Global Antibiotic Resistance Partnership-Kenya
First Meeting of the National Working Group
November 9, 2009
KEMRI Headquarters, Nairobi
The first meeting of the National Working Group of GARP-Kenya was held on November 9, 2009 at the Kenya Medical Research Institute (KEMRI) headquarters in Nairobi. Attending were representatives and senior researchers from KEMRI-CMR and the KEMRI department for traditional medicine, Aga Khan University Hospital, Centers for Disease Control-Kenya, Wellcome Trust in Kilifi, the Department of Veterinary Services, and Maseno University in Kisumu. Agenda items focused on the framework and information needs for a situation analysis on the state of antibiotic use and resistance in Kenya, the research agenda and projects in development to investigate factors driving resistance, as well as the health burden of bacterial and drug-resistant infections. The meeting closed with a discussion of possible intervention studies for the next phase of the project.
Dr. Sam Kariuki, chair of the National Working Group (NWG), opened the meeting by briefing members on the GARP inaugural meeting held in August 2009 and presenting key findings. Members were informed by Cara Winters, GARP-Kenya Country Coordinator with Resources for the Future, about the start of GARP projects in India and Vietnam and plans for the inaugural meeting for South Africa in February 2010.
GARP-Kenya Research Agenda and Discussion
Dr. Kariuki and Ms. Winters updated NWG members on the current status of a GARP-Kenya research agenda for the initial phase of gathering the baseline information necessary to target future intervention studies. The research agenda was broken into two categories: 1) drivers of resistance and reasons for antibiotic use and 2) burden of bacterial disease and drug resistant infections. NWG members discussed ideas for strengthening research items and the need for additional studies. Key points from this section of the meeting included the issue of stock-outs in public facilities driving purchases of second- and third-line medicines from private distributors; the need to investigate the role of hospital incentives and financing in enforcing professional guidelines on prescribing behavior; the importance of tracing back bacterial samples to the animal and producer in livestock studies; and the role of lab fees, supplies, facility resources, and technician education in the diagnostic use of microbiology laboratories.
Situation Analysis Framework and Discussion
Ms. Winters provided the situation analysis outline and a short document briefing members on areas where information is lacking and NWG input is desired. After reviewing the structure and purpose of the situation analysis, the group mentioned relevant studies, data, and insight in specific categories and talked about how to handle missing information.
New Ideas for Intervention Studies and Policies
Dr. Linus Ndegwa, Centers for Disease Control-Kenya, and Dr. Gunturu Revathi, Aga Khan University Hospital, led the group in proposing intervention studies for the future and addressing what data would need to be gathered now to make those studies viable. The discussion focused on whether resistance is a clinical problem and causes of treatment failure, as well as what drives use and misuse in Kenya and how to intervene in these areas. Possible interventions include the impact of rapid diagnostic tests, clinical algorithms and improved education in health care provision and diagnosis, and the impact of the Streptococcus pneumoniae vaccine scheduled to begin next year on prescribing behavior.
Closing Comments
Dr. Kariuki reviewed the basic timeline for GARP-Kenya and the purpose of the NWG. Ms. Winters followed by emphasizing the importance of completing the situation analysis in the coming months as a foundation for the next phase of research centered on gathering baseline information and assessing interventions.
The next meeting of the NWG has not yet been scheduled.
For more information on this initiative, please contact:
KENYA
Cara Winters
GARP-Kenya Country Coordinator
Email: winters@rff.org
Mobile: [+254]732962138
WASHINGTON, D.C.
Hellen Gelband
GARP Coordinator
Email: gelband@rff.org
Phone: (202) 328-5104
