It's been 30 years since 30 year-old Dr. Harrison Spencer; an employee of the US Centres for Disease Control and Prevention (CDC) first came to Kenya to begin a public health research collaboration with the newly created Kenya Medical Research Institute. A medical officer with CDC’s Bureau of Tropical Diseases Dr. Spencer first arrived in Nairobi in a bid to start a research station with KEMRI, mainly focusing on malaria prevention, treatment, and control. The time, which he says was one of the most enjoyable in his life, began what has now become one of the greatest investments in the history of public health research in Kenya.

The KEMRI/CDC Research and Public Health Collaboration is currently one of the largest collaborations carrying out public health research in Kenya and one of KEMRI’s and the Ministry of Health’s (MoH) main partners.     However, it is amazing to note that when Dr. Spencer first came to begin research activities in Kenya, the collaboration was housed in two small rooms located in the Kisumu District Hospital and the Kenyatta National hospital. Over the years, there have been enormous changes within the collaboration. From one staff in 1979, KEMRI/CDC now employs over 1200 employees and from one program: malaria, there are now six main health branches within the collaboration, each with numerous sub programs. Beginning with virtually no infrastructure, the organization now has numerous state of the art laboratories, high level information technology systems and vehicular support.

This year marks 30 years of the KEMRI/CDC Research and Public Health Collaboration. As a result, the collaboration held a three day celebration from the 6th to the 8th of November 2009 to mark this achievement. That the celebration immediately came after the MIM Pan African Malaria conference (held 2-6 November) was in itself significant because the first research activities by this collaboration focused on malaria, especially on finding out some of the best ways to treat and prevent this disease that kills one million under fives in Sub Saharan Africa.

About the KEMRI/CDC Collaboration

Our Mission

Our mission is to promote public health in Kenya and East Africa through collaborative research, training, control and prevention activities.

Our Work

The Centers for Disease Control and Prevention (CDC), has been collaborating with Kenyan institutions including the Ministry of Health, Kenya Medical Research Institute (KEMRI), and non-governmental institutions for 30 years now. The main focus of the activities of CDC in Kenya includes building Kenyan institutional capacity to implement programs, conduct surveillance, and do research related to HIV/AIDS, emerging infectious diseases, tuberculosis, influenza, malaria, diarrhea, refugee health, viral hemorrhagic fevers, and health systems capacity building.

Malaria

Kenya is a leader in malaria research and programming. CDC works with KEMRI, the Ministry of Health and other partners to develop evidence-based policy and programs to prevent and treat malaria. The collaboration on malaria has generated critical data that has changed national and international policy and reduced the burden of malaria in Kenya.

Global Disease Detection

We support efforts to protect the public’s health by developing and strengthening Kenya’s ability to rapidly detect and respond to disease outbreaks and emerging infectious diseases, as well as improve the health of refugees and help build Kenyan health system capacity.

HIV Research

CDC-Kenya conducts HIV research including a recent Breastfeeding Study and HIV incidence cohort studies for evaluation of biomedical interventions. We also maintain a state-of-the-art HIV laboratory at KEMRI’s Kisumu campus.

Public Health Informatics

We support expansion of the health system in Kenya to deliver timely and accurate health and disease information through improved technology, data management, software development, statistics, and geographic information systems.

Global Aids Program

CDC-Kenya supports the Government of Kenya efforts to expand and strengthen national HIV prevention, care, treatment, and surveillance through technical and financial support.

Tuberculosis

The TB program offers data and information on TB and helps the Government of Kenya in accessing information on TB prevalence. Currently also, the program is in the process of building the capacity of the KEMRI/CDC Program to conduct phase II and III TB vaccine trials.

Highlights

In the past 30 KEMRI/CDC has been involved in research in public health. Some of these have been turned into policy while others have been extensively published internationally and have affected other studies. Some of the highlights of our 30 years in Kenya include:

1. As part of the PEPFAR team, CDC Kenya has made contributions to the following achievements:

• 160,000 individuals taking antiretroviral therapy, 3.5 million people received HIV counseling and testing results in the last 5 years and 96,000 HIV-positive pregnant women received a full course of antiretroviral prophylaxis in a PMTCT setting

• 80-90% of HIV- positive TB patients are taking life prolonging cotrimoxazole treatment

• An annual increased supply of safer blood from 40,000 units in 2003 to 180,000 in 2007

2. Was the only site in Kenya involved in the rotavirus study which evaluated the efficacy of the Rotateq rotavirus vaccine produced by Merck pharmaceuticals;

3. KEMRI/CDC carried out a study that showed that preventive use of antimalarials during routine immunization visits is an efficacious means to prevent malaria during the first year of life;

4.Carried out a study that found that treating HIV-infected mothers with triple antiretroviral therapy from 34 weeks of pregnancy to 6 months after delivery dramatically lowered the frequency of mother to child transmission from 30-40% without intervention, to 6% at one year;

5. KEMRI/CDC was involved in evaluating the 2007 National Bednet Campaign that showed an increase in household bed net use from 22% to 67%, and a reduction in malaria infections; KEMRI/CDC insecticide treated bednet research showed that community provision of bed nets reduced infant mortality by 26%;

6.The level of infrastructure both at the Nairobi office found in the KEMRI offices and at the Field Research Station at Kisumu as well as other areas where KEMRI/CDC works has grown significantly. From transport to state of the art laboratories and communication technology, the growth has been enormous;

7. KEMRI/CDC has been building its capacity to carry out vaccine and drug trials. This is now evident with the rotavirus t vaccine trial that has just ended as well as an upcoming TB vaccine trial that the organization is preparing for. We are also implementing the Phase III trial for the most promising malaria vaccine, known as RTS,S;

8. KEMRI/CDC has also on many occasions supported the Ministry of Health in carrying out outbreak investigations for infectious diseases for example, H1N1 influenza, cholera, rift valley fever, among others. We offer technical and laboratory support to help the the Ministry respond faster to these outbreaks;

9.KEMRI/CDC prides itself in collecting and analyzing high quality data. In 2001 we began a demographic surveillance system that monitors health and demographic dynamics among 240,000 people visited every 4 months in Nyanza province, and supports out-patient and inpatient visits to health facilities. The DSS information supports program work and creates a background for world class research. Recent reports have shown a reduction of childhood mortality in the demographic surveillance area.

These are just a few highlights. KEMRI/CDC continues to carry out high level research in search for answers to critical public health problems.