Kenya facing drug failure crisis against top killer diseases

Kenya is quickly running out of options to treat pneumonia, malaria and HIV, the top killer diseases in the country.

Recent evidence shows high rates of drug failure in treating all these disease, including chemicals used in malaria mosquito control.

Further evidence shows that de-wormers being administered to millions of schoolchildren are no longer working, while most antibiotics have become nearly useless.

Last week, the Swiss Tropical and Public Health Institute reported that the top two drugs, albendazole and mebendazole used to deworm seven million schoolchildren in Kenya, are no longer effective.

In June, the Kenya Medical Research Institute (KEMRI) said the number one malaria treatment based on the compound artemisinin had lost its edge and called for other options.

This followed a regional study covering Kenya, Tanzania and Rwanda, which showed higher than expected treatment failure in patients treated with top line malaria drugs called ACTs.

This week, the scientific journal, The Lancet, warned that malaria resistance to the ACTs in parts of Asia is up to 60 per cent, which when exported to Africa could be catastrophic.

Last year, the Chinese Academy of Sciences and the Sino-Africa Joint Research Center, Nairobi, reported unhealthy levels of soil contamination with DDT from donor malaria control projects in Western Kenya.

It has also been reported that malaria mosquitoes have developed high resistance to the chemical DDT used in indoor spraying and pyrethroid insecticides used in treating bed nets.

A team, led by Dr Elizabeth Kigondu of KEMRI, is analysing the levels of pyrethrins in soils and drinking water around pyrethrum farms in Kiambogo and Naivasha in Nakuru County and Endarasha in Nyeri County.

“We hope to be able to tell whether the levels of pyrethrins present in those samples are safe for the environment, more so for farmers and the people living around pyrethrum farms,” said Dr Kigondu at an in-house conference.

The 2017 Economic Survey shows pneumonia, malaria, cancer and HIV as top killer diseases in the country, accounting for 32.9 per cent of all reported deaths in 2016.

But this could get worse as suggested by the US Army Medical Research Directorate-Kenya and KEMRI, which in June reported high levels of drug resistance pneumonia strains circulating in Kenya.

Samples collected from eight Kenyan clinics, including district hospitals of Kisumu, Kisii, Migori and Homa Bay, showed pneumonia strains that were resistant to all the common available medicines.

As if this is not enough, at a global HIV conference in Paris, France, in August, the charity group MSF (Doctors Without Borders) raised the alarm over high levels HIV treatment failure among patients in its facilities in Kenya and other parts of Africa.

Totally untreatable

In April, a Ministry of Health study reported the emergence of totally untreatable HIV patients in Kenya.

“Our findings indicate that nearly one in four patients in Kenya failing second-line treatment has completely exhausted the available antiretrovirals,” said their report in the journal, Aids.

In response to this escalating HIV drug failure, the Ministry of Health and donors have thrown more drugs to the problem.

This has included the targeting of 500,000 healthy Kenyans with the daily HIV prevention pill Truvada.

Already researchers at Moi Teaching and Referral Hospital and Moi University School of Medicine have presented evidence showing the drug to cause serious kidney problems to users.

The drug, which is also used to treat HIV positive patients, has also been reported to have developed significance levels of resistance in local users.

The over-medicalisation of Kenya’s healthcare, experts say, can be traced to huge donor projects in HIV, malaria, tuberculosis and deworming.

These, they say, are supported by the pharmaceutical industry and their success is measured on the number of doses distributed.

A policy change in 2014 by the US President’s Emergency Plan for Aids Relief (PEPFAR) has since dramatically put treatment over prevention.

In the policy, the Americans classified HIV activities as core, near-core and non-core, with funding reducing as you move from the centre.

The core includes products such as medicines, condoms and testing kits while near-core are healthcare workers and the most outer layer, non-core, includes awareness creation, advocacy and capacity building.

“We are very worried about the persisting high rates of new HIV infections, despite our big spend in treatment and medicines,” said Dr Nduku Kilonzo, head of the National Aids Control Council.