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2022 update
Adrian Gardner, MD, MPH, poses for a portrait at IU School of Medicine.

AMPATH | An Update from Adrian Gardner

IN 2021, the pandemic presented challenges for people around the world. It also exacerbated the longstanding health care inequalities that persist in the United States and on a global level.

Looking back, so many stories reflect the power that comes from AMPATH’s longstanding partnership between Kenyans and colleagues from a consortium of academic health centers around the world. Here are just a few of them.

Responding to the Pandemic

Kenya’s official COVID-related death toll has been relatively low, although limited testing and underreporting may understate the impact. Even so, Kenya hasn’t been spared. That’s evident in our AMPATH family, which lost leaders like Dr. Patrick Chege, Dr. Ashraf Emarah, and Allan Kamanda.

The pandemic also hurt many vulnerable patients through the havoc it brought to supply chains, clinical services, and economic programs. Yet AMPATH rose to the challenge. Lab facilities typically used for HIV testing were rapidly overhauled to handle COVID testing for the region. Isolation wards were created and a new oxygen plant installed at Moi Teaching and Referral Hospital (MTRH), which also launched a home-based isolation and care program.

AMPATH worked with surrounding county governments to equip isolation facilities, supply protective equipment, and infuse direct cash transfers to microfinance programs. Indiana University School of Medicine led the AMPATH Consortium support, as faculty staffed wards and the COVID unit in Eldoret. AMPATH partners also participated in response planning, provided financial support for needy medical students, and contributed to virtual CME presentations.

As the pandemic has unfolded, clinical service at MTRH and AMPATH-supported ambulatory clinics continued when possible. So did in-person research program activities.

Testing data and anecdotal reports suggest the worst of the omicron surge has passed. And while vaccination rates remain low, they are rising.

That said, educational programs have been hit hard by closures and, most recently, a strike by clinical faculty. As a result, some students at Moi University College of Health Sciences are almost a year behind in their training. Yet others have managed to complete training and graduate. Uncertainty remains, but we are hopeful about the future.

Establishing the infrastructure for COVID will help the consortium improve care for all infectious diseases. By expanding our diagnostic capabilities, implementing antibiotic stewardship, and improving infection control, AMPATH and its partners are developing a model that addresses antimicrobial resistance, a major cause of death globally.

Expanding Radiotherapy

For cancer patients in western Kenya, the installation of a linear accelerator for radiation therapy at MTRH ensures crucial access to essential care. More than 500 individuals benefited last year, including young children with Wilms’ tumor, which sees significantly increased cure rates from radiation therapy.

AMPATH’s oncology efforts already include education, early screening, surgery, and chemotherapy. Adding radiotherapy gives oncologists another vital tool to combat cancer, and it also creates new opportunities in teaching and research.

HIV Efforts Enter New Stage

Under the leadership of Professor Sylvester Kimaiyo, AMPATH partners received three multi-year USAID grants totaling $120 million. They will support HIV care and treatment, along with the care of orphans and vulnerable children. Those funds will flow in over the next five years and bolster service delivery to more than 110,000 individuals living in nine counties across western Kenya.

AMPATH also continues hitting targets set by the Kenyan government and PEPFAR, and is striving to transition more care delivery to local counties. That said, supply chain issues impacted the availability of certain antiretroviral medications and lab supplies required for routine monitoring.

I’m also concerned that we don’t fully know the impact of COVID on people suffering from tuberculosis, HIV, and noncommunicable diseases, including mental illness. Many of Kenya’s most vulnerable lost their jobs and income over the past two years. What little cushion they had to absorb health shocks and unexpected needs likely evaporated. Only time will tell what effect this had on their adherence to care.

Addressing Mental Health

In August 2021, MTRH welcomed patients struggling with addiction and mental illness to the Nawiri Recovery and Skills Center. IU and several other institutions worked closely with Kenyan leadership to create this critical transitional facility.

Too often, mental health is a neglected area in global health funding. The MTRH Nawiri Center represents a new option, and it augments AMPATH’s broader strategy to address this urgent need. For example, AMPATH supports community-based groups that aid 1,000 individuals grappling with substance abuse. Another initiative engages with law-enforcement personnel to give them skills to interact with individuals with mental illness.

Innovative Educational Programs

While the pandemic limited travel by faculty to Kenya for the last two years, consortium faculty and Kenyan partners still carried out cutting-edge teaching. Moi University launched fellowships in pediatric oncology, cardiology, and maternal-fetal medicine. Moi Teaching and Referral Hospital also started a training program in palliative care for nurses and clinical officers.

A grant from Project ECHO will help expand programs for tele-mentoring and education. We already see the impact technology can have in the form of a teledermatology program, which offers remote consultation and expands access to continuing medical education.

Exporting Better Health

Over the past 30 years, AMPATH’s collaborative approach and resulting model have set a standard in global health. Now, that partnership will help launch similar efforts in Mexico and Ghana based on experience in Kenya.

In Puebla, Mexico, the Dell Medical School at the University of Texas-Austin will lead the AMPATH Consortium in partnership with the Benemérita Universidad Autónoma de Puebla and Ministry of Health for the State of Puebla. The site at Tamale, Ghana, will be a partnership among the University for Development Studies, Tamale Teaching Hospital, and NYU Grossman School of Medicine as the lead AMPATH Consortium member.

The new sites align with AMPATH’s central mission to strengthen public sector health systems, build sustainable care systems through training and education, and advance research that improves health among low-income populations.

The newly expanded AMPATH Global network builds on longstanding relationships among a group of more than a dozen universities and academic health centers around the world. It speaks well to the model–and the enduring work of our faculty and students.

For its part, IU will provide administrative and regulatory leadership for this burgeoning global network. It will help coordinate the exchange of ideas and personnel among participating institutions, along with taking a lead role in monitoring and evaluating AMPATH.

A Word of Thanks

I am so proud of what AMPATH has achieved through teamwork. As we move ahead, there are many exciting developments to come. You are a large part of those successes. Your generosity powers all our initiatives to improve population health, address social determinants and implement sustainable care delivery. Thank you for all you have done and continue to do to strengthen AMPATH’s impact.

 

 

Make a gift to empower AMPATH’s mission in Kenya.

Contact Teresa Rhodes