillance and Response (2021) emphasize risk communication and community engagement but do not assign a designated spokesperson ⁴⁵⁶.

No additional evidence was found on the websites of the Ministry of Health, the Office of the Prime Minister, or the Department of Disaster Preparedness and Management National Emergency Coordination and Operations Centre to suggest the existence of a designated spokesperson role in national risk communication planning ^{457 458 459}.

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

Uganda’s public health system has actively shared messages via online platforms to inform the public about health concerns and counter misinformation. In July 2025, the Ministry of Health conducted media orientation workshops in the Lango and Acholi subregions to strengthen public health emergency communication. These sessions trained over 50 journalists on ethical health reporting and rumor management. Mr. Tabley Bakyayita, Risk Communication Specialist at the Ministry, stated:
“Journalists are frontline responders in their own right. Accurate, timely, and responsible reporting can help contain outbreaks, reduce panic, and save lives” ⁴⁶⁰.
In June 2025, the Ministry clarified misinformation regarding a false resurgence of COVID-19, stating:
“The circulating messages are old clips being re-shared by unscrupulous individuals to mislead the members of the public” and reassured citizens that “the national situation remains stable and fully under control” ⁴⁶¹.
Furthermore, the electronic Community Health Information System (eCHIS) has been deployed to support community health workers in tracking immunization data and sending reminders. A community health worker noted:
“Seven years ago, parents used to hide their children from us because of fear and misinformation. Now, 9 out of 10 children are vaccinated because our mobile app helps us follow up more easily and gives reminders in real time” ⁴⁶².
In addition to these initiatives, the Ministry of Health website regularly publishes press releases and updates on health issues, including immunization campaigns, outbreak alerts, and public health advisories, which serve as official sources of information for the public ⁴⁶³. While social media activity appears limited, these examples demonstrate consistent and proactive use of official online platforms to share accurate information and dispel misinformation.

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no sufficient evidence that suggests senior leaders in Uganda, such as the president or ministers, have shared misinformation or disinformation on infectious diseases in the past two years. Available reports and media coverage highlight misinformation challenges at the community level, often driven by cultural beliefs, conspiracy theories, and local resistance to public health interventions ⁴⁶⁴. For example, during the malaria outbreak in Kibuku, some local leaders initially resisted indoor spraying due to misconceptions, but later supported government efforts after the situation worsened ⁴⁶⁵. However, these instances do not involve national-level senior leaders directly spreading false information.

On the contrary, ministries such as the Ministry of Health and the Ministry of ICT have actively led campaigns to counter misinformation and promote accurate health communication. In October 2024, the Ministry of ICT partnered with Next Media to launch a nationwide campaign against fake news, emphasizing the importance of verifying health-related information before sharing it online ⁴⁶⁶. Similarly, government communicators were trained and urged to proactively address disinformation, especially during public health emergencies, to maintain public trust and ensure effective response ⁴⁶⁷.

3.6.1a Percentage of households with Internet

Score: 50.86

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 41.26

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 63.33

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 75

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that Uganda implemented restrictions on the export or import of medical goods due to an infectious disease outbreak in the past year ^{468 469 470}. The Ministry of Health provides updates on outbreak responses and health policies, including the Uganda COVID-19 Response and Preparedness Project, but does not mention any trade restrictions related to medical goods ⁴⁷¹. The Ministry of Trade lists general procedures for import/export licensing under the External Trade Act, including amendments in 2022 and 2024, but these do not reference outbreak-related restrictions ⁴⁷². The Uganda Revenue Authority also lists prohibited and restricted goods, but there is no indication that medical goods were restricted due to infectious disease outbreaks ⁴⁷³.

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that Uganda implemented restrictions on the export or import of non-medical goods due to an infectious disease outbreak in the past year ^{474 475}. The Uganda Revenue Authority lists prohibited and restricted goods under customs regulations, but there is no indication that any restrictions were introduced in response to an infectious disease outbreak or based on international recommendations or structured decision mechanisms involving scientific evidence or expert input ⁴⁷⁶. The Ministry of Trade does not reference any outbreak-related trade restrictions in its licensing or regulatory frameworks ⁴⁷⁷.

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that Uganda implemented inbound or outbound travel restrictions due to an infectious disease outbreak in the past year ^{478 479 480}. The Ministry of Health issued a press release in June 2025 confirming that there was no resurgence of COVID-19 and that the national situation remained stable ⁴⁸¹. The Directorate of Citizenship and Immigration Control did not issue any new travel advisories or restrictions related to infectious disease outbreaks in 2024 or 2025 ⁴⁸². The Office of the Prime Minister, which coordinates national emergency responses, does not reference any travel restrictions in its public notices or strategic coordination updates ⁴⁸³. These sources indicate that no travel bans or restrictions were enacted during this period.

3.7.2b Risk-based approach to international travel-related measures

Score: 100

There is evidence that Uganda has applied a risk-based approach to international travel-related measures during public health emergencies. A study analyzing Uganda’s COVID-19 response at Entebbe International Airport describes how the government evaluated multiple policy options for screening and testing incoming travelers based on risk and cost-effectiveness. The analysis compared scenarios such as no screening, symptom screening with RT-PCR testing for symptomatic travelers, and mandatory quarantine with testing for all travelers. The study concluded that screening all incoming travelers, testing symptomatic persons, and isolating positives was the most cost-effective option, and the cost-effectiveness improved with higher prevalence among incoming travelers ⁴⁸⁴.
Additionally, Uganda’s early COVID-19 response included targeted measures such as mandatory quarantine and testing for travelers from high-risk countries, demonstrating the use of risk-based criteria rather than blanket restrictions ⁴⁸⁵. However, there is no publicly available evidence of a formalized framework or legislation mandating risk-based approaches beyond these outbreak-specific interventions.

4.1.1a Doctors per 100,000 people

Score: 2.33

4.1.1b Nurses and midwives per 100,000 people

Score: 30.17

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 100

There is evidence that the country has a health workforce strategy in place which has been updated in the past five years to identify fields where there is an insufficient workforce and strategies to address these shortcomings. The Ministry of Health published the Human Resources for Health Strategic Plan 2020–2030, with an operational rollout plan covering 2020/21–2024/25. The strategy outlines goals to strengthen human resource management systems, develop adequate health workforce to meet changing health needs, and improve workforce planning and productivity. It includes specific objectives such as aligning staffing norms with service delivery needs, expanding training capacity, and improving retention and distribution of health workers ⁴⁸⁶. The plan also includes adaptive workforce planning and a performance monitoring framework to track progress ⁴⁸⁷.

The strategy is referenced in the Environmental and Social Management Framework for the Uganda COVID-19 Response and Emergency Preparedness Project, which identifies the Human Resources for Health Management Information System (HRHMIS) as a key tool for workforce planning and monitoring ⁴⁸⁸. Additionally, the 2023 Joint External Evaluation conducted by WHO confirms that Uganda has made progress in strengthening its health workforce governance and planning, although it also recommends further improvements in multisectoral coordination and workforce surge capacity ^{489 490}.

4.1.1d Health system capacity for essential health services

Score: 100

Uganda has defined the Uganda National Essential Health Care Package (UNEHCP), updated in August 2024, which outlines promotive, preventive, curative, rehabilitative, and palliative services intended for delivery at all levels of the health system ⁴⁹¹. The Ministry of Health Strategic Plan 2020/21–2024/25 prioritizes investments in infrastructure, human resources, and service delivery systems ⁴⁹². However, recent evidence indicates significant gaps in actual capacity to deliver these services.

The Joint External Evaluation of the International Health Regulations (2005) core capacities of Uganda states that continuity of essential health services in Uganda is underpinned by a robust framework supported by well-defined policies and guidelines. This ensures the seamless provision of health care, both in routine situations and during emergencies. The country benefits from a skilled workforce and a functional health system structure that extends to Village Health Teams at the grassroots level, facilitating the effective implementation of continuity of essential health services across communities. Additionally, the presence of well-established programmes targeting prevalent diseases such as TB, malaria, and HIV highlights the country’s commitment to maintaining essential health services for all. The country team proposed a score of 4, which was approved by the external team.⁴⁹³

According to the Annual Health Sector Performance Report for FY 2023/24, Uganda had 160 hospital beds per 100,000 population, 94 nurses and midwives per 100,000, and 19 medical doctors per 100,000 ⁴⁹⁴. These figures remain below WHO-recommended thresholds. A 2023 study reports a 40.3% shortage in basic obstetric care and health care provider density between 0.46 and 0.54 per 1,000 population, far below the WHO benchmark of 4.45 per 1,000 ⁴⁹⁵. Additionally, Uganda faces a shortage of over 180,000 health workers, with only 155,000 currently employed against a requirement of 342,832 cadres ⁴⁹⁶.
These shortages, combined with persistent gaps in specialist care and recruitment delays, indicate that while frameworks and plans exist, the health system does not have sufficient capacity to consistently deliver essential health services nationwide.

4.1.1e Essential health services continuity plan for public health emergencies

Score: 100

There is evidence that Uganda has a plan to ensure continuity of essential health services during a public health emergency ⁴⁹⁷. The Multihazard Preparedness and Response Framework for Public Health Emergencies (2023) includes a dedicated section on “Continuity of Essential Health Services during multi-hazards,” outlining strategies for maintaining critical services such as maternal and child health, immunization, and chronic disease care during emergencies ⁴⁹⁸. These provisions cover surge capacity, logistics, and coordination mechanisms to sustain service delivery when routine systems are disrupted. Additionally, the Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP) incorporated continuity measures, including supply chain management, community health worker engagement, and emergency procurement systems ⁴⁹⁹. The Ministry of Health also issued guidance during the COVID-19 pandemic on maintaining essential health services, which remains relevant for future emergencies ⁵⁰⁰. These documents collectively demonstrate that Uganda has institutionalized continuity planning as part of its emergency preparedness framework.

4.1.2a Hospital beds per 100,000 people

Score: 8.6

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 100

There is evidence that Uganda has capacity to isolate patients with highly communicable diseases in specialized isolation facilities. The Ministry of Health notes that the National Isolation Centre at Entebbe, funded by the World Bank, was completed to strengthen Uganda’s ability to manage high-risk pathogens ⁵⁰¹. While detailed technical specifications of the facility are not publicly available, published literature confirms that Uganda established a dedicated isolation unit for viral hemorrhagic fevers, including Ebola, as part of its preparedness and response infrastructure ⁵⁰².
The National Guidelines for Clinical Management of COVID-19 also reference designated isolation sites for severe cases ⁵⁰³. Additionally, Uganda’s participation in WHO-supported emergency preparedness initiatives and its operational experience during Ebola outbreaks indicate the presence of functional isolation capacity ^504505506.

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is insufficient public evidence that the country has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years, nor is there evidence that the country has developed, updated or tested a plan to expand isolation capacity in response to an infectious disease outbreak in the past two years. While the Ministry of Health notes that the National Isolation Centre at Entebbe was completed with World Bank support, there is no publicly available documentation confirming that the facility has been expanded or tested in the two years preceding early July 2025 ⁵⁰⁷. The 2023 WHO Country Disease Outlook for Uganda does not mention any recent developments or exercises related to isolation capacity ⁵⁰⁸. No further evidence is available on the Ministry of Health’s infrastructure page or the main hospitals’ descriptions ⁵⁰⁹⁵¹⁰.

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

There is evidence that the country has a national procurement protocol in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies (e.g. equipment, reagents and media) and medical supplies (e.g. equipment, PPE) for routine needs. Uganda’s public procurement system is governed by the Public Procurement and Disposal of Public Assets Act, 2003, and its 2023 implementing regulations, which apply to all government entities including the Ministry of Health and the Ministry of Agriculture ⁵¹¹. The PPDA framework provides standardized procedures for procurement planning, solicitation, evaluation, contract award, and contract management, and includes provisions for emergency and framework contracting ⁵¹².

The Ministry of Health issued a public tender in March 2025 for the procurement of specialized equipment and reagents to support outbreak laboratory network preparedness and readiness to respond to pandemics. The procurement was financed by the Arab Bank for Economic Development in Africa (BADEA) and is part of Uganda’s broader laboratory strengthening strategy ⁵¹³. This demonstrates the operational use of the national procurement system for laboratory supplies.

The Essential Medicines and Health Supplies List for Uganda (EMHSLU) 2023, published by the Ministry of Health, outlines the national policy for the selection and procurement of essential medicines, laboratory reagents, and medical supplies. It is aligned with the Uganda Clinical Guidelines and is used by public health institutions to guide procurement and supply chain management ⁵¹⁴.

In addition, the National Medical Equipment Management Guidelines (2024) provide a standardized framework for the acquisition, distribution, maintenance, and disposal of medical equipment across all levels of the health system. The guidelines include a Medical Equipment Master List and are designed to complement the PPDA Act and other national policies. These guidelines are applicable to both routine and emergency procurement and are intended for use by procurement officers, health facility managers, and development partners ⁵¹⁵.

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 0

There is insufficient public evidence that Uganda has a stockpile of medical supplies (e.g., MCMs, medicines, vaccines, medical equipment, PPE) for national use during a public health emergency defined by the overarching national public health emergency response plan. The National Medical Stores (NMS) is mandated to procure, store, and distribute essential medicines and medical supplies to all public health facilities in Uganda, and operates a national warehouse system with a routine delivery schedule and inventory management system ⁵¹⁶. However, there is no publicly available documentation specifying the existence, contents, or operational protocols of a dedicated emergency stockpile aligned with the national public health emergency response plan. The 2023 Joint External Evaluation conducted by WHO does not confirm the existence of such a stockpile or a national-level plan for equitable distribution during emergencies ⁵¹⁷⁵¹⁸. A review of the Ministry of Health, Office of the Prime Minister, and National Drug Authority websites also does not yield evidence of a formalized national stockpile or distribution plan ^519520521. The Medical Countermeasures (MCM) Plan 2024 published by the Ministry of Health includes provisions for creating and maintaining a national stockpile and outlines strategies for equitable distribution during emergencies, but it is unclear whether these provisions have been implemented ⁵²².

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is insufficient public evidence that Uganda maintains a stockpile of laboratory supplies (e.g., reagents, media) for national use during a public health emergency. The National Medical Stores (NMS) is responsible for the procurement and distribution of laboratory supplies and equipment to public health facilities, and recent procurement notices confirm ongoing acquisition of laboratory reagents and instruments for routine and outbreak-related use ⁵²³⁵²⁴. However, there is no publicly available documentation specifying the existence, contents, or operational protocols of a dedicated national stockpile of laboratory supplies. The new Kajjansi warehouse, nearing completion, will significantly expand national storage capacity and includes cold rooms and specialized storage areas, but it is not described as a strategic emergency stockpile ⁵²⁵. The 2023 Joint External Evaluation conducted by WHO does not confirm the existence of a national laboratory stockpile ⁵²⁶⁵²⁷. A review of the Ministry of Health, Office of the Prime Minister, and National Drug Authority websites also does not yield evidence of a formalized laboratory stockpile for emergency use ^528529530. The Medical Countermeasures (MCM) Plan 2024 published by the Ministry of Health includes provisions for creating and maintaining stockpiles of medical countermeasures, which may include laboratory supplies, but it is unclear whether these provisions have been implemented ⁵³¹.

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is insufficient public evidence that Uganda conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency. The 2023–2028 National Medical Countermeasures Plan for Public Health Emergencies, published by the Ministry of Health, emphasizes the principle of a national stockpile and prepositioning to ensure continuous availability and accessibility of medical countermeasures during public health emergencies ⁵³². However, the document does not specify that an annual review of the stockpile is required or conducted. The latest WHO Joint External Evaluation, conducted from 23–27 October 2023, does not mention a national stockpile or an annual review process in the section on health emergency management (R1) or related technical areas ⁵³³. The 2017 Joint External Evaluation for Uganda noted the existence of national medical stores and blood banks but did not mention a national stockpile or annual review mechanisms ⁵³⁴. No additional evidence of a mandated or implemented annual review of a national stockpile was found on the websites of the Ministry of Health, Office of the Prime Minister, Ministry of Defence, National Drug Authority, or the National Emergency Coordination and Operations Centre ^{535 536 537 538 539}.

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

There is evidence of a plan or mechanism to procure medical supplies (e.g. MCMs, medicines, vaccines, equipment, PPE) for national use during a public health emergency. Uganda operates a centralized procurement system regulated by the Public Procurement and Disposal of Public Assets Authority (PPDA), under the Public Procurement and Disposal of Public Assets Act, 2003 (Cap. 205), which includes provisions for emergency procurement. Section 85 of the Act allows for direct procurement in emergency situations, enabling expedited acquisition of goods and services when urgent needs arise ⁵⁴⁰. The Ministry of Health has also issued the National Medical Equipment Management Guidelines in 2024, which promote flexible procurement mechanisms such as hire purchase arrangements, placement models, and managed equipment contracts to improve access to essential medical technologies during emergencies. These guidelines are valid from November 2024 and were developed by the Ministry of Health in collaboration with CHAI and Enabel Uganda ⁵⁴¹. However, there is no public evidence of a formal plan or agreement to leverage domestic manufacturing capacity for emergency production, nor is there evidence of a specific mechanism to expedite medical supplies through points of entry. No such provisions are mentioned in the National Medical Equipment Guidelines ⁵⁴², the Ministry of Health website ⁵⁴³, or the National Drug Authority’s regulatory framework ⁵⁴⁴. The latest WHO Joint External Evaluation, conducted from 23–27 October 2023, does not reference any formal mechanism for leveraging domestic manufacturing or expediting medical supplies through points of entry ⁵⁴⁵.

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 100

There is evidence of a plan or mechanism to procure laboratory supplies (e.g. reagents, media) for national use during a public health emergency. The Ministry of Health has implemented procurement frameworks for laboratory reagents and equipment through the National Medical Stores, including tenders for outbreak preparedness and pandemic response, such as the 2025 procurement of specialized equipment and reagents to support outbreak laboratory network preparedness ⁵⁴⁶. The Uganda Essential Medicines and Health Supplies Management Manual (3rd edition, 2023) outlines procedures for emergency requisitioning and ordering of laboratory supplies, including the use of the eELMIS system to track emergency orders ⁵⁴⁷. The Public Procurement and Disposal of Public Assets Act, 2003 (Cap. 205), as amended, allows for direct procurement in emergency situations under Section 85 ⁵⁴⁸. The latest WHO Joint External Evaluation, conducted from 23–27 October 2023, confirms that Uganda has mechanisms for emergency procurement of laboratory supplies ⁵⁴⁹. However, there is no public evidence of a formal plan to expedite laboratory supplies through points of entry or to leverage domestic manufacturing capacity. No such provisions are mentioned in the 2023 JEE report ⁵⁵⁰, the Ministry of Health website ⁵⁵¹, the National Drug Authority website ⁵⁵², or the PPDA’s procurement framework ⁵⁵³.

4.2.3c Mechanism emergency logistics and supply chain management

Score: 0

There is insufficient evidence to indicate that Uganda has a system or mechanism for national and subnational levels for emergency logistics and supply chain management that is regularly exercised, reviewed, evaluated, or updated, or that explicitly includes cold chain management and public-private sector coordination. The Ministry of Health’s 2023 baseline assessment on logistics preparedness recommends establishing two national supply chain responses—regular and emergency—and redesigning core processes to support emergency transitions, but does not confirm that such a system is currently operational or regularly exercised ⁵⁵⁴. The Uganda Essential Medicines and Health Supplies Management Manual (3rd edition, 2023) outlines general logistics principles and includes a section on emergency requisitioning, but does not describe a dedicated emergency logistics system or its evaluation cycle ⁵⁵⁵. The Standard Operating Procedures Manual for Supply Chain Management (2019) includes procedures for ordering medical countermeasures for public health emergencies, but does not confirm regular review or integration with private sector logistics ⁵⁵⁶. Uganda participated in the AVoHC-SURGE training initiative in 2024, which included emergency response capacity building, but the publicly available documentation does not confirm that logistics and supply chain coordination was a specific component of the training ⁵⁵⁷. Uganda’s cold chain capacity has been strengthened through initiatives such as the installation of 500 solar-powered vaccine refrigerators and the launch of the Vaccine Last Mile Delivery initiative, but these are not described as part of a national emergency logistics system ^{558 559}. The 2023 Joint External Evaluation for Uganda does not confirm the existence of a comprehensive, regularly maintained emergency logistics and supply chain mechanism ⁵⁶⁰.

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 100

There is evidence that Uganda has a plan and guidelines in place for dispensing medical countermeasures (MCMs) for national use during a public health emergency. The National Medical Countermeasures Plan for Public Health Emergencies 2023–2028, published by the Ministry of Health, outlines Uganda’s strategy for ensuring the availability and accessibility of MCMs, including antibiotics, vaccines, therapeutics, and diagnostics. The plan includes provisions for prepositioning, deployment, and dispensing of MCMs during emergencies, and is implemented under the One Health framework ⁵⁶¹. The plan also references coordination with the National Medical Stores and outlines roles for district and facility-level actors in dispensing MCMs. Additionally, the Standard Operating Procedures Manual for Supply Chain Management at Health Facility Level (2019) includes a dedicated section on ordering and dispensing medical countermeasures for public health emergencies, specifying responsibilities and procedures for emergency requisitioning and distribution ⁵⁶². The Uganda Clinical Guidelines 2023 provide updated protocols for the diagnosis and treatment of common conditions, including the use of antibiotics and other MCMs, and serve as a reference for rational dispensing practices during emergencies ⁵⁶³. The 2023 Joint External Evaluation confirms that Uganda has developed and implemented a national MCM plan, although it notes that further improvements are needed in coordination and operational readiness ⁵⁶⁴.

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 100

There is evidence that Uganda has a public plan in place to facilitate workforce surge in an emergency. The Uganda COVID-19 Response Project, supported by the World Bank, includes provisions for mobilizing and deploying health personnel during public health emergencies, particularly through the Community Health Extension Workers strategy and surge staffing for case management and vaccination campaigns ⁵⁶⁵. The Environmental and Social Management Framework for the Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP), published by the Ministry of Health, outlines institutional arrangements for emergency workforce deployment, including coordination with District Health Teams and the Human Resources for Health Management Information System (HRHMIS) ⁵⁶⁶. Additionally, the second National Action Plan for Health Security (NAPHS), launched in 2023, includes strategic actions to strengthen Uganda’s capacity to mobilize and deploy health personnel during emergencies ⁵⁶⁷.
While some plans were developed in the context of COVID-19, the NAPHS provides a broader framework for health security beyond disease-specific scenarios, suggesting that surge capacity planning remains relevant for future emergencies.

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no publicly available evidence that Uganda has a formal plan to receive health personnel from other countries during a public health emergency. The 2023 Joint External Evaluation does not reference any mechanism for foreign health workforce reception ⁵⁶⁸. The National Medical Countermeasures Plan for Public Health Emergencies 2023–2028 focuses on domestic deployment and logistics coordination under the One Health framework, without provisions for international personnel ⁵⁶⁹. The Environmental and Social Management Framework for the Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP) addresses domestic surge capacity and district-level coordination, but does not mention foreign personnel ⁵⁷⁰. No relevant provisions were found on the official websites of the Ministry of Health ⁵⁷¹, the Office of the Prime Minister ⁵⁷², the Ministry of Foreign Affairs ⁵⁷³, or the National Emergency Coordination and Operations Centre ⁵⁷⁴.

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is insufficient public evidence that Uganda has a specific and publicly available plan in place to redeploy existing health personnel within the country, either geographically or by role. The Uganda COVID-19 Preparedness and Response Plan (March 2020–June 2021) outlines a framework for coordination and control of the pandemic, including surge staffing and deployment of additional personnel, but does not include a formalized mechanism for redeployment of existing staff across regions or roles ⁵⁷⁵. The Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP) includes provisions for expanding health workforce capacity through recruitment and deployment of Community Health Extension Workers (CHEWs), but does not specify internal redeployment protocols for existing personnel ⁵⁷⁶. The Environmental and Social Management Framework (ESMF) for UCREPP references mobilization of human resources during emergencies, including coordination with District Health Teams and the Human Resources for Health Management Information System (HRHMIS), but does not outline a structured or operational plan for redeployment ⁵⁷⁷. The Human Resources for Health Strategic Plan 2020–2030 includes strategic objectives for improving workforce responsiveness and resilience, but does not provide a detailed or actionable framework for redeployment during emergencies ⁵⁷⁸. The 2023 Joint External Evaluation does not confirm the existence of a national redeployment plan for health personnel ⁵⁷⁹.

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 50

There is no evidence that suggests the Constitution of Uganda explicitly guarantees citizens’ right to medical care. The Constitution includes National Objectives and Directive Principles of State Policy, such as Objective XIV(b), which states that the State shall ensure that all Ugandans enjoy access to health services, but this is aspirational and not legally enforceable ⁵⁸⁰. The Constitution does not contain a specific article that guarantees a universal or enforceable right to medical care. WHO resources confirm that Uganda, like all Member States, has ratified international treaties recognizing the right to health, such as the International Covenant on Economic, Social and Cultural Rights, but these commitments are not reflected as explicit constitutional guarantees ⁵⁸¹.

4.4.1b Access to skilled birth attendants (% of population)

Score: 82.35

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 94.74

4.4.1d Coverage of essential health services through universal health coverage

Score: 45.83

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 50.68

4.4.1f Rate of mortality amenable to health care

Score: 75.62

4.4.2a Guaranteed paid sick leave

Score: 66.67

There is evidence that workers in Uganda are guaranteed paid sick leave under the Employment Act, 2006. Section 54 of the Act provides that an employee is entitled to full wages during sick leave for up to one month in any calendar year, provided that the illness is certified by a medical practitioner ⁵⁸². The law applies to any condition that renders the employee incapable of work, but it does not explicitly mention mental health conditions as a basis for sick leave. However, the Act’s definition of “disability” includes psychiatric illness and psychological impairment, which may imply coverage under broader disability protections ⁵⁸³. Uganda’s Child and Adolescent Mental Health Policy Guidelines (2017), issued by the Ministry of Health, outline the government’s commitment to improving access to mental health services and integrating mental health into primary care, but they do not establish enforceable labor rights or entitlements to sick leave for mental health reasons ⁵⁸⁴. No additional evidence was found in the Ministry of Health’s labor-related publications ⁵⁸⁵, the Uganda Law Reform Commission’s legislative database ⁵⁸⁶, or the Uganda Legal Information Institute’s repository of employment regulations ⁵⁸⁷ to confirm explicit coverage of mental health under sick leave entitlements.

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no sufficient evidence that suggests the government has issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. The latest Joint External Evaluation for Uganda, conducted in October 2023, does not mention any such commitment in the sections related to health services provision or health emergency management ⁵⁸⁸, ⁵⁸⁹. The Ministry of Health’s Human Resources for Health Strategic Plan 2020–2030 outlines general goals for workforce resilience but does not include provisions for prioritized healthcare access for emergency responders ⁵⁹⁰. The National Emergency Medical Services Policy (2021) and the National Essential Health Care Package (2024) also do not contain any specific commitments to prioritize healthcare services for affected healthcare workers ⁵⁹¹, ⁵⁹². The National Policy for Disaster Preparedness and Management (2010) discusses general disaster response but does not include provisions for healthcare worker prioritization ⁵⁹³.

4.5.1a Existence of system for communication during a public health emergency

Score: 100

There is evidence of a system in place for public health officials and healthcare workers to communicate during a public health emergency. The Ministry of Health operates the Emergency Medical Services ECHO (MOH EMS ECHO) initiative, which facilitates biweekly tele-mentorship sessions and quarterly hands-on training for healthcare workers across the country. These sessions use video conferencing and case-based learning to connect healthcare professionals with subject matter experts, enabling real-time communication and knowledge sharing during emergencies [1]. The Multihazard Preparedness and Response Framework for Public Health Emergencies, approved in October 2023, outlines protocols for information flow and reporting during emergency response, including coordination mechanisms between different departments and healthcare actors [2]. The Joint External Evaluation for Uganda, conducted in October 2023, confirms the existence of structured communication systems within the Public Health Emergency Operations Centre (PHEOC), which supports coordination and communication among stakeholders during health emergencies [3 [4].

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is no sufficient evidence that suggests the system for public health officials and healthcare workers to communicate during an emergency encompasses healthcare workers in both the public and private sector. The Emergency Medical Services Uganda Report (2023) outlines coordination mechanisms and training for emergency response but does not specify whether private sector healthcare workers are included in these systems ⁵⁹⁴. The National Emergency Medical Services Policy, issued by the Ministry of Health in September 2021, identifies the private sector as a stakeholder in emergency medical services and includes Public Private Partnership in Health (PPPH) as one of its pillars, but it does not explicitly state that communication systems during emergencies include private sector healthcare workers ⁵⁹⁵. The Multihazard Preparedness and Response Framework for Public Health Emergencies, approved in October 2023, describes coordination and communication protocols during emergencies but does not mention the inclusion of private sector healthcare providers in these mechanisms ⁵⁹⁶. The Joint External Evaluation for Uganda, conducted in October 2023, confirms the existence of structured communication systems within the Public Health Emergency Operations Centre (PHEOC), but does not provide evidence that these systems systematically include private sector healthcare workers ^{597 598}.

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is no evidence that suggests the national public health system in Uganda is systematically monitoring for and tracking the number of healthcare associated infections (HCAI) that take place in healthcare facilities. While Uganda has implemented the Integrated Disease Surveillance and Response (IDSR) strategy and maintains national surveillance systems for priority diseases, there is no indication in the most recent IDSR technical guidelines that HCAIs are among the routinely tracked conditions ⁵⁹⁹. The Antimicrobial Resistance National Action Plan (2018–2023) includes objectives to strengthen infection prevention and control in healthcare settings, with the aim of reducing HCAIs, but it does not provide evidence of an operational surveillance system for tracking HCAI incidence ⁶⁰⁰. WHO country health profiles and technical documents also do not report on national-level HCAI surveillance in Uganda ⁶⁰¹.

4.6.1b Infection prevention and control programme

Score: 100

There is evidence that Uganda has a national infection prevention and control (IPC) programme in place. The Ministry of Health developed the Uganda National Infection Prevention and Control Guidelines, first published in 2013, which provide protocols for healthcare workers and community health workers on preventing and controlling transmissible infections. These guidelines include standard precautions, disinfection, sterilization, personal protective equipment, safe injection practices, and healthcare waste management ⁶⁰². The Ministry of Health also implemented the Infection Prevention and Control Training of Trainers Manual in 2018, which outlines the structure and functions of the National IPC Committee and the National IPC Technical Working Group ⁶⁰³. The Joint External Evaluation for Uganda, conducted in October 2023, confirms the existence of a national IPC programme and highlights its integration into health facility operations and emergency preparedness systems ⁶⁰⁴⁶⁰⁵.

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

There is evidence of a plan to ensure a safe environment in health facilities nationally. The Ministry of Health published the National Micro Planning Handbook for Water, Sanitation and Hygiene (WASH) in Healthcare Facilities in June 2022, which outlines strategies for improving WASH infrastructure in health facilities to reduce disease transmission and improve occupational health and service delivery ⁶⁰⁶. The Occupational Safety and Health Implementation Strategy, issued in 2011, provides a framework for workplace safety in health facilities, including the formation of health unit OSH committees, accident reporting systems, and provision of personal protective equipment ⁶⁰⁷. The Joint External Evaluation for Uganda, conducted in October 2023, confirms that Uganda has implemented IPC and WASH measures in health facilities as part of its health security strategy ⁶⁰⁸⁶⁰⁹.

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

There is evidence of a national requirement for ethical review before beginning a clinical trial. The Guidelines for the Conduct of Clinical Trials in Uganda, issued by the National Drug Authority (NDA) in 2019, require that all clinical trial protocols be reviewed and approved by a Research Ethics Committee (REC) before submission to the NDA. The guidelines define the REC as an independent body responsible for ensuring the safety, integrity, and rights of trial participants ⁶¹⁰. Additionally, the National Guidelines for Research Involving Humans as Research Participants, published by the Uganda National Council for Science and Technology (UNCST) in 2014, mandate that all research involving human participants must undergo ethical review and approval by an accredited REC before commencement. These guidelines outline the composition, functions, and review mechanisms of RECs, and specify that no research may begin without such approval ⁶¹¹. The Joint External Evaluation for Uganda, conducted in October 2023, confirms that Uganda has a functioning system for ethical oversight of clinical research, including the requirement for REC approval ⁶¹²⁶¹³.

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 0

There is no evidence that suggests Uganda has an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or a formal mechanism for mutual recognition of clinical trial results from other countries during ongoing pandemics or epidemics. The National Drug Authority’s “Guidelines for the Conduct of Clinical Trials in Uganda” outline the standard procedures for clinical trial approval but do not include provisions for expedited review in emergency contexts or for unregistered MCMs ⁶¹⁴. The National Drug Policy and Authority Act also does not provide for emergency use authorizations or fast-track mechanisms for clinical trials ⁶¹⁵. Uganda’s 2023–2028 National Medical Countermeasures Plan emphasizes preparedness and access to MCMs, but it focuses on stockpiling, logistics, and deployment rather than regulatory acceleration of clinical trials ⁶¹⁶. There is no evidence from the World Health Organization that Uganda has adopted expedited or mutual recognition procedures for clinical trials during public health emergencies ⁶¹⁷.

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

There is evidence that Uganda has a government agency responsible for approving new medical countermeasures (MCM) for humans. The National Drug Authority (NDA) is legally mandated under the National Drug Policy and Authority Act to regulate the approval of drugs, including medical countermeasures for human use ⁶¹⁸. The NDA is also responsible for overseeing clinical trials and post-trial evaluations, as outlined in the “Guidelines for the Conduct of Clinical Trials in Uganda” ⁶¹⁹. The Uganda National Council for Science and Technology (UNCST) supports this framework through its “National Guidelines for Research Involving Humans,” which reinforce the NDA’s role in approving and monitoring MCM-related research ⁶²⁰. The 2023–2028 National Medical Countermeasures Plan for Public Health Emergencies further confirms the NDA’s role in coordinating access to MCMs during public health emergencies ⁶²¹. WHO country documentation also recognizes the NDA as Uganda’s national regulatory authority for medicines ⁶²².

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is no evidence that suggests Uganda has an expedited process for approving medical countermeasures (MCM) for human use or a formal mechanism for recognizing approval decisions made elsewhere during public health emergencies. The National Guidelines for Research Involving Humans (2017) allow for expedited ethical review in cases involving minimal risk, but this applies to research ethics and not regulatory approval of MCMs ⁶²³. The National Drug Authority’s “Guidelines for the Conduct of Clinical Trials” and the National Drug Policy and Authority Act do not include provisions for accelerated approval pathways or mutual recognition agreements for MCMs during emergencies ⁶²⁴⁶²⁵. Uganda’s National Medical Countermeasures Plan for Public Health Emergencies (2023–2028) outlines strategies for stockpiling, logistics, and deployment of MCMs, but it does not establish a regulatory fast-track mechanism for emergency use authorization or expedited approval ⁶²⁶. There is also no evidence from the World Health Organization or other international sources that Uganda has adopted such expedited regulatory procedures ⁶²⁷.

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Uganda has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁶²⁸

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 100

There is evidence that epidemics and pandemics are integrated into Uganda’s national risk reduction strategy. The National Policy for Disaster Preparedness and Management, issued by the Office of the Prime Minister in April 2010, remains the foundational framework for disaster risk reduction in Uganda. Chapter 2.1.5 and 2.1.6 of the policy identify epidemics and human epidemics as key hazards and outline policy actions such as strengthening entomological, epidemiological, and disease surveillance systems to mitigate the risk of pandemics like influenza. The policy also mandates the development of preparedness and response plans and assigns responsibilities to institutions including the Ministry of Health, Ministry of Agriculture, and district-level disaster management committees ⁶²⁹.

The continued relevance of the 2010 policy is confirmed by its citation in recent government publications. The 2023–2028 National Medical Countermeasures Plan for Public Health Emergencies, published by the Office of the Prime Minister, references the 2010 policy as a guiding framework for national preparedness and response coordination ⁶³⁰. Similarly, the 2024 Multihazard Preparedness and Response Framework for Public Health Emergencies, developed by the Ministry of Health, builds on the principles of the 2010 policy and integrates epidemic and pandemic risks into broader disaster planning ⁶³¹. Uganda’s reaffirmed commitment to the Sendai Framework for Disaster Risk Reduction 2015–2030 further supports the inclusion of biological hazards such as epidemics and pandemics in its all-hazards approach ⁶³².

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

There is evidence that Uganda has cross-border agreements and participates in regional frameworks related to public health emergencies. Uganda is a member of the East African Community (EAC), which has adopted joint strategies for regional health security. In the 2018 EAC Joint Heads of State Retreat Communiqué, Uganda and its neighbors committed to strengthening the regional rapid response system and the network of medical reference laboratories to address pandemics, biosecurity threats, and other health emergencies. The communiqué specifically outlines commitments to harmonize health policies and enhance regional coordination mechanisms for epidemic preparedness and response ⁶³³.

Uganda’s 2023–2028 National Medical Countermeasures Plan for Public Health Emergencies, issued by the Ministry of Health, further emphasizes the importance of regional coordination and cross-border collaboration for the deployment of medical countermeasures and personnel during emergencies. Section 3.2 of the plan highlights Uganda’s participation in regional One Health platforms and its commitment to joint planning and resource sharing with neighboring countries ⁶³⁴.

Additionally, Uganda is a signatory to the EAC Regional One Health Strategy 2022–2027, which institutionalizes cross-border collaboration for managing zoonotic diseases and public health emergencies. The strategy outlines mechanisms for joint surveillance, risk communication, and coordinated response across partner states ⁶³⁵. Uganda also participates in the Strengthening Uganda’s Emergency Response and Recovery to COVID-19 Project, which includes cross-border surveillance and coordination with neighboring countries to manage disease hotspots in border districts such as Amuru, Kasese, and Busia ⁶³⁶.

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 100

There is publicly available evidence that the country has cross-border agreements, protocols, or MOUs with neighboring countries with regards to animal health emergencies. Uganda is a signatory to the Multilateral Memorandum of Understanding between the Federal Democratic Republic of Ethiopia, the Republic of Kenya, the Republic of South Sudan, and the Republic of Uganda on Cross-Border Animal Health Coordination, signed in 2016 and valid indefinitely. The MoU was published by the Ministry of Agriculture, Animal Industry and Fisheries of Uganda, and coordinated by IGAD, AU-IBAR, and EAC. The agreement outlines synchronized animal health legislation and policy enforcement interventions, joint planning and execution of strategic action plans, and harmonized surveillance and response mechanisms for transboundary animal diseases. These provisions are detailed in Articles 1–3 of the MoU document ⁶³⁷. Uganda also participates in the Eastern Africa Regional Animal Health Network (RAHN), established in 2008 and coordinated by IGAD/ICPALD and EAC, which facilitates regional coordination and information sharing on transboundary animal diseases and zoonoses. Uganda’s involvement was reaffirmed during the 6th RAHN meeting held in Kampala ⁶³⁸. Furthermore, Uganda is part of the Health Emergency Preparedness, Response and Resilience Programme (HEPRRP) coordinated by IGAD, which promotes integration of animal and environmental surveillance systems across borders. This initiative was discussed during a regional workshop held in August 2025 in Machakos, Kenya, and includes Uganda among its participating countries ⁶³⁹. The East African Community (EAC) also supports regional collaboration on disease surveillance and epidemic control, as outlined in Article 118 of the Treaty for the Establishment of the EAC, and Uganda is an active member of this framework ⁶⁴⁰.

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

There is evidence that Uganda has acceded to the Biological Weapons Convention (BWC), which has the same legal effect as ratification. According to the United Nations Office for Disarmament Affairs (UNODA) treaty database, Uganda acceded to the BWC on 12 May 1992, thereby becoming a State Party with full legal obligations under the treaty ⁶⁴¹.

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 100

There is evidence that Uganda has submitted confidence building measures (CBMs) for the Biological Weapons Convention (BWC) within the past three years. According to the official BWC Confidence Building Measures portal, Uganda submitted CBM reports in 2024 and 2025, demonstrating compliance with the reporting obligations under the Convention ⁶⁴².

5.3.1c Submission of UNSCR 1540 reports

Score: 100

There is publicly available evidence that Uganda has provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540. According to the official list of national reports maintained by the 1540 Committee, Uganda submitted its initial national report on 14 November 2005 (document S/AC.44/2004/(02)/125) and an additional report on 12 March 2010 (document S/AC.44/2007/25) ⁶⁴³. There is no evidence of more recent submissions beyond 2010. Therefore, Uganda has complied with the initial reporting obligation but has not provided updates in recent years.

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

There is no publicly available evidence that Uganda meets at least two of the following criteria: membership in the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction, the Australia Group, or the Proliferation Security Initiative. Uganda is not listed among the member states of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction, as confirmed by the official Global Partnership website ⁶⁴⁴. Uganda is also not listed among the participating states or adherents of the Australia Group, according to the official participant list maintained by the Department of Foreign Affairs and Trade of Australia ⁶⁴⁵. Uganda does not appear among the endorsing states of the Proliferation Security Initiative, as listed by the United States Department of State – Bureau of International Security and Nonproliferation ⁶⁴⁶.

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

There is evidence that Uganda has completed a Joint External Evaluation (JEE) and published a full public report in the last five years ⁶⁴⁷. Uganda conducted its second JEE from 23–27 October 2023, coordinated by the Office of the Prime Minister and the Ministry of Health with support from WHO and partners ⁶⁴⁸. The full mission report was published by WHO in August 2025 and is available on the WHO website ⁶⁴⁹. This report assesses Uganda’s International Health Regulations (2005) core capacities and provides recommendations for strengthening health security.

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

There is no evidence that Uganda has completed and published a Performance of Veterinary Services (PVS) assessment in the last five years. The most recent publicly available PVS evaluation for Uganda was conducted in 2012, and a follow-up evaluation occurred in 2018, according to WOAH regional documentation ⁶⁵⁰⁶⁵¹. However, no PVS evaluation, gap analysis, or related report has been published since 2018, which is outside the five-year window for this indicator ^652653654.

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

There is no evidence that suggests Uganda has completed and published a Performance of Veterinary Services (PVS) gap analysis in the last five years. Uganda is not listed among the countries with a publicly available PVS gap analysis report on the World Organisation for Animal Health (WOAH) website, and no such report has been published since 2020 ^655656657.

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 100

There is evidence that Uganda has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years. The Health Sub Programme Grant, Budget and Implementation Guidelines for Local Governments for FY 2022/23, issued by the Ministry of Health, earmarked 30% of Non-Wage Recurrent funds at each level of care for activities related to health promotion, disease prevention, and public health emergency response ⁶⁵⁸. This allocation demonstrates the use of domestic resources to strengthen preparedness and response capacity.

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no sufficient evidence that the Joint External Evaluation (JEE) report, National Action Plan for Health Security (NAPHS), or national GHSA roadmap allocates or describes specific funding from the national budget to address identified gaps. The National Action Plan for Health Security (NAPHS) 2019–2023 outlines the need to “map and align existing and potential domestic and external financing to support NAPHS implementation,” but does not specify any national budget allocations or time-bound financial commitments ⁶⁵⁹. The 2021 Uganda Multi-Sectoral Self-Assessment and Operational Planning Report includes a 2021–2022 operational plan with prioritized activities and timelines, but does not reference specific national budget allocations ⁶⁶⁰.
The Second Joint External Evaluation of Uganda, published in October 2023, provides recommendations and priority actions but does not include evidence of specific national budget allocations for addressing gaps ⁶⁶¹. Uganda launched the Second National Action Plan for Health Security (NAPHS II) in June 2024, but the launch announcement does not mention any specific national budget allocations or financial commitments ⁶⁶². Uganda has not published a national GHSA roadmap that includes budgetary allocations.

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

There is no evidence that suggests the Performance of Veterinary Services (PVS) gap analysis and/or PVS assessment allocates or describes specific funding from the national budget to address the identified gaps. Uganda has not published a PVS gap analysis in the last five years, and the most recent publicly available PVS assessment, conducted in 2012, does not include any reference to national budget allocations for addressing identified gaps ^663664665.

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is a publicly identified special emergency public financing mechanism and funds which the country can access in the face of a public health emergency. Uganda is eligible for International Development Association (IDA) support and has received financing through the World Bank’s Pandemic Emergency Financing Facility (PEF) and the Uganda COVID-19 Response and Emergency Preparedness Project (UCREPP). The PEF was designed to provide rapid financing to low-income countries during large-scale outbreaks and Uganda received US$2.7 million from the facility in 2020 to support its COVID-19 response ⁶⁶⁶. UCREPP was approved by the World Bank on 15 July 2020 and implemented by the Ministry of Health and the Ministry of Finance, Planning and Economic Development. It included a Contingency Emergency Response Component (CERC), which allowed for rapid reallocation of funds in response to public health emergencies, and covered activities such as vaccine procurement, deployment, and strengthening of essential health services ⁶⁶⁷. In December 2021, Uganda secured an additional US$180.3 million in financing under IDA to expand vaccine access and support continuity of health services ⁶⁶⁸.

While Uganda’s National Policy for Disaster Preparedness and Management, issued by the Office of the Prime Minister, recommends the establishment of a National Disaster Preparedness and Management Fund, there is no publicly available evidence that such a dedicated national reserve fund has been created or operationalized ⁶⁶⁹⁶⁷⁰.

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is publicly available evidence that senior leaders in Uganda, in the past three years, have made a public commitment to improve the country’s domestic capacity to address pandemic or epidemic threats by expanding financing and strengthening health systems. In April 2024, the Minister of Health, Hon. Dr. Jane Ruth Aceng Ocero, reaffirmed Uganda’s commitment to achieving Universal Health Coverage by 2030, emphasizing investments in health workforce development, vaccine research, and preparedness for public health emergencies such as Ebola and COVID-19 ⁶⁷¹. In May 2025, the Prime Minister, Rt. Hon. Robinah Nabbanja, reiterated this commitment during a national dialogue on sustainable health financing, highlighting the government’s efforts to expand access to healthcare and reduce reliance on donor funding ⁶⁷². Uganda’s 2023 Health Financing Progress Matrix assessment, conducted by the World Health Organization, identified priority areas for increased domestic health financing, including reducing catastrophic health spending and improving service coverage ⁶⁷³.

There is no publicly available evidence that senior leaders have made a commitment to support other countries in improving their pandemic or epidemic preparedness capacities. No such statements or initiatives were found on the websites of the Ministry of Foreign Affairs, the Office of the Prime Minister, or the Ministry of Health ^{674 675}.

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Uganda has, in the past three years, requested financing and technical support from donors to improve its domestic capacity to address epidemic threats. In September 2024, Uganda requested and received nearly US$1 million from the Global Fund to support its response to the mpox outbreak. The funding was allocated for case management, laboratory testing, surveillance, and community engagement activities ⁶⁷⁶.
Additionally, in March 2025, the United Nations in Uganda launched a joint emergency appeal for US$11.2 million to support the national response to the Ebola outbreak. UN agencies, including WHO and UNICEF, mobilized resources and provided technical, logistical, and operational support, including disease surveillance, case detection and management, infection prevention and control, and risk communication ⁶⁷⁷.
There is no sufficient evidence that Uganda has provided other countries with financing or technical support to improve capacity to address epidemic threats.

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

There is evidence that Uganda has fulfilled its full contribution to the World Health Organization (WHO) within the past two years. According to the WHO’s official report on the status of assessed contributions, Uganda had no outstanding balance as of 31 December 2024, indicating that it had paid its full assessed contributions for the relevant period ⁶⁷⁸.

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is no evidence that Uganda has a publicly available plan or policy for sharing genetic data, clinical specimens, and/or isolated specimens (biological materials) along with associated epidemiological data with international organizations or other countries beyond influenza. Uganda’s 2023 Health Data Access, Sharing, and Use Guidelines provide procedures for data sharing, including in public health emergencies and across borders, but these focus on individual-level health data and do not explicitly address the sharing of biological materials or genetic data with international entities ⁶⁷⁹. Similarly, Uganda’s National Policy Guidelines for Biobanking outline procedures for the acquisition, storage, and use of biological materials, but they are primarily oriented toward domestic research and do not establish a framework for international sharing beyond influenza ⁶⁸⁰. No additional evidence of such a policy was found on the websites of the Ministry of Health or the Ministry of Science, Technology and Innovation ⁶⁸¹.

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no evidence that Uganda has failed to share samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years. No such evidence could be identified through the World Health Organization ⁶⁸², the Ministry of Health ⁶⁸³, the Ministry of Science, Technology and Innovation ⁶⁸⁴, the Central Public Health Laboratories ⁶⁸⁵, or the Uganda Virus Research Institute ⁶⁸⁶.

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no evidence that Uganda has failed to share pandemic pathogen samples during an outbreak in the past two years. WHO situation reports on Uganda’s 2024 mpox outbreak confirm that laboratory confirmation of cases was conducted by the Uganda Virus Research Institute through routine sentinel surveillance, and there is no indication of non-compliance with international sample sharing practices ^687688689690.

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 25

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 25

6.1.1e Corruption

Score: 26

6.1.1f Accountability of public officials

Score: 50

6.1.1g Human rights risk

Score: 25

6.1.2a Orderly transfers of power

Score: 0

6.1.3a Risk of social unrest

Score: 25

6.1.4a Risk of terrorism

Score: 25

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 75

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6a Government territorial control

Score: 0

6.1.7a International tensions

Score: 50

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 83.8

6.2.2a UNDP Gender Inequality Index score

Score: 34.85

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 46.44

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4a Public confidence in government

Score: 0

6.2.5a Robust, open, diverse local media and reporting

Score: 50

6.2.6a Gini coefficient

Score: 57.3

6.3.1a Adequacy of road network

Score: 25

6.3.2a Adequacy of airports

Score: 50

6.3.3a Adequacy of power network

Score: 25

6.4.1a Urban population (% of total population)

Score: 83.94

6.4.2a Change in forest area (percentage points)

Score: 52.02

6.4.3a Natural disaster risk

Score: 75

6.5.1a Total life expectancy (years)

Score: 62.55

6.5.1b NCD mortality rate

Score: 73.38

6.5.1c Population aged 65+

Score: 97.91

6.5.1d Tobacco use (% of adults)

Score: 72.23

6.5.1e Level of adult obesity (%)

Score: 83.02

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 34.92

6.5.2a Access to potable water

Score: 62.95

6.5.2b Access to at least basic sanitation facilities

Score: 23.89

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 85.42

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 2.21

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 50