As Uganda grapples with the escalating effects of climate change, one of the more concerning health impacts is the rising incidence of malaria.
This mosquito-borne disease, already a perennial issue in many parts of the country, has found a new avenue for spread due to shifts in the climate.
Ugandans have long recognised the intertwined nature of climate and health, with 20% of citizens acknowledging an uptick in malaria cases over the past five to ten years, according to a recent Sauti za Wananchi survey.
With the frequency of extreme weather events such as flooding, unpredictable rainfall, and longer rainy seasons, the conditions for malaria transmission are becoming more favorable.
The relationship between climate change and malaria is complex but clear. Warmer temperatures and increased rainfall create the perfect breeding ground for Anopheles mosquitoes, which transmit the malaria parasite.
These mosquitoes thrive in stagnant water, which becomes more prevalent after heavy rains. Prolonged wet seasons, as reported by many Ugandans, provide the mosquitoes with longer periods to breed and spread the disease.
Furthermore, shifting weather patterns disrupt traditional agricultural cycles and, in some areas, may lead to greater human exposure to mosquito habitats.
According to health experts, the longer rainy seasons, combined with rising temperatures, extend the window in which mosquitoes can thrive.
Shakira Miremebe, a community relations officer at Busoga Forestry company resident of Mayuge District, witnessed firsthand the effects of these changing weather patterns on mosquito breeding.
Historically, Mayuge’s well-defined seasonal cycles allowed swamps and stagnant water to dry up, reducing mosquito breeding conditions.
However, shifting weather trends have disrupted these patterns, with rainstorms arriving before water bodies can dry, thereby prolonging mosquito breeding seasons.
"Malaria has always been common during specific times of the year. But with unpredictable rains, mosquitoes are breeding at an accelerated rate," Miremebe explains.
Living near a swamp, a prime mosquito breeding ground, Miremebe has struggled to combat the growing pest population. Despite her efforts to spray the area, the mosquitoes keep returning spraying is not feasible in the swamp due to environmental conservation concerns.
“We can’t spray in the swamps because we must protect other insects and wildlife,” she says. “The mosquitoes keep coming back.”
While the government has taken steps to address the malaria crisis, including distributing mosquito nets, Miremebe believes more needs to be done.
“The government is trying, but they need to do more research and understand how ordinary people are tackling the issue. Sensitisation is key,” she urges.
“It’s not enough to just provide nets; we need more follow-ups and better outreach,” she adds.
Environmental degradation also compounds the situation. Miremebe points out that deforestation and encroachment on buffer zones have worsened climate change effects, which, in turn, increase malaria transmission.
“Community members continue to encroach on buffer zones and cut down trees, which leads to further climate changes. Protecting the environment is crucial to reducing the spread of malaria,” she asserts.
Experts agree that controlling mosquito breeding sites is only part of the solution. In the fight against malaria, broader efforts to mitigate climate change effects and promote community-led environmental protection are essential.
Dr. Herbert Nabaasa, Commissioner for Environmental Health Services at the Ministry of Health, has highlighted the links between climate change and malaria transmission.
He attributes the rise in malaria cases to factors like increasing temperatures, unpredictable rainfall, and flooding.
The 2023 Twaweza survey reflects a broad acknowledgment of these changes in climate variables (e.g., longer rainy seasons, warmer temperatures), and citizens have noticed a correlation between environmental changes and the increased spread of diseases, including malaria.
The survey found that 20% of respondents directly linked environmental changes to an increase in malaria cases, indicating growing concern at the community level.
According to the report, Ugandans are not just worried about the climate, they are experiencing it firsthand. Over half of the citizens (57%) believe the climate is worsening, with a staggering 86% concerned about its future effects on their lives. A significant portion (70%) attributes deforestation as the primary cause of the escalating climate crisis.
However, a rising recognition of industrial pollution also hints at a broader understanding of the global sources of climate change.
In rural Uganda, particularly in the Northern and Eastern regions, the effects are deeply felt. With agricultural production at an all-time low, 7 out of 10 Ugandans report declining yields, and nearly 70% acknowledge that making a living has become more difficult over the past decade.
The changing climate is not just altering rainfall patterns; it is also contributing to soil infertility, unpredictable seasonal changes, and crop
“The variation in temperature has caused a significant increase in mosquito populations because their breeding conditions have become more favorable, which in turn has led to a rise in malaria transmission,” says Nabaasa.
Moreover, mosquito behavior has shifted as a result of climate changes. Traditionally active during evening hours, mosquitoes are now biting throughout the day, reducing the effectiveness of traditional prevention methods like closing windows and using mosquito nets.
A growing concern is the increasing resistance to malaria treatments.
“Many former treatment regimens are no longer effective, and we are seeing poor responses to medication,” Nabaasa explains. Genetic changes in the malaria parasite and mosquitoes are contributing to this challenge, making treatment more costly and less successful.
Flooding, another consequence of climate change, has also contributed to the crisis.
“Heavy rains create breeding sites, allowing mosquito populations to double, which in turn increases infection rates,” says Nabaasa.
Uganda currently loses an estimated 54 people to malaria daily, with children under five being the most vulnerable group.
In response, the Ministry of Health has implemented several interventions, including larviciding to target mosquito breeding sites in high-malaria districts.
The government is also promoting community awareness and environmental management practices, such as clearing bushes and draining stagnant water.
Additionally, Uganda has developed Africa's first Climate Change and Health Plan, a five-year strategy aimed at strengthening the resilience of the health system against climate-related diseases. The plan includes community engagement, leadership development, and the construction of climate-resilient health infrastructure.
“If fully implemented, this plan will significantly reduce malaria and other climate-driven health challenges,” Nabaasa asserts.
As Uganda continues to face the dual threats of climate change and rising malaria cases, experts call for increased funding and collaborative efforts to mitigate the impact of climate change on public health.
Nabaasa also urged Ugandans to take personal responsibility in the fight against malaria. “Government efforts alone cannot be sufficient,” he says.
“Individuals must manage their homes properly, maintain a green environment, clear bushes, eliminate stagnant water, and plant trees. Lack of tree cover is a major challenge, contributing to climate change and worsening malaria cases,”
One of the major challenges, according to Nabaasa, is the misuse of government-provided mosquito nets.
“We provide mosquito nets, but some people use them for fishing instead of for malaria prevention,” he laments. “We disseminate information, yet some communities disregard it.”
As Uganda faces the challenges of climate change and its impacts on public health, a collective effort from the government, health experts, and communities will be vital in curbing the rising malaria burden.