Hjf Medical Research International Inc

GH16-006: CONDUCTING PUBLIC HEALTH RESEARCH IN KENYA

SURVEILLANCE AND RESPONSE TO AVIAN AND PANDEMIC INFLUENZA AND NON-INFLUENZA RESPIRATORY PATHOGENS IN KENYA - INFLUENZA VIRUSES CIRCULATE ANNUALLY, CONSTANTLY UNDERGOING MUTATIONS, WHICH MAY LEAD TO ANTIGENIC DRIFT RENDERING EXISTING THERAPEUTIC AND PREVENTIVE MEDICAL COUNTERMEASURES INEFFECTIVE. INFLUENZA CIRCULATES YEAR-ROUND IN KENYA AND HAS BEEN DETECTED IN HUMANS, POULTRY, AND SWINE. ALTHOUGH HIGHLY PATHOGENIC AVIAN INFLUENZA (HPAI) HAS NOT BEEN DETECTED, KENYA IS HIGHLY SUSCEPTIBLE BECAUSE OF ITS POSITION ALONG MIGRATORY BIRD ROUTES AND PROXIMITY TO OTHER HIGH-RISK COUNTRIES. IN 2007, THE KENYA MINISTRY OF HEALTH (MOH), WITH TECHNICAL SUPPORT FROM CDC AND THE KENYA MEDICAL RESEARCH INSTITUTE (KEMRI), ESTABLISHED A NATIONAL INFLUENZA SENTINEL SURVEILLANCE (ISS) SYSTEM. THE ISS HAS ENABLED KENYA TO DOCUMENT THE BURDEN OF INFLUENZA-ASSOCIATED ILLNESS, CONTRIBUTE TO GLOBAL BURDEN ESTIMATES, INFLUENCE POLICY, MONITOR CHANGES IN CIRCULATING VIRUSES, AND CONTRIBUTE EPIDEMIOLOGICAL AND VIROLOGIC DATA TO WHO GISRS AND SPECIMENS TO THE WHO COLLABORATING CENTER AT CDC. EVEN WITH THE ABOVE SUCCESS, DATA AND SPECIMEN SHARING HAVE HAD CHALLENGES DUE TO LAG IN TESTING/SHIPPING, OTHER COMPETING NATIONAL TESTING PRIORITIES, AND TESTING SUPPLY STOCK-OUTS. IN ADDITION, DATA ARE GENERALLY NOT USED AT THE SUBNATIONAL LEVEL TO INFLUENCE PRIORITY SETTING OR BUDGET ALLOCATIONS TO ENSURE THE GREATEST IMPACT IN KENYA. THE ISS, THE BACKBONE OF MOH SURVEILLANCE, IS ALSO NOT UTILIZED ROUTINELY FOR SURVEILLANCE OF NON-INFLUENZA RESPIRATORY PATHOGENS WITH PANDEMIC POTENTIAL AND/OR WITH CAPACITY TO CAUSE SEVERE RESPIRATORY ILLNESS. THOUGH IT HAS BEEN LEVERAGED AT TIMES TO DETECT AND RESPOND TO DISEASE OUTBREAKS, INCLUDING NON-INFLUENZA VIRUSES AND BACTERIAL PATHOGENS, LACK OF DEVELOPMENT OF THE ISS BEYOND ROUTINE INFLUENZA SURVEILLANCE HAS CONTRIBUTED TO A SUB-OPTIMIZED PLATFORM TO SERVE AS AN EARLY WARNING SYSTEM FOR DISEASE OUTBREAKS. IN ADDITION, RECENT EXPERIENCE DURING THE COVID-19 PANDEMIC IDENTIFIED OTHER WEAKNESS IN THE GOVERNMENT OF KENYA’S (GOK) ABILITY TO EXECUTE A STRONG OUTBREAK RESPONSE TO INCLUDE LIMITED HUMAN AND FINANCIAL RESOURCES AND POOR COORDINATION WITHIN/AND AMONG KEY MINISTRIES DUE TO LACK OF A PANDEMIC-PREPAREDNESS FRAMEWORK. TO RESPOND TO THESE CHALLENGES, HJF MEDICAL RESEARCH INTERNATIONAL, INC. (HJFMRI), THE MOH’S BONA FIDE AGENT FOR THIS SUBMISSION, HAS ASSEMBLED AN OUTSTANDING TEAM THAT INCLUDES THE MOH DISEASE SURVEILLANCE AND RESPONSE UNIT, MINISTRY OF AGRICULTURE LIVESTOCK AND FISHERIES (MALF), THE ZOONOTIC DISEASES UNIT, KEMRI, AND THE UNIVERSITY OF NAIROBI (UON). WE WILL BUILD THE CAPACITY OF, AND PROVIDE TECHNICAL SUPPORT TO, MOH AND MALF THROUGH OUR MULTIDISCIPLINARY TEAM, WHICH INCLUDES: HJFMRI PUBLIC HEALTH SCIENTISTS AND ADMINISTRATIVE/PROGRAM MANAGEMENT PERSONNEL; AND KEMRI AND UON VIROLOGISTS, EPIDEMIOLOGISTS, STATISTICIANS/DATA MANAGEMENT PERSONNEL, AND MONITORING AND EVALUATION EXPERTS. WE WILL WORK WITH THE MOH AND CDC TO EXPAND ISS TO INCLUDE EVENT-BASED SURVEILLANCE AND TO: (A) BETTER COLLECT, MAKE USE OF, AND SHARE SURVEILLANCE DATA SUB NATIONALLY, NATIONALLY AND GLOBALLY, AND CAPTURE MORE DATA ON VULNERABLE POPULATIONS; (B) MONITOR CHANGES IN CIRCULATING INFLUENZA VIRUSES AND RESPOND TO HIGHLY PATHOGENIC VARIANTS TRANSMISSIBLE TO HUMANS; (C) ROUTINELY COLLECT DATA ON ZOONOTIC INFLUENZA; (D) RAPIDLY DETECT, CHARACTERIZE, AND MONITOR CHANGES IN NON-INFLUENZA VIRAL AND BACTERIAL RESPIRATORY AND VACCINE-PREVENTABLE PATHOGENS; (E) RESPOND TO OUTBREAKS OF SEVERE RESPIRATORY ILLNESS; AND (F) IMPROVE THE GOK RESPONSE TO POTENTIAL INFECTIOUS DISEASE OUTBREAKS BY ESTABLISHING/OPERATIONALIZING A PANDEMIC-PREPAREDNESS PLAN AND IMPROVING MOH/MALF ONE HEALTH COORDINATION. BY THE END OF THE PERFORMANCE PERIOD WE WILL HAVE STRENGTHENED KENYA’S TECHNICAL, OPERATIONAL, AND INFRASTRUCTURAL CAPACITIES TO PROMPTLY DETECT, REPORT, MONITOR CHANGES IN, AND RESPOND TO INFLUENZA, INCLUDING AVIAN AND PANDEMIC INFLUENZA, AND