In a recent discussion in Nairobi, experts drawn from a range of fields including Kenya Medical Research Institute (KEMRI), Ministry of Health, World Health Organization officials, Civil Society Organizations representatives emphasized on the need for more resources on research.

Dr Emmanuel Tanui Deputy Director of Pharmaceutical Services in the Ministry of Health and the National AMR Focal Point, says that the fight against this challenge has worsened due to limited diagnostic capacity in public hospitals in Kenya.

“Majority of our laboratories lack capacity to diagnose AMR, less than 20% of our labs have the capacity, so let’s strengthen the capacity of our labs and leverage on Information Technology like TikTok, Instagram, so that we can reach more people to advocate on AMR and leverage on existing structures,” said Dr Tanui.

AMR occurs when bacteria, viruses, fungi, and parasites evolve and become resistant to the medications typically used to treat infections. This resistance can lead to prolonged illnesses, higher medical costs, and increased mortality.

“We must reduce the need for antibiotics, improve diagnostic tools, and enhance monitoring and evaluation frameworks,” he said.

The Economic Impact of AMR

The economic toll is severe with an advocacy call to leaders to recognize it as it may be one of the leading causes of death globally if nothing is not done.

“Dr. John Kariuki, an AMR survivor, shared his personal experience, revealing that he never imagined the impact AMR would have on his life. ‘I spent four months in the hospital, with my medical bill rising to Sh 4.5 million ($35,000),’ said Kariuki.

Kariuki advocates for One Health Approach that is basically integrating human, animal and environmental health in addressing AMR.

One Health approach is a collaborative, multi-sectoral, and transdisciplinary strategy that recognizes the interconnectedness of human health, animal health, and the environment. It aims to improve health outcomes and prevent risks that arise at the intersection of these three domains

“AMR is invisible and humans are visible, advocacy does not know AMR, nobody is invisible as far as AMR is concerned, AMR does not discriminate, minor infections can lead to deaths, lets join hands in prevention,” added Dr Kariuki.

Both Dr Tanui and Dr Kariuki advocates for Infection Prevention and Control (IPC) practices and enhanced surveillance systems and promotion of education on the dangers of antibiotic misuse.

“We need to strengthen diagnostic capacity and raise awareness among all stakeholders,” said Dr Tanui. “Infection Prevention Control (IPC) measures must be embraced, and the use of antibiotics in animals should be discouraged.”

The discussion convened partners from across the region to deliberate on matters AMR and endorse its regional and national position statements for the UN High-Level Meeting (UNHLM) on Antimicrobial Resistance AMR.

Imali Ngusale, Technical Lead at the African Centre for Health, Climate, and Gender Justice Alliance, addressed the link between climate change, AMR, and the poultry industry during the recent discussion. She pointed out that the recent floods had washed away essential products used to feed chickens, forcing farmers to explore alternative feeding options.

“We lack sufficient data to correlate with antibiotic use in poultry farming. This data is critical to determining whether antibiotics are necessary and understanding the potential consequences of their use,” Ngusale reiterated

She advocated for regenerative agriculture as a potential solution to the growing problem of antibiotic misuse in livestock farming. “Regenerative farming aims to ensure that beef and poultry farmers refrain from using antibiotics unless necessary and to fully understand the repercussions of such use,” she said.

In the discussion, experts urged the government to prioritize AMR in its health budget to address the lack of data and diagnostic capacity, which is hampering efforts to curb its spread.

What Are the Solutions?

Despite the challenges, some progress is being made. The Kenya Medical Research Institute (KEMRI) has allocated more funding to research on AMR, with increased support for grants and research initiatives. However, experts say more must be done to address the lack of diagnostic infrastructure and training in many laboratories across the country.

Dr Robert Onsare senior research scientist at KEMRI said that they have build a case to be able to increase funding that comes to KEMRI. “Research has increased for Research and Development, we have grants and various groups are applying for the funds to be able to do more research,” said Onsare.

Evaline Kibuchi emphasized that leveraging on existing structures since they are already established and the challenges cut across various diseases, she said that they will also help in minimizing the available resources.

“The use of the existing structures is a solution to minimize the resources needed for new interventions,” said Kibuchi.

Stakeholders also suggested using social media platforms like TikTok and Instagram to raise awareness among younger populations.

Why is This Urgent?

AMR has been a growing concern globally, and the issue will be highlighted at the United Nations General Assembly’s High-Level Meeting on September 26, 2024. The meeting will focus on the theme, “Investing in the present and securing our future together: Accelerating multi-sectoral global, regional, and national actions to address Antimicrobial Resistance.” Kenyan stakeholders including Imali Ngusale from the  African Center For Health, Climate & Gender Justice Alliance (ACHCGA), are ramping up local discussions ahead of this meeting to align with global efforts.

How Can Kenya Move Forward?

To tackle AMR effectively, stakeholders are calling for better data collection and sharing, particularly in Sub-Saharan Africa, where accurate information is scarce. “In the Global North, data collection is more advanced. Kenya must adopt similar practices to better understand the economic and health impacts of AMR,” said Dr Tanui.

While civil society support and political commitment remain low, experts stress that political will is crucial for progress. “For any real change to happen, it must start with political willingness,” added Kibuchi.

As Kenya prepares for the UN General Assembly meeting, stakeholders hope that these discussions will lead to concrete actions to combat the growing threat of AMR.

Shantel Mwikali, one of the panelists, highlighted Female Genital Mutilation (FGM) as a major issue for young girls. She also mentioned early pregnancies and period poverty as key challenges faced by girls in remote areas.

“We as adolescent girls face so many challenges that hinder us from accessing quality education and our health rights,” said Mwikali. “Some of the girls have been forced to drop out of school due to early pregnancies.”

According to Kenya Demographic & Health Survey (KDHS) data for 2022, the prevalence of FGM is 15 percent in the country, meaning that 15 percent of girls and women aged 15 to 49 have been circumcised. This is much too high. Yet, progress is being made.

In her opening remarks, Kate Kiama, Director of Programs and Impact at She’s the First, emphasized the organization’s commitment to equipping women with essential skills and certifications to secure a brighter future for girls.

“By building women’s capacity, we ensure a brighter future for girls worldwide,” said Kiama. She also pointed out that discussions on Sexual Reproductive Health and Rights are often avoided at the family level, making it difficult for adolescent girls to share their concerns with their parents

She’s the First is a global leader in girls’ education and empowerment, women’s rights; Leadership development; Youth development; Community and economic development; Reproductive health care; International development; Equal opportunity in education

This year the one-day event that brought together 40 grassroots organizations from 235 in 2023 aimed to impact practical training on girl-centered programs and Sexual Reproductive and Health Rights (SRHR) education

“This key event coincides with the launch of the groundbreaking Girls First Institute, designed to equip women leaders with the tools to transform communities and uplift girls, ” said Kiama.

Tina, who was also one of the panels during the one-hour talk added that security, clean water, access to sanitary towels, decent schools, and mental health support are some of the challenges young girls from the rural areas are grappling with.

“Lack of security during school going days have led to some of the girls getting impregnated by the motorcycle people better known as ‘Boda Boda’,” said Tina.

During the one-hour talk, girls with disabilities also shared that they face many barriers when joining programs due to lack of sign language interpreters and lack of access to information. “Communication is a problem when we get into such programs due to lack of sign language interpreters,” said one of the girls with a hearing disability.

“We need to be included in all programs, our families also need to be trained in sign language so that it can be easy for us to communicate with them,” she adds.

Another challenge the girls shared was lack of safe spaces to share and highlight their SRHR rights. “Many girls when faced with feelings, they don’t open up but keep to themselves resulting in anxiety, depression and substance use,” she said. “Parents pay attention to your children; you never know what they are going through.” they reiterated.

One girl added that some donated sanitary towels are not inclusive to the girls with heavy flows. “Some girls have heavy flows and others low; the donors need to put in mind and include sanitary towels that accommodate the girls with heavy flows,” she said.

They called upon authorities to ensure that the perpetrators of sexual offenders are brought to book like the ones who defile girls with disabilities.

She’s the First was founded 15 years ago in New York City and currently operates in East and West Africa, South Asia and Latin America with its headquarters in Nairobi. It is dedicated to a world where every girl can choose her future.

According to Kiama, She’s the First also formally launched the Girls First Institute, offering two certification levels, “Essential” and “Advanced,” to empower organizations and attract new funding opportunities.

“The Institute provides vital skills in girl-centered program design, feminist mentorship, and sexual and reproductive health and rights programming, addressing the lack of affordable, high-quality training for women-led, girl-focused organizations in the Global South,” reiterated Kiama.

Heilu Ward, located in Moyale sub-county, Marsabit County in northern Kenya, greeted us with a cacophony of braying donkeys and the clanging of jerrycans. Curiosity drew us towards the noise, leading us to a nearby water point where the animals were gathered.

At the dam’s entry, security guards told us that everybody was required to pay five Kenyan shillings for a 20-liter jerry can for locals and 10 Kenyan shillings for Ethiopians, the buyers later sold the water in Moyale town at 100 Kenya shillings per 20 litre jerrycan.

Out of curiosity, I peeped inside the dam to see how locals were fetching the water, and to my shock, the water was visibly unfit for human consumption.

Fatuma Dalle, a 42-year-old mother of six, villager, confirmed our fears. “The water is dirty, but we have no choice,” admitted Dalle while explaining how the lack of donkeys only worsened their plight.

Dalle spoke through a translator, a middle-aged man, who, decoded her Borana dialect.

Dalle admitted that, “The lack of proper water storage forced the residents to rely on rainwater which unfortunately was shared with wildlife and was often made dirty hence unfit for human consumption.”

“Before the dam was built, we used to trek for over five kilometers to look for water but since the dam was established through efforts of community members around Heilu ward, we have been relieved from the burden of walking for long distances. We water vendors have taken the initiative of employing two security guards to watch over the water from being contaminated by wild animals,” explained Dalle.

The water business was booming in the area as the vendors bought a 20-litre jerry can for five shillings and sold it for 100 shillings in the town.

Strategically located at the Kenya-Ethiopia border, Heilu Water Point served as a meeting point for communities from both sides. Ethiopians and residents from other wards paid a premium for the life-sustaining liquid.

Accordingly, Dalle admitted that the water business enabled her to fend for her family and even pay school fees for her six children. She remained optimistic and hopes that with time she will manage to buy more donkeys and expand her business.

Heilu Manyatta ward is a central point for donkey vaccination

A team from Africa Network for Animal Welfare (ANAW) in partnership with the County government of Marsabit in Moyale Sub-county partnered to vaccinate donkeys in Heilu and Banisa wards, targeting the dam site because of its central point for the beasts of burden.

As we strolled by the water point, a man named Abdi Dida caught our eye. He was arranging a row of bright yellow jerrycans to collect water. Despite his busy schedule, he stopped to share his approach to caring for his loyal donkeys.

“I rely on Ethiopians to look after them,” Dida explained. “They come from the neighboring country, and work from dawn to dusk.”

He went on to detail their employment terms, noting, “They receive a monthly salary ranging from Ksh. 2,000 to Ksh. 3,000, depending on the size of my donkey herd.”

The 48 year old said that most of them sought Ethiopians to enable them to engage in other activities and their children to go to schools without being troubled by having to graze their cattle.

“We share one market with the Ethiopians so in case anyone wants to buy a donkey it is never a problem. There are Kenyan men there who help with negotiation and even act as witnesses during the purchasing process,”  explained Dida .

Dida who had been in the business for more than 20 years mentioned that one of the major challenges that the community faced was the inability to identify their donkeys in a herd when they got lost.

Dida also highlighted the challenges of identifying lost animals, he said, “We simply observe the direction from where the animal is coming from to tell if it is from Manyatta or Ethiopia. Ethiopian donkeys have dark body marks while the Kenyan ones have tattoo on the ears or use physical marks which at times resemble.”

Dida also revealed that the donkey  owners only embark on a two-month search mission before giving up completely.

Inter- county transfer of donkeys a threat to the animals

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“This village bore witness to the  crackdown of slaughterhouses,” recounted Doctor Dennis Bahati, a Programs Manager from ANAW. “Illegal cross-border movements left numerous donkeys vulnerable to theft.”

We approached the water point with cautious steps with tension unfolding from a distance, mindful of the animals’ skittish nature.

Two middle-aged men gently restrained a donkey by its ears, signaling for the removal of the metal grille from its back to facilitate the procedure. Nearby, a veterinarian poised with needle in hand awaited the opportune moment, ready to administer the vaccine.

The metal grilles, once laden with water from the dam, served as makeshift supports for jerry cans.

Once the donkey grew calm, the vet swiftly injected the vaccine into its neck, withdrawing before the animal could detect any threat.

Dr. Bahati reflected on ANAW’s efforts since their arrival in 2021 to collaborate with Moyale sub-county and border patrol to bolster the security of these endangered creatures. “We’ve uncovered numerous welfare issues demanding attention,” he acknowledged.

“In recent weeks,” he continued, “we’ve witnessed a surge in illegal donkey movements across the Kenya-Ethiopia border. These unsuspecting animals venture into areas known as hotspots for donkey bush slaughter, posing a significant threat.”

Hassan Guyo, an official from the Marsabit County Department of Livestock and Veterinary Service overseeing the vaccination, confirmed that at least 400 donkeys had received treatment that day.

Guyo conceded to the prevalence of illegal cross-border donkey movement in the area over the past three months.

“It was reported that eight to ten lorries, transporting between 4000 to 6000 donkeys, crossed from the Moyale border to unknown destinations, leading to an increase in bush slaughter cases in areas like Naivasha,” Guyo disclosed.

However, there was a glimmer of hope in February 2024, when African heads of state and government collectively agreed to ban donkey slaughter for their skin, a measure aimed at protecting the continent’s 33 million donkeys.

Despite this progress, Guyo emphasized lingering legal loopholes that needed addressing to ensure the animals’ security.

“Donkey slaughter may be banned, but there remains a loophole allowing for their movement,” Guyo explained. “Traders exploit this gap, transporting animals to destinations for bush slaughter.”

He called upon the government and advocacy groups to take decisive action to ban the movement and slaughter of donkeys entirely.

Guyo expressed optimism in the potential of a donkey identification and traceability system to aid in the recovery of stolen animals in the event of large-scale theft.