Uganda

In 1996, after absorbing the River Blindness Foundation, The Carter Center began supporting the Uganda Ministry of Health to conduct health education and annual mass drug treatment with Mectizan® (donated by Merck & Co. Inc.). 

• The work expanded the Center’s involvement in the country, which had begun with the Guinea Worm Eradication Program in 1991. 

Our Work and Methods 

• Uganda positioned itself to be one of the first endemic countries in Africa to wipe out the disease nationwide through health education, Mectizan® distribution, and vector control. 

• A unique aspect of Uganda’s success has been the use of extended family groups, known as kinship groups, for effective Mectizan® distribution. 

• Vector control or elimination continues in select areas using the safe and effective ABATE® larvicide (donated by BASF). 

Impacts 

• The kinship approach, developed by a native Ugandan who was a senior epidemiologist at the Center, was adopted by the government as a national health policy that’s been used for other programs, including malaria control and prevention of infant mortality. 

• In 2024, the program distributed more than 1.16 million treatments, achieving 93% of the treatment goal. 

Fifteen of 17 transmission zones, or foci, in Uganda have eliminated river blindness, also known as onchocerciasis. arter Center began supporting the Uganda Ministry of Health to conduct health education and annual mass drug treatment with Mectizan® (ivermectin, donated by Merck & Co., Inc.).

• The work expanded the Center’s involvement in the country, which had begun with the Guinea Worm Eradication Program in 1991.

Our Work and Methods

• Inspired by the success of river blindness elimination activities in the Americas, Uganda positioned itself to be one of the first endemic countries in Africa to wipe out the disease nationwide through health education, Mectizan distribution, and vector control.
• A unique aspect of Uganda’s success has been pioneering the use of extended family groups, known as kinship groups, for effective distribution of Mectizan.
• Vector control or elimination continues to be conducted in selected areas using the safe and effective larvicide Abate (Temephos), donated by BASF.

Impacts

• Developed by Moses Katabarwa, a native Ugandan who was a senior epidemiologist at The Carter Center, the kinship approach was adopted by the Uganda government as a national health policy. It has provided positive results for other programs such as malaria control and prevention of infant mortality.
• Strong political and financial support from the government and active community participation throughout endemic districts were critical to the program’s early progress.
• In 2024, the program distributed 1,164,907 treatments, achieving 93% of the treatment goal.
• 15 foci in Uganda have eliminated onchocerciasis transmission.

Building on a 30-year trusted partnership with the Ministry of Health, The Carter Center expanded its support to the government to strengthen mental health systems in Uganda in early 2025.  

With the aim to accelerate access to quality mental health care and treatment, the Center has initiated its foundation-building phase in Uganda to reform national mental health strategic plans, develop regulations to implement the Mental Health Act of 2018/2019, and strengthen a core workforce to provide mental health services at all levels of care. 

Current Status: Transmission Stopped, July 2003 
Certification of Dracunculiasis Elimination: 2009 

When the Center began working in 1991 with the Uganda Ministry of Health to establish one of the first Guinea worm elimination programs in Africa, there were more than 120,000 cases in more than 2,600 villages in 17 districts in the northern half of the country. 

Our Work and Methods 

We worked with the health ministry to eliminate the disease by: 

• Educating people and changing behavior 

• Teaching people to filter all drinking water 

• Preventing transmission by keeping anyone with an emerging worm from entering water sources 

Impacts 

• Uganda reported its last indigenous case of Guinea worm disease in July 2003. 

• In 2009, the country received World Health Organization certification of Guinea worm elimination. 

In November 2014, The Carter Center was appointed coordinating partner in a five-year trachoma control program supported by the Queen Elizabeth Diamond Jubilee Trust and led by the Uganda Ministry of Health. 

• With implementing partners Sightsavers and CBM (previously the Christian Blind Mission), the Center aimed to eliminate blinding trachoma in Uganda. 

Our Work and Methods 

The project targeted trachoma-endemic districts in the Karamoja and Busoga regions by using the SAFE strategy, endorsed by the World Health Organization: 

• Surgery to reverse in-turned lashes caused by advanced trachoma, helping people at immediate risk of blindness 

• Antibiotics to treat active infections and reduce transmission 

• Facial cleanliness and improved hygiene to prevent the spreading of bacteria 

• Environmental efforts to improve access to clean water and basic sanitation to reduce the fly population 

The initiative also coordinated training for surgeons and health workers in the region and  

worked with all levels of government to improve access to safe water sources in the program areas. 

Impacts 

• The initiative built more than 15,000 latrines and provided sight-saving surgery to more than 38,000 people. 

• The Center invested significantly in sanitation and hygiene programs, and trained more than 50,000 volunteers to promote these efforts. 
• At the start of the project, trachoma was endemic in 36 of the 122 districts throughout the country. By the end of the initiative, only two endemic districts remained. 
• With implementing partners Sightsavers and CBM (previously the Christian Blind Mission), the Center aimed to make significant advances toward eliminating blinding trachoma in Uganda together.

Led by Nobel Peace Prize winner Norman Borlaug until his death in 2009, a joint venture between The Carter Center and the Sasakawa Africa Association helped more than 8 million small-scale sub-Saharan farmers improve agricultural production in countries where malnutrition is a constant threat. 

• In Uganda, the main objectives were to improve cultivation of maize and to eliminate varieties of cassava that were susceptible to a virus that had blighted extensive farmland in the country. 

Our Work and Methods 

• Farmers received credit for fertilizers and enhanced seeds to grow test plots. 

Impacts 

• After their test plots yielded up to 400% more crops, participating farmers went on to teach other farmers, creating a ripple effect to stimulate self-sufficiency. 

• The program was so successful it enabled Uganda to help other nations by exporting excess maize to famine-stricken countries like Zambia and Malawi.

The Carter Center ended its agricultural activities in Uganda in 2011. 

Through its groundbreaking Inform Women, Transform Lives campaign, The Carter Center partners with city leaders worldwide to raise awareness about women’s right to access information and to help cities reach women with valuable information and essential municipal services. 

Access to this information empowers women with a stronger voice, enabling them to participate in public life, utilize public services, and make more informed decisions for themselves, their families, and their communities. In Uganda, the project has partnered with the city of Kampala.

How It Started

Since the mid-1980s, the government of Uganda had been fighting the Lord’s Resistance Army (LRA), a quasi-spiritual Ugandan rebel group that had bases in Southern Sudan and had become infamous for the use of child soldiers. The LRA had kept northern Uganda in a state of almost continuous insecurity and had contributed to hostilities between the governments of Uganda and Sudan, leading to the severing of diplomatic relations in 1995.

• In early 1999, the governments of Sudan and Uganda asked President Carter to help normalize relations.

Our Work and Methods

• President Carter and the Center’s Conflict Resolution Program negotiated the Nairobi Agreement, in which Sudan and Uganda committed to stop supporting forces against each other and agreed to eventually reestablish full diplomatic relations, opening the door for improved regional peacemaking.

Impacts

• To ensure the agreement’s implementation, the Center convened ministerial and security meetings between the two governments and other interested parties and made strenuous efforts to initiate dialogue between the LRA and the government of Uganda.
• Full diplomatic relations were restored between the two countries, and Uganda became a key regional partner in pushing for a peaceful resolution to Sudan’s civil war.
• The Carter Center also continued to make strenuous efforts to initiate dialogue between the LRA and the government of Uganda. The Carter Center worked with UNICEF, Uganda’s Acholi community, and the governments of Sudan, Uganda, Canada, Egypt, and Libya and sought additional meetings with the leader of the LRA in an effort to end fighting in northern Uganda and return the child soldiers to their villages.
• Through 2003, the program continued its efforts to establish a peace process between President Yoweri Museveni of Uganda and the LRA, leaving only after concluding that the conditions were not ripe to establish a peace dialogue between the two sides. President Carter remained in touch with key leaders while offering support to later peace efforts by Betty Bigombe.

This project ended in 2003.

How It Started

Following the Rwandan genocide of 1994, the presidents of Uganda and Zaire (now the Democratic Republic of the Congo) asked President Carter to facilitate a meeting between themselves and the presidents of Burundi, Rwanda, and Tanzania — countries collectively known as the Great Lakes region of Africa — to negotiate a regional initiative to combat the climate of genocide, repatriate 1.7 million Rwandan refugees, and curb violence in the region.

Our Work and Methods

• President Carter was joined in this effort by former Tanzania President Julius Nyerere, former Mali President Amadou Touré, and South Africa Archbishop Desmond Tutu.
• Summits with the five Great Lakes presidents were held in Cairo and Tunis in March 1996.

Impacts

• After the summits, the presidents agreed on important points, including:
  • To prevent cross-border raids
  • To halt arms flow to rebel groups
  • To return military equipment to its country of origin
  • To turn over individuals indicted for genocide crimes to the International Tribunal for Rwanda
  • To allow 300 human rights observers in Rwanda to work with returning refugees
• Despite these important commitments and strenuous efforts to implement them, there was little support from the international community, and most refugees finally returned to Rwanda only when full-scale violence broke out in Zaire in late 2006.

This project ended in 1996.