It seems a lifetime ago since I joined KAVI as a scrawny pimply young doctor on 12th January 2004. After working 7 years at a busy A/E department, I knew clinical practice wasn’t for me. I had tried my hand in ENT surgery but that didn’t work out either. Somewhat lost and disillusioned, I needed out but didn’t know what I wanted. Joining KAVI was a stepping stone to the unknown. Little did I know then that in KAVI I would find the true purpose of my career in medicine in the field of clinical research. Sixteen years later I reflect on my experiences and the lessons that I have learnt.
Transition from clinical practice to research was a culture shock – I entered into the world of research ethics that is informed by centuries of regulations that now govern the field globally. Its sole purpose is to guarantee the safety, wellbeing and rights of study participants- protecting them from exploitation and ensuring studies are conducted to the highest standards of integrity. Conducting clinical trials has been the most rewarding- it is regimented, standardized and global in its impact. It has helped me appreciate the long and often frustrating product development process that brings new drugs/vaccines/ diagnostics or interventions into the market. It is an expensive process that needs committed investments by governments and other funding agencies.
My work at KAVI also brought me face to face with my nemesis IMMUNOLOGY. The study of HIV vaccinology is a deep dive into that cryptically mysterious world of cells and proteins that keep us all healthy- protecting us from ourselves and the world around us. I have witnessed KAVI become a centre of excellence in mucosal immunology with the capacity to track viruses as they move across the various layers of the mucosa making KAVI only the second centre in Africa to do so. The microscopic world of viruses is the stuff of science fiction. It is an insight into the fascinating ways pathogens break through our defences to invade our bodies and make us ill.
By far my greatest joy has been working with lay communities. Community engagement at KAVI is informed by the principals of Good Participatory Practice. Through this process, we have sought to empower communities to become equal partners to the research process. The science of HIV vaccines is becoming increasing complex as we introduce vaccine designs that target the development of broadly neutralizing antibodies. Our task as we work with lay communities has been to break down that science into non-technical language in order to leverage community support for the studies we conduct. Our work has been made even harder by a growing trend towards vaccine hesitancy driven by multiple conspiracy theories. In spite of this, our community partners including community advisory boards and peer educators have been steadfast in their support. They have helped us address community concerns as well as advocate for HIV vaccine research. We have drawn study participants from these communities and achieved >90% retention rates from our clinical trials- a clear indication of their support and commitment to the process. I have developed a healthy respect for community wisdom- the combined pool of skills, knowledge and resources that communities bring to the table to address matters that affect them. I have admired those who have braved stigma and discouragement to become study participants. I have been humbled by the deeply personal and sometimes tragic stories that inspire their participation in HIV vaccine research.
As I leave KAVI, dreadlocked and grey haired, I know I have done my time in the trenches. I know it is time to find the next generation of investigators. I leave at the time when we face yet another viral pandemic- SARS CoV- 2 – which is threatening the lives and economies across the globe. The studies conducted at KAVI have never been more needed or more relevant as the frequency of new zoonotic and arboviral disease outbreaks increases. The potential for institutions like KAVI is unlimited and remains vital for the country and beyond. I am grateful to have worked at the University of Nairobi (where I did my basic and post-graduate training) and specifically at KAVI with some of the Kenya’s top scientists- Prof Walter Jaoko (KAVI-Director), Prof Omu Anzala (KAVI founder), (Late) Prof Job Bwayo, (Late) Prof. Elizabeth Ngugi and (Late) Prof. Ndinya-Achola. I am grateful for them, to the management and staff at KAVI and the community partners that have shaped who I am today. I leave, not to abandon the field, but to serve it in a different capacity. Thank you for 16 amazing years.