Kenya turns to natural viruses as antibiotic resistance grows
In Kenya, antibiotic overuse is seen as one of the key drivers of antimicrobial resistance.
What you need to know:
- One factor contributing to the problem is the frequent use of antibiotics before the cause of a patient’s illness has been established.
Antibiotics are becoming less effective as bacteria develop resistance, making infections harder to treat. According to Dr Wilson Aruasa, presidential advisor on Health, antimicrobial resistance is estimated to cause up to 37,000 deaths annually in Kenya, placing it among the country’s leading causes of death.
“We are losing thousands of lives to bacterial infections that are becoming increasingly difficult to treat,” he said, “because medicines are no longer working as effectively as they should.”
One factor contributing to the problem is the frequent use of antibiotics before the cause of a patient’s illness has been established.
Also read: The bathroom fall that cost Sh4.5m: A doctor's story of surviving antimicrobial resistance
“An estimated six in every 10 patients coming to hospital are put on antibiotics, sometimes even before we understand what the problem is,” Dr Aruasa said.
Such practices, alongside gaps in infection prevention and control, are said to be contributing to the growing problem of antimicrobial resistance.
Dr Joel Lessan, senior director of clinical services at Kenyatta National Hospital, explained that antibiotics are widely used among patients seeking treatment at the facility.
“About 30 to 40 per cent of patients who come to hospital are put on antibiotics,” he said.
He added that prolonged hospital stays expose patients to the risk of infections resistant to multiple drugs.
“Patients who stay for more than a week may develop bacterial infections that have multiple drug resistance,” he explained, “and these can lead to sepsis, particularly among vulnerable patients.”
He identified newborns and patients with conditions such as diabetes as the most vulnerable to these infections; they may require treatment.
Doctors culture the bacteria, test available antibiotics and sometimes combine different medicines in an attempt to find one that can overcome the infection.
“The problem is becoming harder to contain as some bacteria develop resistance to as much as 80 per cent of available antibiotics,” Dr Lessan said, “making infections increasingly difficult to treat.”
As a result, doctors are forced to use multiple medicines, driving up treatment costs while patients may still have poor outcomes.
“A treatment that works today can become ineffective over time,” Dr Aruasa emphasised, “forcing doctors to turn to stronger, more expensive or less readily available alternatives.”
The growing difficulty of treating resistant infections is pushing scientists to look beyond conventional antibiotics.
“If the bacteria are many and cause an infection that is resistant to treatment with the known antibiotics,” Dr Aruasa said, “then we come up with other solutions, including phages, to kill the bacteria.”
Unlike viruses that infect humans, phages attack bacteria.
“These naturally occurring viruses target specific bacteria and are found in the human body,” Dr Lessan explained, “including on the skin, in the stomach and intestines, where they exist alongside bacteria and other organisms.”
The proposed treatment involves identifying phages capable of attacking particular bacteria and developing them for use against infections that no longer respond to conventional antibiotics.
Dr Frenk Smrekar, chief executive officer of JAFRAL Biosolutions, said phages could be useful when antibiotics fail.
“This is the treatment that works when nothing else works; when the antibiotic doesn’t work,” he said.
Kenya is working with the Government of Slovenia to explore the use of phages across human health, livestock and crops, with the long-term ambition of developing the technology locally.
But health experts caution against presenting phages as a replacement for antibiotics or basic infection prevention.
Handwashing, sanitation, proper diagnosis and responsible prescribing remain central to reducing antimicrobial resistance.
“When you do those basics with the right antibiotic, for the right condition being treated, handwashing and other modalities like those, then antimicrobial resistance itself drops,” Dr Aruasa said.
According to experts, the same medicines used to treat bacterial infections in people are also used in livestock, while antimicrobials are applied in agricultural production.
“Antimicrobial resistance is a very big issue that we are dealing with in human health, animal health and environmental health,” Dr Aruasa noted.
As resistance grows, its effects can spread across human health, animal health and the environment.
In livestock, bacterial diseases can cause suffering, deaths and production losses, while resistant strains can make infections harder and more expensive to treat.
The World Organisation for Animal Health says the spread of resistant bacteria in terrestrial and aquatic animals increases animal losses and threatens the livelihoods of 1.3 billion people who rely on livestock. Excessive or inappropriate use of antimicrobials can further accelerate resistance.
Dr Stella Kiambi, One Health and Antimicrobial Resistance expert at the Food and Agriculture Organisation (FAO), explained that antibiotics are used in both human and animal health.
Their use in livestock can therefore have wider implications for antimicrobial resistance.
“If we have many bacterial infections in livestock, then phages can come into play and be used instead of antibiotics.”
Reducing antibiotic use in animals could help preserve medicines that are also needed to treat people.
Bacterial infections can damage crops, reduce yields and force farmers to rely on antimicrobial and chemical treatments.
According to FAO, bacterial diseases pose significant threats to crops, causing more than Sh129.86 billion (US$1 billion) in losses globally each year and raising concerns over the use of antibiotics in crop production.
“Researchers are exploring whether phages can provide another way of controlling these diseases,” Dr Kiambi said.
Jure Tomc, an adviser at the International Centre for Promotion of Enterprises, said research is already under way to examine the use of phages against bacterial infections in tomatoes.
The work involves identifying and testing phages capable of targeting bacteria affecting the crop.
“If that is all successful, Kenya will have its first phage product, which will be tested on tomatoes,” Tomc said.
In addition, researchers are said to be exploring applications in farming, fisheries, poultry and other areas affected by bacterial diseases.
“Kenya has to be ambitious from this perspective to have the first phage-based facility in the country and also in the region,” Smrekar urged.
However, turning the technology from research into a treatment or commercial product will require evidence, regulation and safety assessments.
Dr Aruasa said local manufacturing will take time because phage products must go through regulatory and ethical requirements.
In exceptional cases involving highly resistant infections, Kenya could potentially access phages produced in Slovenia through compassionate-use procedures.
“Whenever it is needed, phages can be accessed through compassionate use,” he explained, “subject to approval by the Pharmacy and Poisons Board and other relevant bodies through the normal processes.”
He estimated that Kenya could take five to seven years to reach the point where it can manufacture phages locally for the region.
Slovenia’s Ambassador to Kenya, Kristina Radej, said the partnership with Slovenia is also focused on research, training, technology transfer and building the systems needed to support the technology.
“I’m proud to bring our scientists and businesses together,” she said. “We look forward to supporting businesses vital to health and [the] future for both nations,” she added.
