The anonymous pulse of a nation

A number of treatments for neglected tropical diseases like leishmaniosis were tried and tested in Kenya among Kenyans at Kemri-where research on triple treatment for malaria was conducted through collaboration with other partners. [iStockphoto] After today's Jamhuri Day, Kenya will turn 60 next year as an independent country in which time a lot has been done by local scientists in various fields including research on drugs, diseases, and vaccines. Other medics have made breakthroughs in the areas of infertility and penile surgeries. Others still, left their mark as innovators in science and biotechnology: They are our medical heroes and heroines this Jamhuri Day, alongside medical entrepreneurs who have made Kenya the largest exporter of vaccination syringes in the continent. But first, let us start with medical researchers like Dr Rose Jalang'o, a public health specialist in 'vaccinology,' credited with the malaria vaccine RTS,S/AS01. She is now spearheading its rollout in Kenya through the National Vaccines and Immunisation Programame-after its approval by the World Health Organisation (WHO) for use in children in Sub-saharan Africa. Wodera James, the Communications Director at the Kenya Medical Research Institute (Kemri) says Dr Jalang'o worked alongside several researchers at Kemri in the malaria vaccine invention as "we had five research scientists; Dr Bernhards Ogutu, Dr Simon Kariuki, Dr Lucas Otieno, Dr Martina Oneko and Dr Patricia Njuguna." Dr Njuguna, then head of Clinical Trials at Kemri Welcome Kilifi, but now a senior medical officer at PATH, was the), was for years the Principal Investigator during pilot tests for the malaria vaccine (RTS,S) until the malaria vaccine was approved by WHO in 2021. Trials were done in Kenya, Malawi and Ghana and it has helped reduce the cases of malaria, Kenya's biggest killer disease. Clinical trials are currently being done in 11 countries The responses from Western Kenya have been life-changing: Samson Okoth, for instance, lost seven children in five years to malaria which he mistook for fever. The children were between one and five years and "death snatched my hopes for the future. Had I known that malaria kills, I would have taken them to hospital earlier," said the father of 15 children and two wives. The first wife lost three of her 11 children while the second wife lost four of her 10 children. Had it not been for malaria, Okoth would now be a father of 21. But the work of researchers like Dr Jalango and Dr Njuguna, the mortality rate of malaria which stood at 13 per cent in 2010, with over 90 per cent of hospital admissions, has significantly been reduced since the rollout of the malaria vaccine in 2019 in counties including Homa Bay and Busia-which at 39percent leads in the country's malaria burden according to the 2020 Kenya Malaria Indicator Survey. Asked what the malaria vaccine means, Dr Njuguna told Malaria Vaccine Initiative (MVI) in 2010: "An efficacious malaria vaccine would mean that we could reduce the burden of sickness and death to affected populations in Kenya. It would mean less anaemia, better cognitive performance (better school performance), and more productivity as parents have more time and resources for development." Over 65, 000 vaccines have been administered in Vihiga, Homa Bay, Kisumu, Migori, Siaya, Busia, Bungoma and Kakamega where it has proved to have a 30 per cent reduction in malaria cases. Besides the malaria vaccine, it was also at Kemri where induction on the treatment of DOT commonly known as Direct Observed Therapy Treatment (treatment from many months to a few months) was done. The research made the mosquito-nets standard of care for malaria in the world! From malaria, great strides have also been made in the area of HIV prevention and treatment. As the globe struggled with the management of patients, the late Prof Ndinya Acholla, focused his research on HIV vaccine and sexually transmitted infections (STI). He was among a team of Kenyan doctors who took the emergence of HIV seriously for over three decades, culminating in the founding of the Kenya Aids Vaccine Initiative (KAVI). Prof Ndinya was also among the leading researchers spearheading Voluntary Medical Male Circumcision (VMMC) in Kisumu, whose uptake helped reduce infection rates of HIV by 60 per cent, according to the National Aids and STIs Control Programme (NASCOP). In late 2008, Kenya launched its VMMC programme which became one of the biggest boots against HIV with 2.3 million adolescent boys and men having faced the cut by 2020, according to NASCOP and our VMMc became the standard model for other African countries including Uganda and South Africa. Prof Ndinya was also among the initial investigators of the explosive outbreak of chancroid (a bacterial disease spread only through sexual contact) and other genital ulcer diseases- later shown to be important co-factors in promoting the spread of HIV. In a groundbreaking 10-year study in collaboration with an American scholar and centred on more than 1,000 women at risk of HIV infection from commercial sex workers and HIV in Mombasa, Prof Ndinya found out that sex workers who engaged in internal vaginal washing instead of using condoms were three times more likely to get HIV than those who did not. Prof Ndinya, father of four, died of kidney failure on December 1 - World Aids Day in 2011. Then there is Prof Matilu Mwau, the deputy director at Kemri, who was the brainchild behind the discovery of software used to manage information on viral loads and early diagnosis of HIV. Currently, the software is used in many countries, for instance, Malawi, Zambia, Lesuthu, Eswatini, Kenya, Uganda and Nigeria, among other states. "Bioinformatics tools used for management of viral load and early diagnosis software in many countries in Sub-Saharan Africa were developed at Kemri. I started developing the software in 2005 and by 2010, it was widespread in many countries across the globe," revealed Prof Mwau. At a time of developing the technology, the world had claimed that Africans did not have the capacity to fuse data on viral load and were discouraged from conducting viral load testing for patients. "The entire world conspired against us. But at Kemri, scientists decided to use the money to do viral load testing for free and pushed the data to doctors who began using the data for decision-making. Today, viral testing is the standard care in Africa." But medical research requires tonnes of paperwork, investigations and serious studies of products, movements and interviews. But alas! the Sh250 million allocated to Kemri for medical research, yet it has 250 medical researchers meaning each gets a measly Sh1 million which in research is mere peanuts. Most times financial deficits in medical research is bridged via donor funding and Dr James Kimotho, the Production Manager of Innovation and Technology Transfer at Kemri said in earlier interview that such funding comes with stringent conditions as "the donors ensure the funds do not result in research works that threaten their business interests." Dr Kimotho, adds that laboratory research is four times more costly in Kenya than in Europe due to tax regimes on reagents, equipment, transportation of the instruments and the tedious procurement process as Kenya imports its health reagents. A number of treatments for neglected tropical diseases like leishmaniosis were tried and tested in Kenya among Kenyans at Kemri-where research on triple treatment for malaria was conducted through collaboration with other partners. All these boils down to the governments, both at the national and county level prioritizing medical research and Dr Cecilia Wanjala, a researcher at Kemri calls for "allocating more funds to medical research and improving the status of medical research institutions like Kemri and public universities should be seriously considered", says Dr Wanjala.

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