About ABC
PRIORITY PROJECTS PROPOSED BY THE AFRICAN BIOMEDICAL CENTER (ABC)
A Certified International Non-Government Organization of Kenya
The Principals of the ABC organization are:
Chairman, Surendra. T. Patel, M.D. (Internationally trained physician, Canada, with established medical practice in Kenya, with extensive experience in diagnosis and treatment of HIV/AIDS patients) Physician, M. P. Shah Hospital. He was on of the first physicians to identify HIV/AIDs patients in Kenya and is currently attending to thousands of HIV/AIDs patients.
Secretary (Executive Director), Moses Otsyula, PhD Established virologist with extensive international training in HIV/AIDS diagnosis and treatment, Honored as United States Eisenhower Fellow; Head of Virology, Institute of Primate Research. Dr. Otsyula has also established a highly respected commercial diagnostic laboratory in Kenya for the diagnosis of HIV as well as many other diseases and clinical assays.
Treasurer, Bonnie S. Dunbar, PhD Established scientist with over 22 years of lecturing to United States medical students in histology and cell biology, and biomedical research in reproductive health; Honorary Lecturer of University of Nairobi; and former United States Fulbright Scholar to Kenya; Former Full Professor and currently Adjunct Professor at Baylor College of Medicine, Department of Molecular and Cellular Biology with Joint Appointment, Houston, Texas, USA Dr. Dunbar has had extensive experience in grantsmanship including financial management of funds so she will ensure that all financial investments into this center will be administered with the greatest integrity. She has also been an advisor to international programs through the US AID and World Health Organization.
Background of the African Biomedical Center
The African Biomedical Center has been founded in order to set up an international center of excellence at the M. P. Shah Hospital so that the principals of the organization will have control of the programs as well as be able to guarantee financial integrity. Our rationale for this is that many of the programs involved in research are “Internationally” based. Such programs have been fraught with problems of the lack of continuity with international investigators spending small portions of their time in Africa as well as conflicts due to feelings that Kenya scientists and physicians have not been treated fairly in international recognition. (i.e. lack of sustainable development). Furthermore, many of the large institutions are burdened with bureaucracy leading to inefficient management and the ultimate wastage of funds. As the three directors of the ABC project are based full time in Kenya and have extensive international expertise, we believe that this Center will be the first of its kind to guarantee continuity and integrity in Kenya. We therefore will develop this center for:
- The diagnosis, treatment, and studies of conditions related to infectious agents and disease progression, specializing in (a) HIV/AIDs; (b) Sexually Transmitted Diseases, especially as they relate to HIV infection and AIDs disease progression; and (c) Diseases that are relevant to both human and animal health in Africa (anthrax, clamydia, TB).
- The improvement of Maternal Health through counseling on family planning, basic health with respect to prenatal and pediatric counseling.
- The basic and advanced training, of local and international individuals at the physician, nursing, medical and graduate students, and basic health care providers in advanced methods of disease diagnosis, treatments and psychological support systems.
Laboratory and Clinical Facilities
The laboratory is being established at the M. P. Shah Hospital, This hospital has recently expanded its facilities and is an optimal site for this center. Dr. Patel is a senior physician in this hospital and already attends to thousands of HIV patients in Kenya.
Dr. Dunbar has now established full time residency in Kenya and her associate Medical School, Baylor College of Medicine, in the United States has donated all of her major laboratory equipment (worth millions of $US) to the African Biomedical Center. This equipment is packed in a container in Houston, Texas and the US AID program (CONRAD) has already paid for shipment costs to bring this equipment to Kenya.
Dr. Otsyula has an established and well-respected commercial laboratory for HIV and other infectious diseases. His expertise will be critical insuring that the ABC laboratories are set up to quality standards.
Collaboration with M.P. Shah Physicians and other Local and International Physicians/Scientists
It is a major goal of this center to bring together physicians and scientists to more effectively diagnose and treat patients as well as educate health care workers in all aspects of these disease related issues. There are already a number of excellent physicians at the MP Shaw who will be collaborators, including pathologists, pediatricians, gynecologists, etc. The Center is designed to collaborate and enhance the existing facilities at the M. P. Shah Hospital as well as interact with other Kenyan and International Programs.
All three of the principal investigators have substantial international collaborations. A further goal of this center is to insure that local students or other health care workers receive the best training so a program will be established to have students trained abroad through these international collaborations. We will also establish programs to bring in international physicians, scientists and students to work at the center.
Priority projects to be carried out at the ABC facilities
Establish a facility to help access and establish ACCURATE clinical assays to be communicated to in house and other medical facilities
1. Rationale: It has been the experience of the principles of this center that many of the basic and inexpensive commercial assays for identifying the antibodies to HIV (as well as other diseases such as Hepatitis B) are flawed and can give false positive as well as false negative results. Either of these results is devastating to the patient.
2. Implementation. It will therefore be critical to identify assays and reagents that are of high quality and give consistent results for the initial patient diagnosis.
Establish methods for confirmation of the HIV positive status
1. Rationale: It is well established that once antibodies have been identified to determine if a person is exposed to HIV, it is essential to accurately identify the viral load as well as the levels or CD4+ or CD8 lymphocyte levels.
2. Implementation. These parameters are critical because they confirm the presence of the virus and will predict the timing and need for anti-retroviral and other therapy. (Note: as it is becoming increasingly apparent that many patients are having serious negative side effects from these therapies and it is also apparent that some strains of the virus are resistant to the therapy, the employment of these assays are becoming more and more important in the large picture of HIV/AIDs management in Africa.)
Education and Training of Health Care Workers
Once the methods have been established and standardized at the ABC we will begin education and training programs for physicians, nurses and health technicians to transfer this technology and information to other medical facilities and institutions.
Specific Projects already ongoing by ABC personnel which would impact HIV management in Kenya/Africa
Evaluation of the HIV status within unique population groups which could provide significant information for our understanding of HIV infection and disease progression in the Kenyan population
Dr. Patel Dr. Owilli have established a large patient cohorts (“Discordant Couples”) where they have identified a large percentage (approximately 30%) of which one partner is HIV positive while the other remains HIV negative. He has further identified a patient cohort, referred to as “Long Term Survivors” who are HIV positive for many years (up to 20) who have no disease progression.
It is critical that we begin to understand the medical parameters in these two patients groups as they could hold the answer to more efficiently identifying those individuals who might be at risk and for more effective counseling of couples as well as designing more effective treatment regimes. Understanding these factors will also be important, if we are to develop an effective and safe vaccine for HIV/AIDs.
Evaluation of the HIV status with respect to other diseases (e.g. Hepatitis B and C, Tuberculosis, Sexually Transmitted Diseases etc.)
It is now further apparent that co-infections or pre-infections with other diseases will dramatically affect the rates of HIV transmission or AIDs disease progression. There is also evidence that normal vaccination programs (especially in infants and children who are infected with HIV) may be detrimental to the HIV infected populations. Dr. Otsyula and Dr. Dunbar and other colleagues have begun studies to evaluate these factors in these populations in order to better establish safe and effective vaccine programs. Dr. Collin Forbes, who is a leading pediatrician in Kenya has recently relocated to the M. P. Shah hospital and will be collaborating on these issues.
Sexually transmitted diseases (e.g. chlamydia, gonorrhea, yeast infections, etc.) are also known to be involved with the increased rates of transmission of HIV, as the female reproductive tract is a frequent site of heterosexual transmission. As many of these diseases can be readily detected and treated it is anticipated that a more efficient program for STD management could have a dramatic impact on HIV levels in Africa.
Impact of contraceptive methods on HIV transmission in the female population
Much of Dr. Dunbar’s 25 years of research has related to the immunology of the female reproductive tract. Our international advisor, Dr. Charles Wira is considered the world’s authority on this subject.
Because the female hormones (estrogen and progesterone) regulate the immunology of the female reproductive tract, it now apparent that we must take into consideration both the natural hormones throughout the monthly cycle as well as modifications by these hormones in the contraceptive pills.
There has been some evidence that these hormones may both reduce transmission and suppress disease progression. This is a critical issue that needs to be addressed in detail because these factors could have a major impact on the heterosexual transmission of HIV. Because these studies in the human population are complicated by so many factors, Dr. Dunbar and Dr. Otsyula had prepared a major proposal to use the baboon animal model to address these issues. This proposal was approved with enthusiasm by the World Health Organization; however, their reproductive program budget was reduced so they were unable to fund this project.
Evaluation of African Traditional Medicines in HIV/AIDs Therapy. There is a large amount of anecdotal information concerning the positive benefits of nutrition and traditional medicines from the unique vegetation in Africa. Both Dr. Otsyula and Dr. Dunbar (through her work in the bush on her elephant contraception projects) have been approached to test such therapies. It is now possible to screen many of these agents using in vitro laboratory assays to evaluate the potential for many such treatments. We have initiated such studies with Dr. Ronald Kennedy at Texas Technology University in the United States as he routinely carries out screening assays for such reagents.
« Back