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discount cialis Well, I first visited Kenya in 1987. I was in fact to attend a scientific meeting. At that time I was working in Oxford, the Oxford University, having recently returned from the Gambia in West Africa where I began my research work and training in tropical medicine and health research. At that time, I was planning to, with colleagues, develop a research programme, probably in West Africa, because the programme was about malaria so its location wasn’t an issue. It was about malaria.
And colleagues in Kenya suggested that this was the best meeting. I came down to Kilifi just to visit the place and during that period I got to talk to people in hospitals and people in KEMRI at that time and it became clear that this was a very interesting place because it is developing some collaborative research. That is because KEMRI, in the late 80s, was interested in developing research on the Coast. There was no other research on the Coast. When we came to look at the problems of malaria in this area, we realised that there was a major problem and it was the kind of problem that we were strictly interested in.
So we then began to focus our thinking about our research on developing projects in Kenya on the Coast. We obviously discussed costing with colleagues in KEMRI and also with the Wellcome Trust. The Wellcome Trust is an international funder. It doesn’t actually have a presence here in terms of organisation. It’s a funder, a bit like Rockefeller but they do have a very long interest in Kenya because they’ve been supporting work in Kenya since pre-independence time and they are also one of the organisations that helped the beginning of KEMRI so as a funder they have a lot of interest in Kenya and in KEMRI.
And so the partnership started between Oxford University where I was based, KEMRI as the national science institution and Wellcome Trust as a funder. We discussed starting some projects here in the late 80s and we began in 1989 with two projects about malaria and then to cut a long story short, basically between ‘89 and now, about 21 years, we’ve grown from a project, two projects which perhaps involved a total of 15 people to a program which now has around about 800 staff. It’s still a major presence in Kilifi as you’ve seen. There’s a research institute that has developed out of that. When we started there was nothing.
We started in one small building in the hospital grounds and over 21 years, we’ve developed into a major international high-standard research laboratories and administration and such like. We have four groups in Nairobi and the programme is now not only on the Coast and in the rest of Kenya, but we also work in collaboration with many colleagues in Ministries of Health and research organisations in the East African region. We have collaborative work at the moment going on in Tanzania and Uganda and Somalia at times, although that is not the easiest place to work, Sudan, Southern Sudan, Djibouti. And so basically in a nutshell, that’s how I came to be here. I came to be here because of my interest in malaria and KEMRI’s interest in developing research on the Coast and that initial interest grew over the many years with many colleagues to allow the research programme which now works not only on malaria but all the major causes of ill health in the region.
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discount cialis Yes. I’m a doctor and a scientist. My scientific interest is immunology; the way people learn to resist disease and my medical interest is obviously in tropical medicine and particularly child health in this kind of setting.
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discount cialis I’m British originally but I’ve lived in Kenya for 21 years, so I’m not sure what I am any more. Under the new constitution, I’ll be able to apply for Kenyan citizenship and I will do, I will do. But at the moment of course you can’t have dual citizenship.
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discount cialisWellcome is interesting. The Wellcome Trust people often think it’s the Wellcome drug company and this is because in the past of course, Wellcome was associated with…
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PROF. MARSH: That’s right. Wellcome Foundation. Now, what happened is that when the founder of the Wellcome Company died, he left his company and all the profits of it to charity. So his idea was that the drug company should support not shareholders, but should support research. So some years later in the 1980s, the trustees of this charity decided to sell off the company as it were. So the company eventually ended up being GSK in part. And so what the Wellcome Trust did is the money that came from the sale of that company is used to fund entirely medical and biomedical research.
It spans all over the world particularly in the UK but it has very long term interest in human and animal health in tropical countries and they had a particular interest in Kenya just by chance. They happened to have people working here connected with Wellcome in fact since the late 1940s; that’s for 70 years. And so in pre-independence, the Wellcome Trust was supporting a lot of work in Kenya and when KEMRI was formed in 1979, the Wellcome Trust was one of the partners that were involved in the formation of KEMRI. KEMRI of course is the national body mandated to undertake research about health in Kenya. So the Wellcome Trust as a funder and KEMRI already knew each other very well.
And then the third element is Oxford University which is where I was based in my college. So what we have is a national research institute in collaboration with the university in the UK and in fact now quite a number of other universities and then supported by a funder to whom we apply for funding.
So the Wellcome Trust itself doesn’t have an agenda or research agenda. We as KEMRI and what we call the KEMRI-Wellcome Programme have to apply to the Wellcome Trust. And we also have other funders of course, we don’t only have the Wellcome Trust but the Wellcome name is there because for over 21 years, they’ve been our major consistent funder so although we go to other funders, they are our main funder
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discount cialisYeah, areas of collaboration. Well, it’s interesting in the sense that we don’t think of it as different areas of collaboration in the sense that the whole enterprise is a single programme within KEMRI so we call it the KEMRI-Wellcome programme but it isn’t that we have some people collaborating outside that. The whole programme operates as a single programme within the KEMRI centre.
But of course outside that we have many other collaborations all across the world both in Kenya and in East Africa but also we scientists and other researchers working on the same kinds of things we work on like malaria, in HIV and in malnutrition. Basically we work on all the major causes of ill health strictly in children but increasingly also concerned with others. So we have around about 400 collaborations altogether all over the world.
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discount cialisYes. I think it’s very important when you are thinking about research to recognise the difference between partners, donors and funders. Often I guess, like areas you are particularly interested in, you’re probably often used to talking in terms of donors and partnerships. But research is rather different.
Research is like an internationally competitive enterprise so we actually don’t work any differently as a programme in Kenya from any research program or institute across the world. So, just as in America or Europe so it is in Kenya, a research organisation has to go out and compete for money. And I think that distinction between a funder and a donor is very important.
In a lot of development activities, we have people talk of donors and that kind of implies probably a structural agenda for that donor and partnership with the government or whatever. Ours is rather different. Ours is scientists driven by scientists. We have the governor of all strategy but the actual funds come from funders not donors. We go out and apply to do this, to do that and we compete with people everywhere else.
So if we work on malaria, we might be competing with other people in Kenya, we might be competing with people all across Africa and so we end up actually with a lot of different sources of funding, not just one big source of funding. I said to you before that the Wellcome Trust just happens to be our biggest funder but we do also receive funds sometimes from the World Health Organisation, from Gates Foundation, DFID and a number of other organisations.
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discount cialisNo, not at all. In fact we don’t do any commercial work. We are an academic, if you like, and indeed because we have so much funding from the Wellcome Trust which is a charity, we would not really within the terms of our research be able to work commercially. Our interest is knowledge generation and it sits more with the kind of approach in academia in universities but we are not a commercial enterprise and we are not contracted by them to do commercial work on their behalf.
Our research is driven by the researches and the programmes in interaction in Kenya with the two ministers responsible for health and with the policies of the National Council for Science and Technology. So we have to look at what are Kenya’s health priorities, what’s the information that is required to develop health policies and then we frame our research questions to supply the evidence base that policy makers need in Kenya.
Why do people fund it? I hope it’s because we do good research. As I said, research funding is a competitive issue. You compete for the money and I hope the reason we get money is because we do the research well.
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discount cialis We think so. We hope so
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discount cialis It’s funny. People often talk in terms of breakthroughs but science often doesn’t work in breakthroughs. But we can certainly point to some big areas of research we’ve been involved in which have had a big influence both in Kenya and across Africa. One would be the use of impregnated bed nets for the control of malaria. As you know, this is now the major tool for the control of malaria.
Now this policy all around the world is actually based on just four studies which were carried out about 20 years ago and one of these was a large study that we carried out here in Kilifi District. So I think we are proud of the fact that that large study in Kilifi district was one of the main studies which led to the current international policies where the example of a research programme conducted here which now has an impact all over the world.
Other ones would include the treatment and prevention of malaria in pregnant women. Again, that’s based on research which was done here in Kilifi. We’ve been very involved in the current testing of the malaria vaccine.
You probably know that a malaria vaccine is being developed. It’s currently at what we call phase 3 testing which means that it’s now being tested in multiple sites across Africa, I think 16 sites in 11 countries. Three of those sites are in Kenya and we are one of those sites so we hope this is going to have a big influence.
For the rest of the research, I see people often people talking about breakthroughs but it’s actually yielded different work especially. The yielded works are the building of the bigger picture. So our work has contributed to the current Kenya national guidelines for the treatment of children.
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discount cialis And internationally, a lot of WHO guidelines have been very influenced by the research done in this programme. So it’s more of key milestones rather than one big breakthrough.
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