With Kenya continuing to experience extreme weather and events exacerbated by climate change, our researchers led by Benjamin Tsofa from KEMRI- Wellcome and Jacob Macknight from Oxford University will be working on a project focused on enhancing Health Systems resilience through vulnerability and risk mapping to facilitate climate risk mitigation planning. The project funded by the National Institute for Health and Care Research (NIHR) and named A Novel Extreme Weather Risk Insurance System for Kenya (NEWRISK)” will focus on using the latest methods to provide focused data on extreme weather, population vulnerability, and health system capacity readiness  across various climatic zones in Kenya. “Extreme weather events in the country due to climate change are increasingly having a big impact to population health and the health system capacity in the country. Am glad that as a research Programme, we can leverage on our unique capacity in health policy and systems research, epidemiology and population health, community engagement, and health economics to address this important emerging health challenge. Am grateful to the NIHR for the generous funding support to enable us to undertake this work”. Dr. Tsofa added. The project will further aim to estimate population vulnerabilities to extreme weather events based on where people live, across the different climatic zones; and develop a tool to assess health facilities’ readiness for extreme weather and then use this tool to measure the readiness of public health facilities across Kenya. The project will further analyse the interactions between extreme weather, population vulnerability, and the health system readiness. Finally, the project will use various health economics methods to estimate the costs of doing nothing, and the costs and risks associated with multiple protective strategies.  NEWRISK is among seven other projects focusing on healthcare in the context of extreme weather events that were recently funded through the NIHR’s Research and Innovation for Global Health Transformation (RIGHT) programme. (https://www.nihr.ac.uk/news/nihr-awards-over-20-million-for-global-health-research-projects-focused-on-extreme-weather-challenges/35425. Cover photo credit: ILRI/ Camille Hanotte

We hosted 153 students for the Annual School Leavers Attachment Scheme (SLAS) Open Day.  The SLAS open day targets top performing students in Kilifi to give them an opportunity to information from various stakeholders and scientists that would help them firm up or redefine their career aspirations. It is an opportunity to give the students information about the need to take science and health related careers with the focus on creating the next pool of researchers in Kenya, Africa and beyond. The School Leaver’s Attachment Scheme selects talented students from Kilifi who have just completed high school with excellent grades to go on a three-month attachment. Students gain valuable work experience in laboratories, hospital wards, computer departments and community interaction. This experience gives students an advantage over most other university first-years. This year’s cohort of 12 students will start their 3 months attachment in March. For more about our Schools Engagement Programme, read here https://sep.kemri-wellcome.org/

Over the past 10 years, KEMRI-Wellcome Trust Schools Engagement Programme (SEP) has been engaging local schools with the aim of raising students’ awareness of leading African science; to stimulate students’ interest in pursuing careers in science https://sep.kemri-wellcome.org/. This aims at promoting an interest in science through interactions between researchers, students, and teachers. Dr. Tabitha Mwangi, a former KWTRP scientist now working in the UK, has written an inspirational  book targeted at High school going children but also useful in shaping students already in university in shaping their career journeys. The book, 12 Remarkable African Life Scientists, draws stories from 12 African researchers who have broken the proverbial glass ceiling in the field of research despite their humble backgrounds. This book aims at inspiring the young people towards research. From the 10 years’ experience, we find that African scientists hold potential as role models to inspire local students and to shatter pre-existing scientist stereotypes. Life stories of researchers who have reached prominence from humble backgrounds are likely to inspire local school students. This aligns with the KEMRI-Wellcome Trust Schools Engagement Programme (SEP) overarching aim – promoting an interest in science through interactions between researchers, students, and teachers. After years of review, today’s launch seeks to raise awareness and profile for the book targeted at secondary schools, Universities to relevant stakeholders and institutions. The book was funded through the Wellcome Trust Public Engagement grant.

Coastal Kenya has witnessed recurrent outbreaks of various viral pathogens, including dengue, measles, norovirus, influenza, and SARS-CoV-2. However, there is limited knowledge regarding the origin, transmission patterns, and the distribution of these outbreaks. While Whole-genome sequencing (WGS) is being incorporated into public health surveillance globally, with the potential to make significant contributions to enhance outbreak response, its use in outbreak response in Kenya is limited and there is no existing capacity for real-time analysis.  Furthermore, there is limited evidence regarding integration of field genomic data into epidemiological investigations and how to quantify and evaluate their public health impacts. The RaViG project Launched at KWTRP and led by Dr. George Githinji is aimed at assessing whether implementation of real-time, in-field genomics to support investigation and management of suspected viral outbreaks in coastal Kenya is feasible and provides added value to the conventional response, to support public health surveillance and enhance outbreak response. Speaking during the Launch the Head of the ED Department Dr. Anthony Etyang noted that as seen during the Pandemic Public emergencies required the combined efforts of multidisciplinary fields to be successful. He noted that the RaVIG project was one that could support the collaborative efforts to build capacity to deal with public emergencies. The RaVIG project assessments will involve coordinating with Kenyan Coastal counties rapid response teams, to work out the logistics of deploying portable sequencing alongside conventional responses. The teams will then deploy portable sequencing during outbreaks of suspected or confirmed viral origin. This will also include stakeholder engagement to inform the development of processes for evaluating portable sequencing. The project team will use a mixed methods approach to compare the sequencing for two selected outbreaks with the conventional outbreak responses to evaluate the added value from the portable sequencing. The project is a collaboration between the KEMRI Wellcome Trust Research Programme in Kilifi, Kenya (KWTRP), the UK Public Health Rapid Support Team (UK-PHRST), the Kenya Ministry of Health (MoH) and public health officials of six coastal counties. The work has been funded by UK Government Department of Health & Social Care (DHSC) Official Development Assistance via UK-PHRST research funds. The UK-PHRST is funded by UK Aid from the Department of Health and Social Care and is jointly run by UK Health Security Agency and the London School of Hygiene & Tropical Medicine. Dr. John Kiiru who is Head, Division of Laboratory Sciences, MoH-KE, and Component Head, of the Laboratory Research and Safety at the Kenya National Public Health Institute, highlighted the Partnership with KWTRP during the pandemic that ensured teams worked together and built capacity which has since supported the MOH work beyond the pandemic. “We recognise the RaVIG initiative as being supportive to our aims as a country to accelerate our efforts in early disease warning systems which genomic sequencing is part of” he emphasised. Reflecting on the importance of partnership the Deputy Director for Research at the UK-PHRST, noted that the team traditionally valued partnerships and approached mot projects by co-creating the responses including

It is a bittersweet moment for the KWTRP family as we make changes to our Leadership team. After 10 years of tremendous growth and change in the Programme. Prof Philip Bejon officially steps down as the KWTRP Programme Executive Director. As the Director of the Programme, Philip has led us in successfully securing 2 rounds of the Wellcome Core Award, and under his leadership the Programme has grown tremendously in scope and impact. In his science career and since joining the Programme in 2004, Philip has made major scientific contributions to the Programme in malaria epidemiology and vaccinology examples being his support and valuable contribution in the RTSS Malaria vaccine trials, contribution towards establishing the Human Challenge Studies Platform and providing leadership to the COVID 19 research work among many others. He has equally supported the careers of several PhD students and postdoctoral students. Philip continues being part of the Programme, continuing his research projects and collaborating with colleagues on science. Prof. Edwine Barasa takes over as the Interim Executive Director. Edwine has been part of the KWTRP leadership team as the Deputy Director and the Nairobi Programme Director. Edwine is recognized for his work in Health Economics and financing and has rich experience in providing leadership in evidence-to-policy work. “I am excited to lead the KEMRI-Wellcome Programme in our mission to advance global health research and make a positive impact on people’s lives. Together, we’ll drive innovation, collaboration, and positive change for a healthier future” he said. We welcome the changes as we seek new horizons as a Programme.

We engaged experts in infectious disease surveillance to help identify pathogens that should be prioritized for serosurveillance in Kenya. A carefully selected group of respondents were invited to participate in multiple rounds of consensus building engagement activities until a final list of fifteen pathogens was generated. Read more about the deliberations of the consultative workshop in this meeting Report.

We held a 2-day consultative meeting with our Media Advisory Group (MAG) on promoting public awareness in genome sequencing. The team shared valuable insights on how to develop engagement tools that can be used to build public understanding of genome sequencing and its impact on public health. The MAG also joined community members where we together watched and shared feedback on an animation video that aims at communicating genome sequencing to the public. The Media Advisory Group is composed of both print and broadcast journalists, editors, social media influencers and a representation from professional bodies and the community. The group gives advise on the effective dissemination of our research knowledge.

Delegates from the Ministry of Health, County Departments of Health, health facilities, and academia/ research convened on 17th October 2023 for a Second Consultative Workshop on Research Data Access and Use for Public Health Decision-Making. During this Workshop, delegates discussed pathways towards implementing priority recommendations identified during a prior consultative workshop held on 23rd May 2023. Read more about the deliberations of this workshop below.  

Celebrating World Pneumonia Day 2023 We commemorate World pneumonia Day on the 12th of November annually, a reminder that Pneumonia remains a preventable and curable disease. Despite substantial progress over recent decades, much remains to be done. WHO estimates that pneumonia affects approximately 450 million people per year globally. In 2019, Pneumonia claimed the lives of 740 180 children under the age of 5, accounting for 14% of all deaths of children under five years old globally. Reducing childhood pneumonia mortality in many parts of sub-Saharan Africa remains a major challenge due to limited access to healthcare services, inadequate vaccination coverage, and the high prevalence of underlying conditions such as malnutrition and HIV. Additionally, environmental factors like air pollution and poor living conditions exacerbate the risk of pneumonia in children. Data from the Kenya health Information System indicate a substantial increase in cases over the last year from 477,186 cases in 2020/2021 to 793,864 cases in 2022/2023 particularly in Mandera, Samburu, Narok, Isiolo, Marsabit, Tana River, and Wajir counties. Factors such as poor nutrition and seasonal flooding are significant contributors to this trend. What exactly is pneumonia and what causes it? Pneumonia is an inflammation of the lung tissue (respiratory bronchioles and alveoli), where exchange of oxygen occurs.  It is mostly caused by microorganisms that enter the lower respiratory system causing infection. Viruses and bacteria are the most common causes. However, it can also be caused by TB, fungi, and parasites. Pneumonia can also result from inhaling substances that irritate the lungs. How is pneumonia transmitted? Pneumonia can be spread in several ways. The viruses and bacteria that are commonly found in a child’s nose or throat, can infect the lungs if they are inhaled. They may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. More research is required on the different pathogens causing pneumonia and the ways they are transmitted, as this is of critical importance for treatment and prevention. Who is at a greatest risk of contracting pneumonia? The risk of disease is greatest in children less than 5 years old and adults older than 75 years. This is believed to be due to their reduced immunity. Other risk factors include, smoking, air pollution, upper respiratory tract infections, chronic diseases – lung disease, diabetes, heart disease, cancer, malnutrition, HIV/AIDS, prolonged bed rest among others. Pneumonia also occurs more in low to middle income countries as opposed to high income countries. Where healthcare infrastructure is lacking, and people are least able to afford the treatment. What preventive measures can be taken against pneumonia? Immunization against Hib, pneumococcus, measles and whooping cough (pertussis) has proved to be a highly effective way to prevent pneumonia. Adequate nutrition is also key to improving children’s natural defenses, starting with exclusive breastfeeding for the first 6 months of life. In addition to being effective in preventing pneumonia, it also helps to reduce the length of the illness if a

The KEMRI Wellcome Trust Research Programme (KWTRP) convened stakeholders for a follow-up session on data access and use for public health planning and decision-making. This forum focused on discussing pathways to implementing priority recommendations generated during the first consultative workshop. The priority recommendations and additional information on data access and use for public health planning and decision-making can be accessed in the June 2023 consultative meeting report.

KEMRI participated in this year’s annual ASK Show held in Mombasa where our team participated to show Programme research work. The team scooped 2 top awards: Best Stand in Research and Development and Best Display Services in the Health Sector & Pharmaceutical Stand. Several dignitaries toured our stand including the Botswana High Commissioner to Kenya, H.E Andrew Sesenyi. Congratulations to the team.

The Bioscience Department hosted a 2-week training workshop on metagenomic next-generation sequencing sponsored by Africa-CDC. The trainees included 6 public health workers from East Africa and a research scientist/lecturer from Mombasa Technical University. Many thanks to Leonard Ndwiga, Shaban Mwangi and Kioko Mwikali who were the training instructors.

We hosted the SANTHE Consortium Research visit between 11th and 12th September 2023. Representatives from SANTHE partners (CREMER, Cameroon; Botswana-Harvard AIDS Institute Partnership (BHP), Botswana; Makerere University, Uganda; CFHR, Zambia; AHRI, South Africa; KAVI-ICR and Pwani University were in attendance. The meeting focus was for SANTHE funded Masters, PhD, and Postdoctoral fellows to provide an update on their research projects. It also provided an interactive platform for potential collaborative work and grant writing between the partners.

Congratulations to Emelda Okiro who has been awarded full professorship in Global Health by Oxford University. Emelda who leads the Population and Health Impact Surveillance Group in KWTRP was awarded the title in recognition of her research achievements, contributions to and to the general work of the Nuffield Department of Medicine. With over 18 years of population health experience at country, regional and global levels, Emelda has proven competency in public health and health systems research, implementation, and programme evaluation. In receiving the news Emelda said “I am honoured and thrilled, this achievement wouldn’t have been possible without the support of my incredible colleagues at Population Health Unit, mentors, students and KWTRP and Wellcome Trust. I’m excited to continue my journey in academia, pushing boundaries and inspiring future leaders. Thank you all for being part of this incredible milestone!” Prof. Bob Snow who has been Emelda’s mentor noted “Emelda’s professorship at Oxford reflects her senior leadership in global health. Having had the opportunity to provide support to Emelda has been a privilege and an honor. Her dedication to her personal scientific journey serves as a model for all those starting their careers”. Hongera Emelda!

The growing global commitment to universal health coverage (UHC) has raised a critical question on what services should be made available and under what conditions. This has led countries to focus on developing/updating a set of services that can be feasibly financed and provided given their current circumstances. This set of services is commonly known as a health benefits package (HBP). Low- and Middle-income countries (LMICs) are more disadvantaged than high-income countries in providing more comprehensive health services due to their limited resources. The limited resources have necessitated several African countries to consider a more explicit evidence-informed deliberative process to aid in prioritizing which services to pay for, to whom, and at what cost.  The AfroHTA network hosted a webinar to explore African countries’ experiences developing and refining the Health Benefits Packages to support their commitment to UHC. The webinar brought together experts in health economics to share experiences from Rwanda, Uganda, and Ghana. Here, we summarize key learnings from the webinar. The development processes The Ministry of Health led the process of developing benefits packages by establishing a task force/committee to coordinate the process. The task force ensured it engaged stakeholders such as policymakers, development partners, civil society organizations (CSOs), agencies such as purchasers, providers, representatives of public health facilities, professional associations, academia, the private sector, and patient associations representatives. Enablers The following factors contributed to the success of developing and implementing benefits packages across the three countries: The development of policies and legal frameworks: A vital step in establishing a health benefits package is establishing a policy and a legal framework. For example, Uganda, Rwanda, and Ghana had no policy to aid in developing a benefits package. Where they did exist, they needed to be more comprehensive or updated, prompting the respective Ministries of Health to collaborate with stakeholders to develop policies and guidelines to ensure sustained support for HBP implementation. Institutional arrangement: A structured and functional organizational arrangement with clear mandates on developing and refining the health benefits package is effective in fastening the development process. This reduced the conflict of interest between the purchaser and the provider by enabling constant stakeholder engagement and reaching a consensus. Stakeholder participation: The involvement of diverse actors in developing and implementing of benefits packages enabled comprehensive consultations and sufficient input which created a sense of ownership and facilitated smooth implementation. Explicit evidence-informed criteria: Enable the application of value metrics while developing benefits packages. In Rwanda, what to include in the benefits package considered: – the impact of health problems as measured by financial cost, morbidity, mortality, or their combination; the degree to which the disease affects vulnerable populations; cost-effectiveness; the severity of the disease; budget impact; and political and emergency considerations. In Uganda, the inclusion criteria included: – cost-effectiveness, disease burden, equity, alignment with national health policy guidelines, and feasibility of implementation. In Ghana, they widely used priority-setting tools such as HTA to develop their benefit package and among the criteria considered was equity, burden of disease, and cost-effectiveness. Leadership: Supportive leadership is critical to

The KEMRI Wellcome Trust Research Programme in partnership with the Pasteur Institute of Dakar (IPD) will be hosting a webinar on Market Access for Vaccines – Factors that influence personal choices. Barbara Ngouyombo, Associate Director Partnerships at Institut Pasteur de Dakar with be the guest speaker for the webinar scheduled for the 7th  of September 2023. This webinar will be presented in French. Interested in attending this webinar, Register here. https://shorturl.at/dnxHU. ——– The Pasteur Institute of Dakar (IPD) is a Senegalese private foundation, non-profit and recognized as being of public utility. It is a member of the international network of Pasteur Institutes.  Its objective is to “contribute to public health in Africa, particularly in Senegal, by conducting activities related to research, teaching, training, medical, epidemiological and biological expertise, and yellow fever vaccine production. The IPD stands out as a research hub serving African populations, particularly in addressing public health issues across the entire continent. Its expertise and innovative work radiate on an international scale. The KEMRI Wellcome Trust Research Programme (KWTRP) is a world-renowned health research unit of excellence based in Kilifi and Nairobi in Kenya as well as Mbale in Uganda.  Over the years, KWTRP has excelled in the use of novel ideas, and collaborations to achieve better health for Africa while also developing African scientific leaders. The KWTRP Vaccinology Workforce Development (KWTRP_WFD) is a programme that seeks to expand the technical know-how and capability for sustainable end-to-end vaccine research and development in Africa through collaborative training and knowledge exchange activities. The programme scope covers the vaccine ecosystem including target product profiling, discovery, biomanufacturing processes, quality assurance, pre-clinical and clinical studies, regulatory affairs, and deployment.

This hands-on training for upstream process development in vaccine manufacturing is to equip participants representing the biomanufacturing workforce from LMICs with essential skills required to operate according to current good practices. This course will be conducted in-person over six weeks and will include two weeks of didactic sessions and four weeks of hands-on adenovirus vaccine upstream process development. The course is targeting technicians, scientists, engineers, or managers employed by an entity formally registered in Africa and currently involved in the production of vaccines Course Information (Offline, South Korea) For further information For questions related to this, please contact IVILearningPlatfrom@ivi.int The receipt of the applications will be automatically acknowledged via return email from IVILearningPlatfrom@ivi.int. Applicants who do not receive an acknowledgement within the specified time should contact IVILearningPlatfrom@ivi.int. An acknowledgement of the application receipt does not imply that the application is complete and eligible for review.