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Bill Gates visits Partners PrEP Study in Eldoret, Kenya

Bill Gates, co-chair of the Bill & Melinda Gates Foundation, visited the Eldoret Partners PrEP study site on December 3, 2009. The Partners PrEP study is sponsored by the Gates Foundation, which is also funding projects in the vicinity of Eldoret Town in Western Kenya. At the Eldoret Partners PrEP visit, Mr. Gates and senior leaders from the foundation were hosted by Dr. Edwin Were, the Eldoret Site Principal Investigator, and Dr. Nelly Mugo, the East African Regional Physician and Thika Site Principal Investigator. Representing Moi University, the institution under which the Eldoret site is implementing the Partners PrEP study, were Dr. Paul Ayuo, Dean of the Moi University School of Medicine, and Dr. Sylvester Kimaiyo, the Program Manager for the Academic Model Providing Access to Healthcare (AMPATH), a key collaborating partner for the Eldoret Partners PrEP site.

The visit provided an opportunity for Mr. Gates and other members of the foundation to hear about the importance of HIV serodiscordant couples in the Kenyan HIV epidemic , as evidenced from data from the population-based 2008 Kenyan HIV/AIDS indicator survey. Dr. Were summarized the approaches and challenges to mobilizing couples to be tested together and to disclose their HIV serostatus, a necessary step for recruitment of HIV serodiscordant couples and implementation of the Partners PrEP study. The Eldoret Partners PrEP site has enrolled 323 couples in the past year since study activation.

Mr. Gates and visitors met and held discussions with HIV serodiscordant couples who are participating in the Partners PrEP study, and heard about the couples’ reasons for testing the first time and for joining the study. He learned about their challenges with living as discordant couples, disclosing their HIV status to other family members, and taking a study pill daily.

Mr. Gates, Dr. Steffano Bertozzi, the head of the HIV program at the Gates Foundation, and Drs. Edwin Were and Nelly Mugo from the Partners PrEP study discussed ways to make HIV prevention trials more efficient, including the timelines of regulatory approvals, operational efficiencies, and the cost -effectiveness of study procedures and processes. On hearing the benefits of study participation, including access to couples counseling, he encouraged local partners, such as the AMPATH HIV care centers and the home-based testing program, to facilitate referrals of HIV serodiscordant couples to the Partners PrEP study.

Mr. Gates discussed issues about access to health care, generally, and to HIV care, specifically, and how to make programs such as AMPATH more cost-efficient, especially with regard to the personnel and non-ARV costs. It is imperative to identify cost-efficient models of HIV care delivery as the numbers of new HIV infected persons entering HIV care continue to increase while funding levels remain flat.

Overall, the visit was informative and enriching for the Eldoret site and the couples who met with Mr. Gates. His questions were incisive, the discussion was stimulating and will benefit the Partners PrEP study team, and hopefully, will be useful to the foundation in understanding site challenges in implementing HIV prevention trials. The site visit illustrated the value of partnerships between the couples who participate in the Partners PrEP study, the site and the local treatment and counseling and testing partners in the community in which the study is being conducted, and the sponsor and the site investigators.

(Left to Right): Dr. Dismas Oketch, Mr. Mungai, Dr. Edwin Were, Dr. Paul Ayuo, Bill Gates Jr., Dr. Sylvester Kimaiyo, Prof. Mengech, Dr. Nelly Mugo, Cosmas Apaka.

(December 3, 2009)


Melinda Gates visits Kisumu Site

On March 6, 2006, the Gates Foundation team led by Melinda Gates, made a private visit to the Partners in Prevention Kisumu site, located on the northern shores of Lake Victoria in Kenya. The Gates team visited the Ondiek Voluntary Counseling and Testing (VCT) Center where they interacted with staff. They were able to talk one-on-one with VCT counselors concerning their experiences and challenges in handling couples.

The team witnessed a demonstration of the "air and ground campaign," where a public address system with speakers mounted on a van, broadcasts recorded messages about couples HIV counseling and testing (CHCT). Usually, as the messages fill the air, on the ground, a drama group performs CHCT skits in market centers to mobilize couples to get tested.

Drs. Nelly Mugo and Videlis Nduba gave Ms. Melinda Gates a tour of the Partners in Prevention facility. The team were given a presentation about their outreach activities, CHCT data, enrollment updates, screening and enrollment by month, achievements and challenges of recruitment.

Visit to Ondiek VCT Center (left to right) Renee Ridzon, Samuel Ogembo, Dr. Nelly Mugo, Ms. Melinda Gates, Pacifique Pauline Adhiambo, Dr. V. Nduba, June Kasyoki, Steve Wandiga.

(March 6, 2006)