Time we gave stem cell technology a glance amid cancer cases spike

As Kenyans gathered to bid farewell to veteran TV news anchor Catherine Kasavuli in Vihiga, various leaders came out to lament the burden of cancer that many families are grappling with in Kenya and the region.

So sad is the situation, that each day, we receive invitations to fundraising events for loved ones battling different types of cancers at various stages. Indeed, this is a reality even among our leaders, some of whom are cancer survivors.

The list of those who have since died due to cancer reads like a grim roll of yonder. Kenya being the regional powerhouse in medical achievements brings to the fore the realities posed by this disease, since prominent persons from the neighbouring countries come here for cancer treatment and management, while locals see India as a last resort.

However, India and other Western nations have been seeking ways of dealing with this condition. While some have made ground-breaking discoveries, the cost is prohibitive. In the recent past, German firm BioNTech announced plans to begin trials of vaccines for cancer and other diseases in the UK, with most activists calling for the costs to remain affordable if the efficacy is proved to be high. Other nations in the West have invested heavily in stem cell technology to combat this disease.

In Kenya, a cancer diagnosis almost means death. The cost of chemotherapy and radiotherapy often leaves families in debt apart from the psychological trauma they suffer after their relatives eventually lose the battle. But stem cell technology has been around for a while but there is not a single policy to govern its introduction and use in Kenya.

The delay in the establishment of the Stem Cell and Regenerative Medicine Act, Policy Framework and Research Reference Groups is hurting the quality management of cancer cases.

Regenerative medicine deals with processes of replacing, engineering, or regenerating human or animal cells, tissue or organs to restore or establish new ones and replace the ones afflicted by disease, damaged and/or malformed. It does not seek to cure the affected tissues or organs, instead, it replaces them.

Regenerative medicine heavily relies on nanotechnology and an advanced understanding of Clinical Research in Molecular Medicine. We can't talk about regenerative medicine and forget about stem cells!

Clinical applications of stem cells are vital in regenerative medicine. Understanding stem cells' clinical efficacy is an important annexure in advancements of clinical research in regenerative medicine.

Unfortunately, Kenya has zero structural policies in this area of medicine. No policy framework, human resources and absolutely no funding of any kind since the emergence of stem cells and regenerative medicine. This technology opened promising avenues in dealing with complex medical conditions that have defeated the existing conventional, and/or traditional methods.

Currently, in the UK, US, Japan and China, the advanced knowledge derived from ongoing clinical research in the field of stem cells and regenerative medicine has yielded positive results, especially in the management of composite diseases like various forms of cancer.

If we talk about cancer, the clinical applications of stem cells and deep understanding in this key area of regenerative medicine -- including tissue engineering, biomaterials, biomarkers and cellular therapies -- have greatly helped in the early diagnosis and management of all forms of cancer. This in turn has improved the quality of life for patients who now benefit from prolonged life spans with some even fully recovered.

The unnecessary deaths due to a lack of proper management of various forms of cancer can be prevented if the Kenyan government is willing to develop a policy framework and fund the training of medical experts in various disciplines of medicine like stem cells and regenerative medicine.

The government via the Ministry of Health should consider coming up with a policy framework and guidelines on the establishment of centres for research on stem cell and regenerative medicine with a clear objective on how this will be integrated into the existing policies.

The ministry, clinicians and other stakeholders ought to strive to have access to quality information, knowledge and advice from countries with developed stem cell programmes, like China, US and UK. This can be achieved via exchange programmes, training and funding.

With this framework in place, the government should then fast-track the establishment of clinical reference groups for stem cell and regenerative medicine.

These clinical reference groups should comprise clinicians covering a wide range of specialties with experience in stem cell and regenerative medicine. They can be ophthalmologists, orthopedic surgeons, hematologists and pharmacists. Also, paramedics like biomedical scientists, medical laboratory scientists, biochemists and other scientists should be considered.

In the initial phase, the groups should be divided into four: The first group to be based solely at the Ministry of Health headquarters, and the rest to be domiciled at referral hospitals. The rest can be tasked with incorporating the clinical research at Kenya Medical Research Institute.

These groups can design logistics to respond to specific requirements of stem cell and regenerative medicine like harvesting and processing of cells.

The reference groups should also be tasked with formulating strict guidelines and regulations to govern the development of stem cell and regenerative medicine and its proper and proportionate use by only accredited practitioners. This will provide assurances about the quality, efficacy and safety as well as ensure public confidence that appropriate procedures have been carefully followed.

At various points in the process, other agencies may be factored in such as PPB and NEMA to play a critical role in regulatory oversight, especially in the disposal of medical waste.

In summary, the stem cell and regenerative medicine reference groups may be divided into the following departments.

- Cardiac regeneration and cardiac sarcoma

- Islet regeneration and pancreatic cancer

- Lung regeneration and non-small cell lung cancer.

- Musculoskeletal regeneration and bone sarcoma/ metastatic carcinomas

- Neuroregenerative and glioblastoma

- Valvular and vascular repair and regeneration

- Plastic and regenerative surgery

In summary, the government of Kenya should consider investing heavily in Healthcare services, especially in Cancer research programmes.

The establishment of these research centres will contribute immensely to the management of all forms of cancer and other chronic medical conditions. It is estimated that by 2030, Kenyans will be spending close to Sh200 billion annually on managing cancer alone. This is likely to impact socio-economic dynamics.

Prof Ben Fadhili Jilo - Fellow and a Professor of Neural Stem Cell, UK.

Dr Samson Aluda Mbati - Fellow at the University of Nottingham, School of Medicine - Stem Cell and Regenerative Medicine.

-Additional reporting by Alex Kiarie