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PROF. MARSH:It’s almost like difficult. If you focus on what you call setbacks, in a way, one person’s setback is another person’s challenge and opportunity. I mean, science is hard to do, research is hard to do anywhere in the world. To obtain funding is hard to do. To build up a research centre in a rural town on the coast of Kenya has challenges because for instance, when staff are thinking ‘where do I want to work,’ many people, many trained professionals wouldn’t see coming to a rural town as their favourite. They want to work in Nairobi. So those kinds of things you could regard as challenges and setbacks and we certainly have to work quite hard to make it the place that people want to work and come to but I don’t see that as a problem, I just see that as the concept we work in and the outcomes. I think we are actually very lucky in not having major setbacks. I think, we do expansion of our support. As I said to you, we’ve gone for 21 years from about 15 people to 800 people. We’ve been able to have a huge group. We’ve actually developed this research centre. As you go around, you’ll see that it’s a research centre which Kenya can be proud of.
But on a daily basis, we’ve got many challenges to overcome. We have to continuously explain ourselves, discuss with the community. To work long term in a community, it’s important. You can’t just take people for granted even though the work we do is for the benefit of everybody. But of course if you are working with communities, you are asking them questions, you are asking to take samples of blood or whatever for research, you can’t expect them to say, ‘great, we really like that.’ so, all these things, there’s a lot of hard work that goes into it. But in terms of setbacks, I don’t think we have any that other people don’t have. The problem for scientists across Africa is support from funding. Kenya is no different from most African countries. Most people feel there isn’t sufficient investment in research. That’s a challenge. And they need to build up leadership, scientific leadership within the region. We start from a base where the number of scientists, Kenyan scientists is not as high as we would want.
Everybody knows that a lot of work is supported from outside the collaborations. This is tricky because all over the world, work is supported by many from outside and that is the problem. In England at the universities, we don’t see it as a weakness or problem if we draw lots of money, say from the Gates Foundation in America. So the idea of support from outside being a problem I think is a strange one ‘cause that’s how science works everywhere. But of course what is a problem is that the work isn’t driven within Kenya by Kenyan scientists. You must think I’m in a strange position and that’s so because I’m also not from Kenya but having been here for a very long time, my main interest is to make sure that we really do have a strong group of Kenyan scientists to lead the research. So, I think the lack of capacity is a challenge but it’s a challenge which I think we are tackling.
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buy levitra online It’s not. Of course if you are the government, then the problem is everyone is arguing, ‘you make my thing a priority’ but I think there is a general international feeling that a proportion of your GDP should be spent on research but I think most African countries are well below what even collectively they’ve agreed to do. There are some countries which are trying to increase their research spending; Tanzania has really pushed hard, our National Council for Science & Technology is pushing hard to raise government investment, but that’s a challenge for research in general in Africa. There isn’t sufficient investment.
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PROF. MARSH:Well, that’s a good question. Firstly, we are all in Kenya. We are all within the KEMRI umbrella. So within an organisation one should know what other people are doing. I think in general, we try and make sure that we have good communication with all the groups in Kenya and we don’t want to duplicate work although sometimes it’s important to be working on the same thing. Like for instance, you are absolutely right, one of the big studies on bed nets work done in Western Kenya was by CDC. One of them was done here in the Coast. And that’s a good thing because if you’ve got a really important intervention, you need to make sure that it really works in several places, not just one.
So I think we have group communication with different groups in Kenya and we look at our programme and we look at what they are doing and we try and make what we do complementary rather than try to repeat what other people have done.
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buy levitra online It’s different in some ways but not in others. Our study was done earlier. People still thought they needed more evidence the bed nets work and they were particularly interested in how to protect people who are not under the nets, so when they set up a study in western Kenya it was a somewhat different design, but either way, they gave the same information as here. You know if told you one piece of information and say on the basis of this, you should go out and buy this or that, you’d say ‘No’ but if I give you a second time or third time or fourth time, well it’s a bit like that with a big intervention. By the time you have three or four big studies which have all shown the same results, that’s when international agencies say ‘well, we should now make our policies clear. This really works. It doesn’t just work in one place; it works wherever it’s tried.
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buy levitra online Yes. I feel proud when our research team does well. I feel proud for everybody’s success, when they have success. Just last week, we had four of our team members awarded research fellowships and every individual person who succeeds in their career makes me feel very proud. The big ones would be certainly when we built and opened this research centre. This opened in 1995, about 16 years ago. Prior to that, all our work was done in Kilifi hospital. We were very fortunate that the hospital had a little demand of the old buildings.
We were working in really very restricted physical setting and we were lucky to have the partnership between KEMRI and the Wellcome Trust. The Wellcome Trust funded the building and we were very proud when that was opened by the Hon. Charity Ngilu who was the Minister for Health. You could see in a concrete way, what had been built so I think that’s for sure. When particularly important pieces of work have an effect on policy, we are proud whenever that happens.
I’m always proud when the centre is well known outside. What’s quite interesting is that around the world, people would know, which is a bit ironic, people would know more about Kilifi than most people in Kenya would. If you go to any international health meeting around the world, people would know where Kilifi is because of the work that we do. It’s possible that a lot of people in Kenya don’t know what goes on here. So I’m always very proud when you hear people talking about the work that goes on in Kilifi particularly if you overhear that, when they don’t know if you are associated. That’s what makes me proud.
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buy levitra online Ok, when you talk about visions and missions and that sort of thing, the long-term vision is that we want to see a healthy Kenya. We want to see everybody in Kenya healthy. That’s what drives what we do. In terms of the vision of how the work will develop, I think for us the key issue is the building of a very strong group of Kenyan scientists to lead the research, so in one sense, it’s not for me to say what will be happening in 10 years. It will be for the group of scientists who come in. But in a broader sense, my vision is that we will continue to identify and work hard in major health problems. So, it’s not like a commercial company where your vision might be to be able to get bigger and bigger and bigger and richer and richer and richer. I think we are already at the size and we work all over Kenya and we work in other countries in East Africa. So in terms of what I see in 10 years, I don’t see us being a lot bigger. I see us really being well known for working on areas of importance and I see us being recognised as a regional research programme and one that is very strongly led by Kenyan researchers.
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buy levitra online: Yes. Capacity building or capacity strengthening, people argue about what you call these things because building sometimes implies that there’s nothing to start with. We have plenty of capacity and in fact Kenya is very lucky because compared with many African countries, it has an enormous number of science graduands, high quality education compared with many countries.
So in that sense, there is a lot of capacity. We think of it more as strengthening rather than building, but our aim is to have a very strong, vigorous, internationally competitive Kenyan research programme and the centre itself will be developed but the programme goes beyond the centre. We work not only in Kenya but in many other countries.
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buy levitra online In broad terms at the moment, our annual total cost of the programme is about 12 to 40 Million pounds sterling. About 70 per cent of our total support comes from the Wellcome Trust. But this is not given one big grant. At any one time, we might have 70 different grants. In terms of our output, we publish about 150 publications a year with one of the most scientifically productive groups in Africa in terms of the number and quality of publications from the number of researches we have, so we are proud of that.
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PROF. MARSH: An HIV vaccine is a real challenge. I have to say at the moment that a HIV vaccine development is only in its early stages. There are people working on the vaccines of course and we are associated with groups that work on vaccines. We hope that our involvement with HIV, will lead us to testing vaccines. It‘s been very difficult to develop a HIV vaccine. Malaria is difficult but HIV is even more difficult and so I think in future I think it’s possible there will be a malaria vaccine and HIV vaccine. I think it’s possible but if you were to say to me ‘Am I certain there’ll be one within 15 or 20 years…’
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buy levitra online You can say there might never be a HIV vaccine. We hope there will be but it’s really tough to make a HIV vaccine
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buy levitra online:No, I don’t think there’s no hope at all because in fact if you look at the prevalence of HIV, it’s coming down in many African countries including Kenya. So although vaccines are great, it’s not the only solution. So drugs have been developed. Many people thought it wouldn’t be possible to develop effective treatment for HIV. Now we have a lot of effective treatment that’s revolutionised people’s lives. Prevention of HIV by both social and educational methods, by condoms and also there’s a potential of preventing HIV also by drugs. So I don’t think there’s no hope at all, I think we can be very optimistic that HIV can be controlled but there’s a whole society that needs to control it. I think we are more optimistic about malaria vaccine because the current one being tested we know worked in the earlier test to a good degree. We don’t know how effective it will be when it’s used across Africa as a whole but at least there is room to be optimistic that it will be possible to develop a malaria vaccine.
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PROF. MARSH: We don’t really do that kind of research in the sense that drug development tends to be done, as you say, in drug companies and so that’s not really the kind of work we do. What we do is more involved with testing those new products when they come out. For instance, oh, not when they come out. Like the malaria vaccine we didn’t develop the malaria vaccine, but we can help test it. We have developed new things that are not necessarily drugs. So for instance, we did develop a kind of intervention based on training rural shop-keepers about how to treat people and children and that was adopted but that’s an educational approach. So no, we are not in the business of making drugs. That tends to be the drug companies’ business.
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PROF. MARSH: For us, there’s a whole different types of communities we need to communicate with. So here in the district, I had said to you earlier that to work in a community for over 21 years and to repeatedly go back to that community to engage them in research, you’ve got to work very closely with them. So we have a very well developed network of consulting with the community and this involves having groups of people and individuals identified as community representatives. We have a lot of large group meetings but we also consult with these small groups of leaders within the community, both administrative leaders and other sorts of leaders but then people who are elected within the community as representatives. They are representatives; they are not like community advisory boards often are. Their main aim is not to represent us to the community. It’s to help us know about what the community thinks on an issue. It’s a constant process going on; a very large grouping whose only job is to maintain those relationships.
But then as you implied, there’s also an issue of how we communicate with the general public in Kenya. I think that’s the thing which research centres and societies often don’t do very much. We are happy to have the opportunity to do this kind of interview. We do have people in the programme who are now developing that kind of science… the science communication side that’s a very interesting set up. There’s an organization that colleagues are involved in Nairobi called the Science Café. They are involved in setting up the organisation called ‘To Do Kenya Science Cafés’ and what this involved is literally holding meetings in public places like cafes where a scientist would go along, it would be advertised to the general public, people go and ask questions. It might be about anything. It might be about HIV, it might be about absolutely anything. So we’re definitely aware of the need to do more of that kind of work.
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buy levitra onlineIt’s interesting. Somebody asked that the other day. We don’t do that specifically because I think there’s a difference between an organisation whose primary output aims to be a good as it were and an organisation whose primary output is commercial and that fulfills the obligation as public relations. So we would say that our core work fits under that umbrella so we don’t specifically in addition go out and promote ourselves in that way that the commercial organisation like Safaricom or Barclays Bank or whatever. But of course we do when we are specifically in the community and we are called on to help, we try and help out as one of the many, many large groups within the community. At times when there are specific things, whether challenges like food security or whatever, we’ll be called on by people in the community to help and we do that both as an organisation and as individuals. A lot of individuals in the programme will get very involved with local initiatives, local fundraisings in the local community.
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buy levitra online:One other thing that we are proud of is that we now currently support within the programme 50 Kenyan Ph. D students which is a lot, I mean, it’s more than many universities would have. Now, more than half our post-doctoral scientists, I mean people who are qualified scientists as opposed to people in training, we now employ about more than half of the scientists from Africa and that’s something we are very happy about and also through the programme, we’ve got many senior scientists who not necessarily sit in the programme to train through the programme and having an effect in Kenya, for example Prof. Gilbert Okwaro who’s headed the Controlled International Health Research for 20 years within our programme and if we look in other departments in KEMRI or in universities, many of their staff or senior members are people trained through the programme, so that’s an area that we feel very happy about.
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buy levitra online Well, the centre, the physical centre, the KEMRI centre is here, but members of the programme are based outside. Four of our groups are based in Nairobi and they come under this centre. And then we have individuals working in many other sites with collaborators elsewhere so have members of our programme who might be based in Uganda for a while or in Tanzania for a while. But the two large groupings are here at the actual centre and in Nairobi where several large groups are based.
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buy levitra online No they are not in the main KEMRI campus. KEMRI has several sites, so it has its main campus but it also has several of its centres actually in the grounds of the Kenyatta Hospital so our particular offices are in the grounds of the Kenyatta Hospital.
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