Kenya has launched a five-year strategic plan to tackle non-communicable diseases, such as diabetes and hypertension. The National Strategic Plan for Prevention and Control of NCDs 2020/21-2025/26 (2021) sets out to strengthen the national health system’s capacity to manage non-communicable diseases and promote a healthy lifestyle. Surveillance, monitoring, evaluation and research form one of the five pillars of the plan. The next step will be to establish national research priorities and an implementation plan (Govt of Kenya, 2021; Nakweya, 2021).
As the UNESCO Science Report (2021) explains, universal health coverage is one of the National Research Priorities 2018–2022 unveiled by Kenya’s National Commission for Science, Technology and Innovation, established in 2013. The other sectoral research priorities are food and nutrition security; manufacturing; and affordable housing.
These priorities form the third in a series of five-year plans used to implement Kenya Vision 2030 (2008), the country’s blueprint for developing a knowledge economy. This third plan is being driven by the president’s Big Four Agenda, which mirrors the National Research Priorities, namely food security, affordable housing, manufacturing and affordable health care for all (Kingiri and Onana, 2021).
According to Mercy Mwangangi, chief administrative secretary at Kenya’s Ministry of Health, non-communicable diseases were responsible for 39% of Kenyan deaths in 2020, up from 27% in 2014. She has stated that more than half of these diseases are occurring in people aged 40 years or less. Risk factors include unhealthy diets, tobacco consumption and lack of exercise. An estimated one in five Kenyans are currently overweight (Nakweya, 2021).
The World Health Organization (WHO, 2020a) estimates that, by 2030, deaths from NCDs are likely to increase by 17% globally and by 27% in the African region. Nearly one in five Covid-19 deaths in Africa have been linked to diabetes, according to WHO (2020a, 2020b).
Type 2 diabetes, or adult-onset diabetes, is becoming more prevalent around the world as lifestyles change. This is spurring an increase in research in this field in Africa, the Arab States, Asia and Europe, in particular, according to original research by UNESCO.
A rise in Kenyan scientific output on Type 2 diabetes
The number of publications by Kenyan scientists on Type 2 diabetes is rising, even if domestic output remains lower than the global average intensity. According to original research by UNESCO, Kenya’s research output on diabetes doubled from 33 to 68 publications between 2012–2015 and 2016–2019. This represents a growth rate of 106%, slightly higher than for sub-Saharan Africa as a whole (73%) [Straza and Schneegans, 2021].
Over 2016–2019, Kenyan scientists contributed to 4.3% of the subcontinent’s output on Type 2 diabetes, up from 3.6% over 2012–2015. This value is approaching the share of Kenya’s overall contribution to the subcontinent’s scientific output (6.5%) over 2016–2019.
Kenyan output rising on pollution, a risk factor for health
In addition to the major NCDs, Kenya’s new strategic plan recognizes upstream risk factors for health, such as environmental pollutants and agrichemicals (Govt of Kenya, 2021). Management of these risk factors qualifies as preventive health care.
Kenyan researchers have increased their output on the impact on health of soil, freshwater and air pollution from 43 (2012–2015) to 73 (2016–2019) publications, according to the UNESCO study. Over 2016–2019, Kenya’s output formed 6.7% of the sub-continent’s publications on this topic, behind South Africa (34.8%), Nigeria (31.2%) and Ghana (8.1%).
By 2019, Kenyan researchers were publishing more on the potential impact of pollution on health than on Type 2 diabetes (see Figure 1).
Overall, Kenyan scientists produced 58 publications per million inhabitants in 2019. This is the highest publication intensity in East Africa but is lower than that of Ghana (86 per million) and, above all, South Africa (360 per million). As for Nigeria, it had a publication intensity of 46 articles per million inhabitants in 2019.
A stronger policy framework for research in East Africa
Weak science, technology and innovation (STI) have delayed member countries’ transition to knowledge economies, according to the East African Community’s Vision 2050 (2015) document (Kingiri and Onana, 2021).
To address this gap, the East African Science and Technology Commission (EASTECO) has spearheaded the development and implementation of common STI policies and programmes under its ambitious Strategic Plan (2017–2022).
This led to the approval of the East African Regional Policy for Science, Technology and Innovation (2019–2029), EAC Regional Intellectual Property Policy and EAC Regional Bioeconomy Strategy by the EASTECO Governing Board on 31 March 2021 (Kingiri and Onana, 2021).
Countries contributing to East African research and technological fund
Partner states have also collaborated with EASTECO to establish a Research and Technological Development Fund which has been operational since 2018. The fund promotes market-led research, industrial research and technology transfer, as well as technology acquisition, adaptation and development (Kingiri and Onana, 2021).
The Research and Technological Development Fund is financed by member states through their national science bodies. These include Kenya’s National Research Fund, Uganda’s National Council for Science and Technology, Tanzania’s Commission for Science and Technology and Rwanda’s National Council for Science and Technology (Kingiri and Onana, 2021).
The fund has received additional support from the UK’s Department for International Development, South Africa’s National Research Foundation and Canada’s International Development Research Centre. The level of funding support currently varies from year to year, based on the expressed need and availability of funds in partner states. In 2021, EASTECO has been developing legal statutes to define the manner and level of financial contribution from each partner state (Kingiri and Onana, 2021).
Disease prevention and control a continental priority
Health care has become a priority across Africa. In 2015, heads of state and government of the Economic Community of Central African States approved the creation of the Central African Health Organization, along with a watermark Community Health Fund for Central Africa. This initiative complements the common pharmaceutical policy adopted in 2014 with the aim of improving access to health services by making safe, effective and low-cost pharmaceutical products available to the entire population (Kingiri and Onana, 2021).
At the continental level, the prevention and control of diseases was one of six priorities endorsed by the African Scientific Research and Innovation Council at its second congress in 2019 (Kingiri and Onana, 2021).
In May 2018, the continent’s ministers of health adopted a treaty for the establishment of the African Medicines Agency. This ‘represents a giant step towards harmonizing the continent’s regulatory framework for drugs’ (Kraemer-Mbula et al., 2021).
This treaty follows the establishment of the Africa Centres for Disease Control and Prevention in Addis Ababa in 2016, which serves as an information-sharing platform for member states across the continent. The development of the pharmaceutical sector is one priority of Ethiopia’s Growth and Transformation Plan covering the 2016–2020 period. Since 2017, Addis Ababa University has hosted a centre of excellence for innovative drug development and therapeutic trials for Africa, within a project supported by the World Bank.
Figure 1: Volume of scientific output on Type 2 diabetes and on the impact of pollution on health in Kenya and sub-Saharan Africa, 2011–2019
- Govt of Kenya (2021) National Strategic Plan for Prevention and Control of NCDs 2020/21-2025/26. Government of Kenya: Nairobi.
- Kingiri, Anne and Charles Awono Onana (2021) Central and East Africa. In: UNESCO Science Report: the Race Against Time for Smarter Development. Schneegans, S.; Straza, T. and J. Lewis (eds). UNESCO Publishing: Paris.
- Mohamed, S.F., Mwangi, M., Mutua, M.K. et al. (2018) Prevalence and factors associated with pre-diabetes and diabetes mellitus in Kenya: results from a national survey. BMC Public Health 18: 1215.
- Nakweya, Gilbert (2021) Chronic diseases reduce Kenya income by 29 per cent. SciDev, 9 August 2021.
- Straza, T. and S. Schneegans (2021) Are we using science for smarter development? In: UNESCO Science Report: the Race Against Time for Smarter Development. Schneegans, S.; Straza, T. and J. Lewis (eds). UNESCO Publishing: Paris.
- WHO (2020a) Noncommunicable diseases: progress monitor 2020. World Health Organization: Geneva. https://apps.who.int/iris/handle/10665/330805
- WHO (2020b) Nearly 1 in 5 COVID-19 deaths in the African region linked to diabetes. WHO Africa press, 20 November 2020