MHRP

Kenya

Walter Reed Project–Kenya

Walter Reed Project (WRP) is the local name for U.S. Military HIV Research Program activities executed in Kenya. All WRP activities in Kenya are conducted under the U.S. Army Medical Research Unit–Kenya (USAMRU-K), which is on the campus of the Kenyan Medical Research Institute (KEMRI) in Nairobi. WRP has extensive expertise and infrastructure to support HIV vaccine and therapeutics research as well as an expansive HIV prevention, care and treatment program. WRP integrates HIV research and comprehensive care, which enables the team to achieve critical research goals while improving HIV treatment services for the region.

WRP has demonstrated excellence in executing HIV cohort, vaccine and therapeutics research as well as establishing a sustainable prevention, care and treatment program.

  • Conducted the first HIV vaccine study in Kericho to be held outside of Nairobi and the largest to date in Kenya
  • Established Kenya's first and only College of American Pathologist (CAP)-accredited laboratory
  • Maintains two NIH AIDS Clinical Trials Group (ACTG) Clinical Research Sites (Kericho and Eldoret) under the U.S. Military HIV Research Program Clinical Trials Unit

The U.S. military has maintained a substantial program for infectious disease research in Kenya for nearly 40 years. HIV field site activities have been based in Kericho, in the Southern Rift Valley, since 1999. HIV care and treatment activities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program are also conducted with the Kenya Ministry of Defense (KMOD) and at a field site in Kombewa along Lake Victoria. WRP in Kenya has worked with the Infectious Diseases Clinical Research Program (IDCRP) to open IDCRP’s first sponsored HIV clinical trial in Africa, an Immune Reconstitution Inflammatory Syndrome (IRIS) study being conducted in Kericho. WRP also collaborates with Boston University and KEMRI in conducting HIV-related health economic research.

HIV Research

  • Cohort development and surveillance (initial community cohort 2003-2006)
  • Phase I/II Clinical Trial of Candidate HIV Vaccine (VRC product)
  • ECHO–A pilot acute infection study at four network sites in East Africa and Thailand
  • Phase III ACTG “Optimal Combination Therapy After Nevirapine Exposure (OCTANE)” study
  • IDCRP IRIS study
  • Phase III ACTG “A Strategy Study of Immediate Versus Deferred Initiation of Antiretroviral Therapy for HIV-Infected Persons Treated for Tuberculosis with CD4<200 Cell/mm³" study
  • CLinic-based ART Diagnostic Evaluation (CLADE), a PEPFAR public health evaluation
  • Boston U/KEMRI/WRP HIV health economics studies
  • Qualitative research: “Multi-Cultural Qualitative Assessment of Acceptability of Amenorrhea Secondary to Contraception and Desired Contraceptive Features among HIV-Infected Women”

Upcoming Research Studies

  • Phase I trial using DNA/modified vaccinia virus Ankara (MVA-CMDR) prime-boost vaccine strategy focusing on HIV subtype A
  • ACTG therapeutics studies evaluating optimal therapies for cryptococcal meningitis and Kaposi’s Sarcoma in resource-limited settings
  • PEPFAR Basic Program Evaluations of viral load use in monitoring ART and prevention campaigns associated with male circumcision ceremonies

 Facilities

  • The Kenya Medical Research Institute/Walter Reed Project (KEMRI/WRP) Clinical Research Center (CRC) in Kericho, Kenya
  • A new KEMRI/WRP CRC in Kericho, Kenya to support the growing clinical research portfolio
  • A tuberculosis culture lab to support HIV care and treatment facilities in the southern Rift Valley Province

Walter Reed Project–Kenya

WRP began providing PEPFAR-supported services in Kericho in 2004. By working with local partners throughout the South Rift Valley, WRP is focused on developing the capacity of partner health facilities and local organizations. Treatment sites include the Kericho District Hospital, six other district hospitals in the region, and two neighboring tea plantations as well as two mission hospitals. In June 2008, WRP also added the Kombewa District Hospital (located in Nyanza Province) to its area of responsibility. 

In addition to the treatment facilities that WRP works with, the program also supports three non-government organizations and one faith-based organization that support and conduct activities focused on children, adolescents, university students and the community at large. 

WRP supports communities by:

  • Expanding the number of HIV clinical sites
  • Improving laboratory services and infrastructure
  • Assisting with data collection and human capacity development
  • Fostering counseling, testing and prevention programs

Prevention of Mother-to-Child Transmission

Kericho’s Prevention of Mother-to-Child Transmission (PMTCT) program, initiated in 2001, has been the foundation for HIV care and treatment activities in the region. Director Frederick Sawe, MBChB, MMED, has played an integral part in setting up and coordinating the PMTCT program. With the help of the WRP team and partners, the PMTCT program has grown to include 260 clinics and has provided HIV testing and counseling to more than 260,000 women.

Inventive Prevention Programs

One of the supported NGOs, the Kericho Youth Center (KYC), has been instrumental in ensuring that young people in the district learn their HIV status—an important aspect to prevention and access to care and treatment. Formerly a part of the Kericho District Hospital, but now a stand alone NGO of its own, the center offers a dynamic approach to behavior change and HIV prevention by combining recreational services with HIV counseling and testing. Of key importance are KYC staff efforts to go beyond static voluntary counseling and testing (VCT) and reach out to the larger community via mobile and moonlight VCT initiatives.

Community Engagement

WRP-K has developed a novel approach for HIV prevention and education that builds on Kenya’s tribal rites of passage tradition of male circumcision. By working with and obtaining approval from key village elders, WRP-K brought peer educators into villages, creating an opportunity to discuss HIV prevention and sexual and reproductive health. It is the engagement of the community that is key to determining the most appropriate and effective delivery of HIV prevention messages.