Thought Leadership

Lessons from Kenya: from Research to Nation Building

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Editor’s Note: Last week Nigeria Health Watch Team members Ada Ezeokoli, Chibuike Alagboso and Bashar Abubakar were in Kenya to participate in the 8th KEMRI Annual Scientific and Health Conference (KASH), held at the Safari Park Hotel in Nairobi, and organized by the Kenya Medical Research Institute (KEMRI). The team learnt quite a bit about how much value Kenya places on research and came away with lessons that Nigeria can learn when it comes to implementing scientific findings.

Looking at the population and economic statistics of Kenya and Nigeria, many Nigerians would argue that it makes little sense advising Nigeria to learn from Kenya. And yet, our recent visit indicates that there is much that Kenya is doing correctly to achieve reproducible research that can be adapted to fit Nigeria’s context.

In health and science research, implementation and dissemination of findings, it appears that Nigeria has a lot to learn from the Kenya Medical Research Institute (KEMRI) model.

Legal framework for effective operation

Run as a State Corporation, the Kenya Medical Research Institute was established through the Science and Technology (Amendment) Act of 1979 as a body responsible for carrying out health research in Kenya.

It is interesting to note that two years before this, a similar act establishing the Nigerian Institute of Medical Research (NIMR) was established through the National Science and Technology Act of 1977.

The huge gap between what these two institutes have been able to achieve 40 years after establishment calls for urgent action on the part of the Nigerian institute, which appears to still be struggling to fulfil its promise.

Opening ceremony of the KEMRI Annual Scientific and Health Conference. Photo credit: Nigeria Health Watch

KEMRI and the Annual Scientific & Health Conference

KEMRI, has seven core values, which are; Purity, Innovativeness, Customer Focus, Team Work, Uprightness and Integrity, Respect and Fairness, and Excellence. One of these, “Customer Focus,” underpins how the institute has grown beyond an agency that solely depends on government budget or donor funds to a business enterprise with a good understanding of their customer segments, specific value propositions and significant contributions to national development.

KEMRI has six research programme areas aligned to help them achieve their Strategic Master Plan. These are: Biotechnology, Natural Products Research & Drug Development, Infectious and Parasitic Diseases, Public Health & Health Research Systems, Non-Communicable Diseases, and Sexual, Reproductive, Adolescent & Child Health.

Of these six, Natural Products Research and Drug Development (NAPREDA) is dedicated to identifying and developing effective traditional/alternative medicines and drugs for use against human diseases. In Nigeria, the Federal Government announced in January that it would release N100m to the National Institution for Pharmaceutical Research and Development (NIPRD), targeted towards the research and development of traditional medicines.

Some ground-breaking technologies like the one from MAGBIO exhibit at the
conference. MAGBIO makes blood storage containers that enables research and
diagnostic laboratories preserve their samples for over 11 hours under room
temperature. Photo credit: Nigeria Health Watch

KEMRI has research links that span across all the regions of Africa, Asia, Europe and America. The Kenyan Government recently made it constitutional to appropriate two percent of its national budget to research. KEMRI helps to disburse such funds to research that addresses public health concerns in Kenya. NIMR on its part was allocated a paltry N815m in the 2016 budget and out of this, a large chunk (N759m) was for recurrent expenditures. This implies it only had just N56m to invest in new ventures and activities. Little wonder it continues to lag.

KEMRI has six constitutional mandates, which are: To carry out research in human health; to cooperate with other research organisations and institutions of higher learning on matters of relevant research and training; to liaise with other relevant bodies within and outside Kenya carrying out research and related activities; To disseminate and translate research findings for evidence-based policy formulation and implementation; to cooperate with the Ministry of Health, the National Commission for Science & Technology.

Of their six constitutional mandates, KEMRI is very proactive with dissemination and translation of research findings for evidence-based policy formulation and implementation. This mandate was probably the motivation for the recently completed KEMRI Annual Scientific and Health Conference (KASH) which held in Safari Park Hotel Nairobi, Kenya, from February 13th – 16th 2018.

Running for the 8th year, the KASH conference brings together KEMRI researchers working in various counties across the country and provides a unique opportunity for them to share updates with colleagues, find collaborators, and prevent duplicating already existing research.

“The Conference started as a collaboration between KEMRI and the Kenya Trypanosomiasis Research Institute of Kenya. Then it used to be called Africa Health Sciences Congress and held across various regions,” says Professor Jennifer Orwa, Chief Research Officer, KEMRI.

“The KEMRI management was supporting over 50 scientists from the ten research centers,” she says, adding, “They didn’t know each other, and they would go back to their respective labs after the conference without knowing what others are working on. This inspired us to start the KASH conference to enable researchers network and share what they are doing with each other. We started holding it at the institute but when it became big, we moved it out of the institute.” Professor Orwa is fondly called “Mama KASH” as she is the backbone behind the annual conference. She highlighted funding as one of the challenges that KEMRI continues to face in their operations.

Dr. Amit Thakker makes a case for achieving Universal Health Coverage in
Kenya during his plenary session. Photo credit: Nigeria Health Watch

Implementation and dissemination of scientific findings

The conference had over 400 participants this year with six plenary sessions, seven symposia sessions, and oral and poster presentations in 12 research areas.

One of the plenaries dealt with the road to Universal Health Coverage (UHC) and what Kenya still needed to get there. Speaking during the plenary presentation, Dr. Amit Thakker, President of the Africa Healthcare Federation, argued that what the health sector needs to thrive is creative and sustainable financing models that reduces out of pocket spending by patients. His presentation focused on achieving UHC for Kenya using the Sustainable Development Goal 3.8 as a framework. He emphasized the role of health plans built around communities-to achieve this.

Honorable Dr. James Nyikal, a Member of the Kenyan Parliament who is also on the health committee, said he participated actively in the conference with his colleagues to help them understand the needs of the institute before their budget is presented to the house. Active participation also ensured that findings are implemented to improve public health outcomes, he said.

To ensure that research findings from the conference are disseminated effectively, the conference organizers engaged in a partnership with Science Africa. Science Africa is a media house specializing in science and health journalism and communication, development support communication, and publishing. Science Africa worked with the Solutions Journalism Network to organize a pre-conference attended by science reporters from Tanzania, Uganda, Nigeria and Kenya. The pre-conference helped the journalists understand the role of Solutions Journalism in driving positive social change. It also gave the journalists an opportunity to learn from researchers and scientists in Kenya and get access to research findings to help develop their stories.

Researchers and participants during a plenary session at the KASH conference. Photo credit: Nigeria Health Watch

Any takeaways for Nigeria?

In this 2017 interview with Professor Babatunde Salako, Director General of National Institute for Medical Research (NIMR), he listed a plethora of problems as to why the institute is currently underperforming. Top on the list were funding and management challenges. Commenting on achievements since his one year in office, Professor Salako is quoted to have said, “The institute has sent to the health ministry, reports on highly resistant bed nets and HIV drug resistance”.

Looking at what KEMRI has been able to achieve since inception, there is need for the Nigerian government to take a critical look at the KEMRI model, take a more proactive stance on research and development in the health care space and most importantly, work towards turning research findings into actual strategies that can improve the Nigerian health sector. To achieve this, the Federal Government needs to invest more funds in the activities of NIMR because it’s obvious KEMRI has been able to attain international recognition in research and development as a result of sustained investment by its government.

Yes, we understand the focus of the government on infrastructure, but a society that does not invest in research will continue to be dependent on foreign interventions, and this is no sustainable way to build a country.

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