30
120 YEARS OF ADVANCES FOR MILITARY AND PUBLIC HEALTH
Check-up exam prior to malaria vaccination in Kisumu-Kombewa, Kenya, as part of a joint GSK/PATH-MVI/KEMRI/WRAIR RTS,S Phase III trial. JohnMichael Maas; Darby Communications
research and animal and human challenge models. They also collaborate with the Department of Agriculture on pesticide effectiveness and safety, vector surveillance, and dispersing equipment. 6) Veterinary Medicine – is another support department that maintains an AAALAC-accredited non-human primate research facility that is used to explore the pathophysiology of diseases and conduct pre-clinical animal studies of products. 7) Epidemiology and Disease Surveillance – is primarily responsible for coordinating infectious disease surveillance activities across 8 different countries in the region funded by DoD-GEIS. Led by a veterinary microbiologist, they also support zoonotic disease field research. All AFRIMS projects are collaborations with militaries, universities, private institutions, governments, etc., which became more difficult due to travel restrictions under recent budget restrictions. “That has been frustrating. Building relationships in Asia is extremely important, but slow developing. And if I’m engaging a collaboration running on generator power a few hours a day and can’t actually travel to meet with them personally, it can make things difficult,” he explained.
U.S. ARMY MEDICAL RESEARCH UNIT-KENYA USAMRU-K is composed of 11 U.S. military officers, four locally engaged staff, and approximately 550 locally contracted personnel. In 1969, WRAIR was invited by the government of Kenya to perform research on trypanosomiasis in western Kenya. The success of this effort led to a cooperative agreement between USAMRU-K and the Kenya Medical Research Institute (KEMRI) in 1979 to conduct militarily and public health relevant infectious disease research
and surveillance. KEMRI is the principal human medical research component of the Kenya government. The expanded mission includes developing and testing improved products for predicting, detecting, treating, and preventing infectious disease threats to deployed U.S. military personnel and the people of Kenya. USAMRU-K also provides HIV prevention, care, and treatment to Kenyan civilians and military through the PEPFAR program. Some other specific areas of USAMRU-K’s research and surveillance activities are: drugs and vaccines for malaria and other tropical diseases; drugs and vaccines for HIV; DoD-GEIS; medical entomology and vector biology; military-to-military medical engagement with the Kenya Ministry of Defense; Malaria Drug Resistance Laboratory; and Malaria Diagnostics Center. USAMRU-K is headquartered in Nairobi, on the KEMRI campus. The DoD PEPFAR program for the Kenya Defense Forces and Military to Military Medical Program conducts operations from this location along with the DoD-GEIS program. USAMRU-K operates two field stations located in Kisumu and Kericho, Kenya, and each has well-established clinical research centers, with a high prevalence of HIV and malaria in the surrounding communities. “We are able to do very powerful studies with a lower number of subjects due to the high infection rates. The study sites are the most important aspects of our work, being right in the middle of some of the highest incidence rates in the world for both HIV and malaria,” said Col. Tom Logan, a Ph.D. entomologist in the Medical Service Corps who commands the unit. “Each of our field stations has its own director and staff. For example, Kericho has 120 personnel, is collocated with a Kenyan district hospital, and has Professor Samuel Sinei and Dr. Fred Sawe as director and senior deputy director, respectively. This facility is part of the global Military HIV Research Program network that is an internationally recognized research leader. This site has nearly 20 active protocols underway, including an early phase HIV vaccine trial. In addition, the Henry Jackson Foundation-Medical Research International agency provides crucial research support activities and is a key part of this unit’s success. The Kericho Field Station is also a major contributor to the successful implementation of the PEPFAR program in Kenya. This site executes and oversees PEPFAR programs with a budget of over $21 million USD in the lower South Rift Valley with a base population of over 10 million people. The program is comprised of 11 primary treatment centers, 88 satellite rural health centers, 353 HIV testing and counseling centers, and 410 prevention of mother-to-child transmission [PMTCT] of HIV centers. “Kombewa, the site of another clinical research center, sits about 40 kilometers outside Kisumu along with a Kenyan district hospital. Closer, at about 20 kilometers from the city are two other labs, one for malaria drug-resistance testing and another for entomology, collocated on the KEMRI-CDC [Centers for Disease Control and Prevention] Center for Global Public Health Research campus at Kisian. In Kisumu City we have a Malaria Diagnostics Center and our Basic Sciences Lab/ Administration Center next to the Obama Children’s Hospital.”