In Uganda’s informal settlements, where access to safe water and sanitation remains a daily struggle, a group of young public health advocates is rethinking how to confront one of the world’s most pressing health threats—antimicrobial resistance (AMR). These youth, organised through the Uganda Youth Campaign on Water, Sanitation, and Hygiene (WASH) in the fight against Antimicrobial Resistance (AMR), are seeking to reverse this tide.
Antimicrobial resistance, a medical term, means when bacteria, viruses, fungi, and parasites evolve to resist the drugs designed to kill them, rendering treatments ineffective and infections harder to manage. The global watchdog, the World Health Organization (WHO), estimates that AMR is already responsible for 1.27 million deaths globally each year, with the burden heaviest in low- and middle-income countries like Uganda.
Poor sanitation and hygiene are major contributors to the problem, as they allow infections to spread, increasing the demand for antibiotics, which in turn accelerates resistance. One of the AMR and environmental stewards, Dr. Fred Edema Otoo, the president of the Uganda Youth Consortium for Antimicrobial Stewardship (UYCAS), a platform that unites AMR champions from different regions across the country to fight antimicrobial resistance, warned that Uganda loses over 7,000 lives each year due to AMR, and yet the number continues rising.
“We are empowering young people to lead efforts in AMR prevention. Our current focus is on raising awareness through innovative activities. We have used music, dance, and drama in communities, and during last year’s World Antimicrobial Resistance Awareness Week, we launched a social media challenge that engaged over 500 youth. We’re now focusing on increasing knowledge around WASH, recognizing that reducing infections leads to less reliance on antimicrobials, which in turn reduces AMR,” Dr. Edema asserted.
The campaign, anchored in the One Health approach, which recognises the interconnectedness of human, animal, and environmental health, acknowledges that AMR cannot be tackled in isolation. The youth seek to address environmental hygiene and promote behaviour change at the community level, targeting the root causes of infection and resistance, empowering young people and affected communities to lead change through building cleaner, healthier communities, and reducing Uganda’s AMR burden from the ground up.
The team, between 11th and 12th April 2025, had a Training of Trainers (ToT) with over 30 young people representing different institutions of higher learning across Uganda as well as a community outreach to Katanga and Kamwokya to raise awareness on water, sanitation, hygiene, and antimicrobial resistance and co-design solutions with the locals in these areas.
“We are targeting university students, not just medical doctors, but all health-related professions. Often, other critical roles in diagnosis and treatment are overlooked in training. That’s why we brought together youth from Makerere, Gulu, Busitema, KIU, and Victoria University, among others, to take this message back to their communities,” Maureen Kisakye, a medical laboratory technologist specializing in microbiology and facilitator during the training, revealed.
“Today, we have over 30 AMR champions present, but across the campaign, we have reached over 300 youth. The campaign has been running for about a month and will continue until the end of the year, aligning with the Uganda National Action Plan on AMR, which emphasizes awareness and advocacy. We are targeting overcrowded areas like Katanga and Kamwokya, where poor sanitation and hygiene exacerbate infection risks.” She added.
The outreach campaign reached over 500 community members, where young people were involved in cleaning, training, awareness raising, and distribution of sanitary materials. Kisakye said within the informal settlements and health facilities, both patients and healthcare workers are at high risk, as poor infection prevention and control (IPC) can spread resistant microorganisms, leading to longer hospital stays and higher medical costs.
Her co-facilitator, Douglas Bulafu, a Research Associate in the Department of Disease Control and Environmental Health at Makerere University School of Public Health, said environmental health involves a wide range of factors that influence people’s well-being, pointing out that issues such as overcrowding, inadequate drainage, and pollution prevalent in urban informal settlements significantly contribute to poor health outcomes, hence the intervention.
“Using the One Health approach, we look at the connections between people, animals, and the environment. For example, microorganisms excreted by one person can infect others through shared environments or animals. The pesticides used in agriculture also contribute to antimicrobial resistance when consumed through food,” Bulafu asserted.
Adding: “To make real change, we must focus on simple, practical solutions. For low-income communities, education and advocacy are key. We must teach people what AMR is and how to prevent it and provide handwashing facilities and soap. Engaging communities through human-centred design ensures sustainability. During COVID-19, handwashing and IPC were enforced, and infection rates dropped. But post-pandemic, enforcement has weakened. We need to revive that discipline through education and policy.”
The youth-led intervention is part of a broader effort under the Research on the Hygiene Optimisation and Knowledge Empowerment Toolkit (R’OHOKET), which aims to co-create scalable, context-specific interventions that integrate WASH into AMR strategies, supported through the French Embassy. The youth campaign aligns with the WHO Global Action Plan on AMR and Uganda’s national efforts to reduce the spread of resistant infections
By Okeya John
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