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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Public Health Rev.</journal-id>
<journal-title-group>
<journal-title>Public Health Reviews</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Public Health Rev.</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2107-6952</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1609302</article-id>
<article-id pub-id-type="doi">10.3389/phrs.2026.1609302</article-id>
<article-version article-version-type="Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Commentary</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Strengthening Uganda&#x2019;s Climate-Resilient Health Systems: A Position Paper on Climate and Health Policy</article-title>
<alt-title alt-title-type="left-running-head">Zikanga</alt-title>
<alt-title alt-title-type="right-running-head">Climate-Resilient Health Systems Uganda</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zikanga</surname>
<given-names>Bernard Jackson</given-names>
</name>
<xref ref-type="aff" rid="aff1"/>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/3269108"/>
</contrib>
</contrib-group>
<aff id="aff1">
<institution>Seed Global Health</institution>, <city>Boston</city>, <country country="US">UG, United States</country>
</aff>
<author-notes>
<corresp id="c001">
<label>&#x2a;</label>Correspondence: Bernard Jackson Zikanga, <email xlink:href="mailto:bernardzikanga@gmail.com">bernardzikanga@gmail.com</email>
</corresp>
<fn id="fn001" fn-type="other">
<p>This Commentary is part of the PHR Special Issue &#x201c;Public Health Diplomacy in a Complex World&#x201d;</p>
</fn>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2026-04-23">
<day>23</day>
<month>04</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2026</year>
</pub-date>
<volume>47</volume>
<elocation-id>1609302</elocation-id>
<history>
<date date-type="received">
<day>19</day>
<month>11</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>22</day>
<month>01</month>
<year>2026</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2026 Zikanga.</copyright-statement>
<copyright-year>2026</copyright-year>
<copyright-holder>Zikanga</copyright-holder>
<license>
<ali:license_ref start_date="2026-04-23">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. PHR is edited by the Swiss School of Public Health (SSPH&#x2b;) in a partnership with the Association of Schools of Public Health of the European Region (ASPHER)&#x2b;</license-p>
</license>
</permissions>
<kwd-group>
<kwd>climate -resilient health systems</kwd>
<kwd>health systems strengthening</kwd>
<kwd>public health diplomacy</kwd>
<kwd>domestic health financing</kwd>
<kwd>and climate change adaptation</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declared that financial support was not received for this work and/or its publication.</funding-statement>
</funding-group>
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<fig-count count="0"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="10"/>
<page-count count="2"/>
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</front>
<body>
<sec sec-type="intro" id="s1">
<title>Introduction</title>
<p>Climate change is already impacting health outcomes in Uganda. Rising temperatures, erratic rainfall, floods, and droughts have increased the incidence of climate-sensitive diseases such as malaria, cholera, and respiratory infections [<xref ref-type="bibr" rid="B1">1</xref>]. Nearly half of Uganda&#x2019;s health facilities are located in areas prone to floods or droughts, with over 70% experiencing interruptions in service delivery during climate-related disasters [<xref ref-type="bibr" rid="B2">2</xref>]. The combined effects of environmental degradation, food insecurity, and forced migration compound the burden on an already fragile health system. These challenges underscore the urgent need for integrating climate adaptation into health sector policies, workforce development, and financing structures.</p>
<p>Uganda&#x2019;s approach to integrating climate change into health policy also reflects a growing dimension of public health diplomacy aligning national adaptation priorities with global climate and health commitments through negotiation, policy alignment, and cross-sector partnerships.</p>
</sec>
<sec sec-type="discussion" id="s2">
<title>Discussion</title>
<p>Uganda&#x2019;s policy landscape provides a strong foundation for climate&#x2013;health integration. The Health National Adaptation Plan (HNAP 2025&#x2013;2030) outlines strategies for building resilience in health service delivery, workforce training, infrastructure, and surveillance [<xref ref-type="bibr" rid="B3">3</xref>]. The Nationally Determined Contribution (NDC3.0), expected in 2025, offers an opportunity to embed measurable health adaptation indicators within national climate commitments [<xref ref-type="bibr" rid="B4">4</xref>].</p>
<p>These multisectoral efforts illustrate health diplomacy in practice, where technical adaptation actions intersect with governance, partnership-building, and dialogue between domestic institutions and international frameworks such as the United Nations Framework Convention on Climate Change (UNFCCC) and WHO&#x2019;s climate&#x2013;health agenda [<xref ref-type="bibr" rid="B5">5</xref>].</p>
<p>Health workforce capacity remains a cornerstone of climate adaptation. Training health professionals to anticipate, prevent, and manage climate-related diseases improves the system&#x2019;s responsiveness. Integrating climate&#x2013;health modules into pre-service and in-service curricula is a practical first step [<xref ref-type="bibr" rid="B6">6</xref>]. Similarly, climate-sensitive budgeting ensures predictable financing for adaptation. Evidence shows that <italic>ad hoc</italic> or project-based funding leads to inefficiencies and poor sustainability [<xref ref-type="bibr" rid="B7">7</xref>]. Domestic financing mechanisms and tagged budget lines enable better tracking of resources, accountability, and integration with broader health financing reforms.</p>
<p>Strengthening data and surveillance systems is equally essential. Uganda&#x2019;s District Health Management Information System version two (DHIS2) offers a strong platform for integrating climate and environmental indicators. Pilot initiatives such as the DHIS2 Climate App demonstrate feasibility for combining climate and health data to enhance early warning and response [<xref ref-type="bibr" rid="B8">8</xref>]. However, scaling such innovations nationally requires standardized indicators, multisectoral data sharing, and sustained technical capacity. Robust monitoring, reporting, and verification (MRV) systems would improve national planning and international reporting under the UNFCCC [<xref ref-type="bibr" rid="B9">9</xref>].</p>
</sec>
<sec id="s3">
<title>Recommendations</title>
<p>
<list list-type="order">
<list-item>
<p>Integrate climate&#x2013;health adaptation into health workforce training and continuous professional development programs.</p>
</list-item>
<list-item>
<p>Establish dedicated budget lines for climate adaptation within the Ministry of Health and district plans to ensure sustained financing.</p>
</list-item>
<list-item>
<p>Strengthen surveillance and monitoring systems to include climate and environmental indicators.</p>
</list-item>
<list-item>
<p>Foster cross-sectoral collaboration between health, environment, water, agriculture, and disaster risk management agencies. This collaboration reflects practical health diplomacy, where local and international stakeholders work together to strengthen resilience.</p>
</list-item>
<list-item>
<p>Enhance community engagement to build awareness and local resilience through participatory planning and risk communication.</p>
</list-item>
</list>
</p>
<sec id="s3-1">
<title>Conclusion</title>
<p>Uganda&#x2019;s transition toward a climate-resilient health system depends on bridging the gap between policy commitments and implementation. Operationalizing HNAP and integrating health into the NDC 3.0 process present unique opportunities to align national adaptation goals with health system strengthening [<xref ref-type="bibr" rid="B10">10</xref>]. Building resilience in the health sector is both a climate and diplomatic imperative, linking Uganda&#x2019;s domestic health priorities with international frameworks and cooperation under global climate governance.</p>
</sec>
</sec>
</body>
<back>
<sec sec-type="author-contributions" id="s4">
<title>Author Contributions</title>
<p>The author confirms being the sole contributor of this work and has approved it for publication.</p>
</sec>
<sec sec-type="COI-statement" id="s6">
<title>Conflict of Interest</title>
<p>The author declares that they do not have any conflicts of interest.</p>
</sec>
<sec sec-type="ai-statement" id="s7">
<title>Generative AI Statement</title>
<p>The author(s) declared that generative AI was not used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<label>1.</label>
<mixed-citation publication-type="book">
<collab>Ministry of Health</collab>. <source>Climate Vulnerability and Adaptation Assessment for the Health Sector</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>MoH</publisher-name> (<year>2023</year>).</mixed-citation>
</ref>
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<collab>Uganda National Meteorological Authority</collab>. <source>Climate Trends and Projections Report</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>UNMA</publisher-name> (<year>2023</year>).</mixed-citation>
</ref>
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<label>3.</label>
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<collab>Ministry of Health</collab>. <source>Health National Adaptation Plan (HNAP 2025&#x2013;2030)</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>MoH</publisher-name> (<year>2025</year>).</mixed-citation>
</ref>
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<collab>Ministry of Water and Environment</collab>. <source>Uganda&#x2019;s Nationally Determined Contribution (NDC 3.0) Draft</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>MWE</publisher-name> (<year>2025</year>).</mixed-citation>
</ref>
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<label>5.</label>
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<collab>World Health Organization</collab>. <source>Operational Framework for Building Climate-Resilient Health Systems</source>. <publisher-loc>Geneva</publisher-loc>: <publisher-name>WHO</publisher-name> (<year>2021</year>).</mixed-citation>
</ref>
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<collab>Uganda Bureau of Statistics</collab>. <source>Statistical Abstract 2023</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>UBOS</publisher-name> (<year>2023</year>).</mixed-citation>
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<label>9.</label>
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<collab>Rockefeller Foundation</collab>. <source>Building Climate-Resilient Health Systems in Africa</source>. <publisher-loc>New York</publisher-loc>: <publisher-name>Rockefeller Foundation</publisher-name> (<year>2022</year>).</mixed-citation>
</ref>
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<label>10.</label>
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<collab>Ministry of Health</collab>. <source>Health Sector Development Plan (HSDP III 2020/21&#x2013;2024/25)</source>. <publisher-loc>Kampala</publisher-loc>: <publisher-name>MoH</publisher-name> (<year>2020</year>).</mixed-citation>
</ref>
</ref-list>
<fn-group>
<fn fn-type="custom" custom-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1002545/overview">Gabriel Gulis</ext-link>, University of Southern Denmark, Denmark</p>
</fn>
</fn-group>
</back>
</article>