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John Kiiru is a Principle researcher at the Kenya Medical Research Institute (KEMRI)’s Centre for Microbiology Research. Having obtained his B.Sc. in Biological Sciences and Chemistry he went on to do an M.Sc. in Microbiology at the University of Nairobi (UoN). During this time, the University’s zoology department received a large contingent of Belgian students taking courses in marine biology. UoN at that time was coordinator of a ten-year VLIR-UOS-funded project. In 2001, John was encouraged to look at further study opportunities In Belgium. Given that at the time there was a major shortage of people with molecular skills in Kenya, John decided to study for the Master’s in the Interuniversity Programme in Molecular Biology (IPMB). He Joined VUB in 2001-2002 and then completed the course at KU Leuven in 2003.
“My interest was in infectious diseases. I recognised a potential to make an impact on healthcare in Kenya. Very few people had a combined M.Sc. in microbiology and molecular biology. I figured that if I combined these two disciplines, it would give me a competitive edge in biomedical research. I was lucky, because the techniques I learned at UoN combined with those at VUB and KU Leuven set me up to work on any topic related to human and animal health”, John explains.
For his Ph.D. (2007-2011, at KU Leuven), he switched focus from bacterial enzymology to bacterial infectious diseases. He chose Belgium for his Ph.D. partly because of an existing VLIR-UOS sandwich programme that allowed him to continue working in Kenya, while doing research in Belgium. He had already built networks at KU Leuven and CODA-CERVA (now Sciensano, the Belgian National Reference laboratory for (re)emerging and zoonotic veterinary pathogens) through his IPMB mentors and this made it easier to secure the scholarship.
“Life in Belgium was amazing and living in Brussels was interesting and fun: the food, the beer, the people, the ease of mobility. Even though there was a language barrier and integration for foreigners was poor in general, my experience in the IPMB programme was awesome. Every day was a learning experience. The course was quite demanding and difficult, but there was a good mixture of international students. This allowed us to exchange ideas and knowledge that were life-changing. Despite studying during a time when mobile telephony and IT platforms were still evolving, we were able to acquire excellent digital skills including bioinformatics, which have been valuable throughout my life and I now use them on a daily basis. In fact, the skills we learned in Belgium in class and through social interactions were life-long and life-changing.” [Continue reading below pictures]
Fighting antimicrobial resistance (AMR)
Today, Dr Kiiru’s research focuses mainly on zoonotic and emerging diseases, with a special focus on multidrug resistant pathogens, a microorganism that can cause disease. One of the major global challenge currently is the emergence and spread of antimicrobial resistance (AMR) . As Dr Kiiru explains, “AMR is a serious issue. We are close to exiting the antibiotic era and entering a post-antibiotic era. If (when?) this happens there will be a likely rise in infection and mortality rates due to treatment failure.”
Fighting resistance or finding alternatives to antimicrobials against both animal and human pathogens is something which preoccupies the healthcare sector in all countries.
“Vaccines are one possible alternative to antibiotics, but most do not cover all major strains of a given disease. In Sub-Saharan Africa for example, we are experiencing a steady and sharp increase in the proportion of strains that are resistant to all major classes of antimicrobials. In addition, resistance to medicines also occurs in other pathogens such as malaria parasites, yeasts and viruses.
Another alternative is infection control – controlling the number of people who acquire infections will reduce the use of antimicrobials and slow-down AMR, but it is difficult to achieve good sanitation, especially in resource-poor settings where water shortage is rampant, droughts and floods are common and disease surveillance systems are lacking.” [Continue reading below pictures]
Cholera in Kenya: a link with climate change and human mobility
Cholera is of specific interest to Dr Kiiru, especially the possible correlations between case prevalence, climate change, and human mobility in dense populations such as those in refugee camps. Other factors which exacerbate water-borne outbreaks such as cholera, include poor access to toilets and clean water, flooding as a result of global warming, political instability and wars.
Although there are a number of cholera vaccines, community uptake is painfully slow. The exact reasons are still unclear, but cost is certainly an issue considering that cholera outbreaks are more common among populations in slums and refugee camps. On top of that, cholera vaccination does not provide life-long protection, necessitating a booster every 2-5 years (the costs of each round being about $30-$90). In addition, outbreaks are unpredictable, and during off-peak periods, people see no need to get vaccinated. There is also a lack of encouragement from governments who could fund sustained cholera vaccination programmes, ensuring that at least 50% of vulnerable populations are vaccinated to expand group immunity.
Dr Kiiru sees this situation mirrored in Sub-Saharan Africa. Political and social instability complicates the chances of controlling many diseases which are entirely preventable such as cholera, polio, HIV and measles. As he explains, “large areas of Western Africa are unstable due to Boko Haram, parts of Somalia and South Sudan are politically unstable, and such scenarios precipitate human displacement and poor vaccine coverage and uptake. Natural calamities such as earthquakes our droughts often result in major outbreaks of cholera.”
The importance of studies
Dr Kirru’s work is multidisciplinary and his preparation for what he does today he attributes to the skills learned in Belgium. His studies enabled him to return to Kenya and allowed him to participate in the search for better healthcare for the communities back home. Trans-disciplinary and multidisciplinary studies, such as the IPMB programme – should be anchored within the One-Health principle, and will contribute to lower mortality rates, better healthcare coverage and better prediction of outbreaks due to the development of more accurate algorithms which factor in climate change, human behaviour and natural disaster patterns.
 Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs when bacteria change in response to the use of these medicines and become resistant. These bacteria may then infect humans and are harder to treat than non-resistant bacteria. Antimicrobial resistance is a broader term, encompassing resistance to drugs to treat infections caused by other microbes as well, such as parasites (e.g. malaria), viruses (e.g. HIV) and fungi (e.g. Candida). (http://www.emro.who.int/health-topics/drug-resistance/what-is-the-difference-between-antibiotic-and-antimicrobial-resistance.html)