Only a Cabinet approval remains to operationalize a new US-supported agency that will render Kenya Medical Research Institute (KEMRI) redundant.
“We have developed a Position Paper on the establishment of the National Public Health Institute (NPHI), which is pending Cabinet approval,” says the Ministry of Health.
This, the ministry says has only been delayed because targeted funds were diverted to Covid 19 pandemic otherwise the proposed NPHI would be visible.
“Resources had been allocated to renovate a building to house the NPHI and to make it operational,” says the Ministry.
However, as the pandemic evolved, the ministry says it became clear that more resources would be required for establishing NPHI.
This is reported in a June 2021 update of the World Bank Covid 19 funding to Kenya, which included Sh300 million for establishing the new agency.
The Kenya Covid 19 Health Emergency Response Project (C-HERP) report says additional funding has been secured for the recruitment of personnel, securing a building, equipment, and a research platform for the proposed agency.
Already preparatory work for the new agency is going on at Afya House Annex located at Kenyatta National Hospital grounds.
The new outfit is part of a US network of National Public Health Institute (NPHI) being established in 33 poor countries 23 of them in Africa.
The local chapter is likely to be known as the Kenya Centers for Disease Control (KCDC) taking over what Kemri does and much more.
The new semi-autonomous agency, the report says will coordinate all public health functions and programs to prevent, detect, and respond to any public health threat.
This, the ministry says will cover both infectious and non-infectious diseases and other health events.
“Activities of the NPHI will cut across national and county level, sectors, and stakeholders in order to implement a “One Health” approach to public health events.”
The NPHI will consolidate the activities of several MoH units such as disease surveillance, neglected tropical diseases, immunization, and research.
Already the US Centers for Disease Control and Prevention (CDC) -Kenya has largely disengaged from Kemri relocating crucial activities to its Nairobi Embassy.
“Some of the CDC-Kenya programmes will move to the US Embassy in 2021 or 2022,” said a CDC Kenya spokesperson.
The spokesperson said the development was mutually agreed on and planned between the two institutions, adding that CDC Kenya would continue to engage with Kemri.
CDC has been the biggest benefactor to Kemri both in funding and guarantying international credibility.
Though Kemri officials refused to discuss the matter openly referring us to the Ministry of Health, they expressed concerns but not surprise.
Kemri currently refunding donor funds lost through fraud has little to show for its research output – without any significant medical product in the market.
“Health research remains donor-driven, fragmented, uncoordinated and of low impact,” says the government’s Mid Term Expenditure Framework report for 2018-2021.
It is however curious whether establishing a US-driven NPHI will cure the alluded to donor influence. Such influence has been blamed for Kenya increasing and almost total dependence on imported biomedicals and deliberate stifling of local production capacity
The US CDC has already handed down two documents to Africa CDC that will guide the establishment of the NPHIs in the continent.
For example, it offers legal guidelines on how functions will be transferred from existing institutions to the new agency.
Anticipating resistance to the proposed changes the guidelines recommend decisions be made for public good “rather than the interests of specific individuals or organizations.”
But even as the legal process takes shape Kemri is already losing influence on the ground. For example, in the recently approved Sanofi/GSK Covid 19 clinical trials in Kenya, Kemri plays a secondary role to several junior partners.
The largest Covid vaccine trial so far involving multiple sites spread all over Kenya (apart from North Eastern) several NGOs seem to play bigger roles than Kemri.
But Kemri still enjoys good links with the UK, mainly through highly shielded studies with Wellcome Trust and Oxford University.