In Uganda’s western district of Ibanda, anthrax is a familiar enemy. As one health worker said, the word ‘anthrax’ has “become part of our vocabulary.” But this familiarity has not led to safety. Communities have lived with recurring outbreaks for years, largely because the warning signs go unnoticed or unreported until it’s too late.
But a new effort is underway to change this, one focused on supporting the very people on the frontline. When we visited Ibanda as part of a supervision visit for the program to strengthen epidemic preparedness, we met Robert Karuhanga, the District Surveillance Officer for Ibanda North. His passion for his community’s well-being stood out immediately.
For Robert, this work is personal. His drive for community-based surveillance was shaped when he was a 13-year-old boy. He witnessed his community get affected by contaminated meat that, having always represented celebration, turned sour. The delayed reporting and response to an anthrax case on one farm led to the infection and death of several cows, with subsequent devastating effects on community members. This experience stayed with him and later inspired him to join the health system, determined to prevent others from facing the same loss.
A siloed system
Robert’s story is a snapshot of a larger, systemic challenge. “We have had situations where people see sick animals or fall ill themselves, but they do not tell us in time,” he said. “By the time information reaches us, it’s already spread. That’s why community-based surveillance is so important.”
This challenge is amplified in Western Uganda. With its porous borders and close interaction between humans and animals, the region is particularly vulnerable to emerging and re-emerging diseases. The Uganda National One Health Strategy (2018-2022) highlights that endemic and emerging zoonotic diseases—from anthrax and rabies to Ebola—require a unified response.
In the past, Ibanda’s surveillance system struggled because a unified response was missing. Human and animal health teams rarely communicated in real time, reporting up through separate, siloed ministries. Animal health officers reported through the Ministry of Agriculture and human health teams through the Ministry of Health, often missing opportunities for early detection. Without this shared communication, outbreaks like anthrax spread quietly, crossing from farms to households before district teams could respond.
Integrating one health in practice
For this reason, Ibanda was identified as a priority region for this program to strengthen epidemic preparedness and response. Through the program, VillageReach and the Uganda Virus Research Institute (UVRI) are working with district health teams to build their capacity for early detection and response.
A key focus is on training and equipping health workers, veterinarians and Village Health Teams (VHTs) with the knowledge and tools needed to protect their communities. The trainings emphasized:
- Community engagement: Understanding how to engage communities and sensitize them on disease risks and the importance of timely reporting.
- Biosafety and biosecurity: Ensuring health workers follow safe practices when handling suspected samples or interacting with affected individuals or animals.
- Sample collection and transportation: Strengthening the hub system so both animal and human samples are collected, packaged safely and delivered to the appropriate testing laboratories for timely confirmation.
This last point is critical.
In practice, it means health facilities that once only sent human samples are now supporting animal sample transport as well, linking veterinary and public health systems in a coordinated network. The introduction of standardized packaging, clear transport routes and shared communication channels between animal and human health teams represents a significant step toward operationalizing the One Health approach in Uganda.
From siloed systems to shared solutions
The immediate relevance of these new skills became clear during our visit. The training session Robert attended had to end early as the team was receiving reports of suspected anthrax cases in a nearby subcounty, highlighting the real-world, real-time nature of this threat.
Robert reflected on how, in past outbreaks, this siloed approach missed critical opportunities. Through the sessions, he saw how true epidemic preparedness begins with awareness and trust; communities understanding risks, recognizing symptoms in both people and animals and reporting quickly.
“It gave me hope,’’ he shared. “We will involve the community: our neighbours, the farmers, the VHTs, even the young people, to report quickly. This training helped us see that we can act faster and stop these diseases before they spread. It really begins with awareness in the communities.’’
After the training, Robert immediately began planning how to take what he learned into his daily work: organizing community dialogues, collaborating more closely with animal health teams and engaging community leaders.
Already, Ibanda is seeing small but significant changes: the VHTs are more proactive in reporting suspected cases, health workers are practicing safer sample handling and joint meetings between district veterinary officers and health surveillance teams happen more often. Each step builds momentum toward a more coordinated, resilient system.
A model for other areas
Through initiatives like this, VillageReach and UVRI are working with district health teams to close the gap between animal, human, and environmental health—the foundation of the One Health approach. By strengthening communication and building trust at the community level, these efforts are helping districts like Ibanda respond to outbreaks faster, more safely and more collaboratively.
The work in Ibanda offers a model for other districts—proof that when communities are empowered with knowledge, skills and trust, they become the first and strongest line of defence against outbreaks.