Planetary Health in 3D: Perspectives from Uganda

How would you define planetary health, and what does it mean to you?

Dr. Charles Ayume: Planetary health is the ecosystem of the Earth's stability. It is the glue that binds us, and unfortunately, we are destroying that glue.

As human beings, we are designed to live around the Earth. The Earth has been the same for generations since time immemorial, and it is only us who have been evolving around it—animals, but especially human beings. It has been a constant. Unfortunately, along the path of evolution, modernization, and urbanization, we seem to be destroying Mother Earth. We seem to be destroying nature.

What are the concrete planetary health challenges for an African nation, particularly Uganda?

Dr. Ayume: We are here for the Trialogue Days, and this is the second edition. I appreciate the fact that partners from three different continents and three different countries have come together to speak.

If I were to use the analogy of an aircraft taking off: one country is taxiing on the runway, where the crew is saying, “Please put on your seatbelts, we are about to take off.” Another country has just reached 15,000 feet, and the third is cruising at 35,000 feet. Uganda is still on the runway. India has reached 15,000 feet—as part of BRICS, they have demonstrated remarkable advancement in technology. Then you have Switzerland, which has been relatively stable for a very long time. It is immensely valuable when three distinct minds from three distinct ecosystems come together to share ideas.

In the case of Uganda, during this 2026 edition, we examined challenges in Europe and North America. While we may not experience all of them directly, we bear the spillover. Take carbon emissions and global warming: the carbon footprint is significantly higher in the Global North, yet nations with minimal footprints are bearing the brunt of the consequences. We also looked at artificial intelligence, which was presented brilliantly, and asked: how will this affect us?

Within our own borders, we face challenges related to legislation and fragmented markets. We tend to plan within small national boundaries rather than at a regional level. If we are to manufacture essential medicines and antibiotics, how do you achieve viability? To attract foreign direct investment, we need regionalization and larger unified markets. COVID-19 made that abundantly clear across the African continent: we must work together.

Recently, Uganda emerged from an Ebola outbreak and was declared Ebola-free by the WHO. But we did not sit back and pop champagne. In neighboring DRC, there were over 5,000 infections and more than 3,000 deaths. In the spirit of Pan-Africanism and good neighborliness, Ugandan medical teams traveled to the DRC at the invitation of the Congolese government to support their Ebola treatment centers. That is the collective mindset we must adopt—not only for global health security, but for planetary health as a whole.

What are your impressions of the Trialogue Days 2026?

Dr. Ayume: The interesting thing is, when I first saw the theme for Trialogue Days 2026—"The house we live in"—I wondered, "Okay, what is this about?" I was trying to forecast and foresee the discussions. Most of the time, when you are invited to a health conference, the focus is strictly on TB, Ebola, genetic sequencing, malaria, or HIV.

But I really liked how this theme was introduced and how groups were assigned to different thematic areas. It truly brought out what health means in a practical sense. For example, when you look at the bedroom, you usually just think, "Oh, I go to the bedroom to sleep." However, we noticed that sleep is an integral part of mental health. If you do not manage your sleep, you are not managing your internal well-being. During the night, the body conducts its physiological audit. As one presenter highlighted, there is vital science behind what happens in our bodies between 9 p.m. and 7 a.m. If you are not getting enough sleep, you are most likely going to slip into depression, develop memory disorders, and face other issues. The science concerning why you are devoid of sleep is enormous.

This also raises questions about how we structure our buildings—dealing with unnatural light at night and noise pollution. As a Member of Parliament and a Minister of Health, I was listening to all of this and thinking, "When I go back home, how do I address this?" There are significant opportunities for policy reform. Unfortunately, in Africa, we often see scenarios where the bedroom doubles as a sitting room, or even a place where animals are kept, and you sleep in that same area.

We also moved to the living room to examine what it is used for and the discussions that take place there. Then, the kitchen: when you unpack the kitchen, you look at the kind of food we eat—is it healthy or unhealthy? But it also extends to the waste generated from the kitchen and how we manage it. We discussed the garden, the office, and the bathroom, touching on the waste we generate in those spaces as well. Slowly, this theme of "the house we live in" unpacked our day-to-day ecosystem as human beings.

If you move sequentially from the bedroom to the bathroom, the living room, the kitchen, and the office, you realize that if we address the challenges within all these avenues, we can fix broader issues related to planetary health. It prompts you to look at how you travel to work or to conferences: Are you cycling? Are you using a car? How does that tie into carbon emissions and so forth? I think it was a remarkably smart way of unpacking the day-to-day issues of planetary health, and I salute all those who carefully crafted it. I didn't see it coming, but I go back to Uganda quite satisfied with the thematic areas and the topics we discussed.

How do these reflections on the domestic environment align with the policy reforms you hope to champion next?

How important is it to discuss planetary health challenges with partners from diverse professional, cultural, and historical backgrounds who encounter the same problems from different angles?

Dr. Ayume: It is vital. When you listen across different perspectives, you see both our contrasts and our commonalities.

In Uganda, arriving at an office or meeting in a personal vehicle is often perceived as a mark of prestige. Here in Switzerland, we walked to the venue, surrounded by an active cycling culture. In many ways, Europe is returning to practices Uganda had decades ago: in the 1960s, Ugandan streets had very few cars and people predominantly cycled, while the West was motorizing rapidly. Now the dynamic is reversing.

We also engaged with emergent realities like artificial intelligence. Projections suggest that within a few years, a vast volume of scientific literature will be AI-assisted or AI-generated. What does that mean for health practitioners and policymakers? We need clinicians who thoroughly build their clinical competencies and judgment first, using AI to refine their practice rather than replace it.

On the cultural front, our underlying aspirations are shared, even when our practices differ. How do we navigate traditions—such as consuming certain meats with zoonotic potential—while safeguarding communities? How do we counter vaccine hesitancy? Immunization remains the single most effective public health intervention in history, yet we now witness an anti-vaccine crusade gaining traction in parts of the Global North, which is deeply counterproductive. Dialogue allows us to tackle these cultural dynamics together.

Finally, global partnerships must address equity and sustainability. Interventions in Africa cannot be five-year programs that leave communities stranded, forcing people back into poverty and environmental degradation. Furthermore, Western markets must open up fairly to African goods rather than imposing protectionist barriers.

Consider energy transition: the largest historical emissions come from the industrialized world. When African nations seek financing from international financial institutions like the World Bank, we need concessional financing for clean energy infrastructure, such as hydroelectric dams, rather than commercial debt. When high-interest loans are passed on through high electricity tariffs, ordinary citizens cannot afford the power running right over their roofs—so they continue cutting down trees for charcoal. If concessional loans or capital grants make clean power truly affordable, households immediately abandon charcoal. That is the kind of practical trade-off international collaboration must deliver.

Looking ahead to the upcoming Trialogue Days 2028 in Kampala, Uganda, in which key areas do you see the greatest potential for collaborative trialogue projects between Bangalore, Kampala, and Zurich?

Dr. Ayume: Research represents our greatest opportunity.

Uganda sits directly on the equator, providing a rich ecological setting where human and plant life thrive—but also where pathogens flourish. Historically, numerous viral and infectious agents were first isolated in Uganda and our immediate region: the Zika virus, West Nile virus, Buruli ulcer, and O'nyong'nyong virus. Ebola remains on our doorstep, and malaria is endemic.

This creates an exceptional foundation for joint academic and clinical research with institutions in Zurich and Bangalore. Beyond human medicine, our wildlife and national parks are central to the equation. You cannot address planetary health without accounting for animal and ecological health.

When Kampala hosts Trialogue Days in 2028, we want to approach health in “3D”: human health, animal health, and plant health.

Delegates will not only engage in conceptual debates; we will bring you into the field to witness firsthand both the frontline impacts of environmental pressure and the restoration initiatives Uganda is driving to mitigate climate and ecological risks.

Martin Boyer spoke with Dr. Charles Ayume on September 3, 2026.

Read more: Trialogue Days