Mapping Kenya’s Clinical Trial Landscape.

The clinical trials department team of Kenya’s Pharmacy & Poisons Board takes a tea break together at 10 a.m. Then, MPH student Kofi Addo gets down to business. “I get my tea, I get to my desk, I crank some music, and I start data mining,” he says.

The music is usually bossa nova, and the data are from all of the clinical trials and medicines approved by the Pharmacy & Poisons Board, which is similar to America’s Food and Drug Administration. For his practicum, supported by the Santander University Scholars Program, Addo is analyzing the organization’s database to find trends in the kinds of clinical trials conducted in the country.

At any given time, Addo says, there are about 200 clinical trials happening in Kenya. How many are for pharmaceuticals, and how many are for other medical products? How many are for HIV, for other infectious diseases, or for non-communicable diseases? How does the breakdown of diseases targeted by these trials compare with the breakdown of diseases people in Kenya actually have? Who is sponsoring these clinical trials, and why did they choose Kenya?

“I read of lot of clinical trial protocols to extract the relevant variables,” Addo says, “then I record them in a data collection tool I created to organize the data.” This will allow the Pharmacy & Poisons Board to understand how all manner of variables are interacting in the country’s clinical trials landscape. “Right now we’re working on getting the data, and then we can go from there,” Addo says.

Addo is completing certificates in Community Assessment, Program Design, Implementation, and Evaluation (CAPDIE) and in Pharmaceutical Development, Delivery, and Access, and was originally interested in a practicum that would apply design, implementation, and evaluation to pharmaceutical development. He reached out to Paul Ashigbie, a global health research fellow focusing on pharmaceuticals. Ashigbie put him in touch with Edward Abwao, the head of clinical trials at the Pharmacy & Poisons Board, who became Addo’s practicum supervisor. Ashigbie continues to offer advice and support throughout the practicum, Addo says.

At SPH, Addo says he became interested in the role that public health knowledge and values can play in the pharmaceutical industry. From the way drugs are created to how they are distributed, a public health lens can ensure “everything is ethical, and streamlined, and proper,” he says. Addo also completed a free online course about Good Clinical Practice (GCP) offered by the National Drug Abuse Clinical Trial Network and read extensively about clinical trials in low and middle-income countries to prepare for his practicum

Working at the Pharmacy & Poisons Board has shown him just how important regulatory bodies are when it comes to pharmaceuticals and public health. “Without regulation, there is no transparency,” he says. Companies in higher-income countries conduct their clinical trials in low- and middle-income countries like Kenya because it is cheaper, Addo says, and there may be a bigger pool of people with the disease of interest—but sometimes a company is also looking to conduct a trial under looser or less enforced regulations.

“People sometimes want to take advantage,” he says, “so prospective registration and regulation of clinical trials is critical. It ensures that transparency and data collection starts from the jump.”

Working at a computer until his eyes are sore may not be the most glamorous job, but Addo says the experience is making him even more passionate about the regulatory and drug development side of pharmaceuticals. “I didn’t expect to enjoy it so much!” he says. “I can see myself working in this area. It’s has helped me hone my data analysis skills and solidified the path that I want to take in bridging the gap between public health and pharmaceuticals.”

—Michelle Samuels

Kofi Addo is taking over the SPH Instagram account from July 2 through 6 to share photos from Kenya. Follow along at Instagram.com/BUSPH/ and with the hashtag #BUSPHSummer18.