Prof. Kevin Marsh has a broad research interest in child health in the tropics, with a particular focus in the immune epidemiology of malaria. Prof. Marsh is director of the KEMRI Wellcome Programme in Kenya; he also coordinates the malaria immunology group within the programme.
Malaria is a major problem for children in Africa. Over the last 10 years there has been a massive international investment for malaria control. This has driven major changes in the delivery of new drugs, ways of preventing malaria and also the basic research that aims to develop vaccines.
Ultimately, medical research must translate into improved treatments for patients. At the Nuffield Department of Medicine, our researchers collaborate to develop better health care, improved quality of life, and enhanced preventative measures for all patients. Our findings in the laboratory are translated into changes in clinical practice, from bench to bedside.
Q: Your research focuses on child health in the tropics. Can you tell us about it?
KM: Originally in fact I trained in adult medicine, but my scientific interest is in malaria and malaria is a major problem for children in Africa. So through that I was drawn into working with children. Then you immediately begin to realise that malaria does not occur on its own; it is in the whole context of many other diseases and nutritional status and so on and so forth. So that is what drew us into working particularly with children in the tropics.
Q: How has your research on malaria changed in the past five to ten years?
KM: There has been a massive change in malaria in general and that really reflects a renewed interest in it in the world. Malaria had been very neglected for a long time, and I think people were very pessimistic; things were getting worse up until the 1990s. Then over the last 10 years there has been a really massive investment internationally in funding for malaria control. That new funding has driven changes in malaria control which has begun to change the research agenda in all sorts of ways; in the delivery of new drugs and ways of preventing malaria, but also in the basic research we do for instance in trying to develop vaccines. The kind of vaccines we will need in the future have changed because of the way that malaria control is reducing malaria, at least in some parts of the world.
Q: What is the KEMRI- Wellcome programme in Kenya?
KM: Well it should really be the KEMRI-Oxford- Wellcome but that is a bit of a mouthful! It is a research programme that has been going for 21 years now. It has 3 major stakeholders; KEMRI (the Kenya Medical Research Institute) which is a parastatal organisation, the national research institute in Kenya. Oxford University has been a major partner from the beginning, and then the Wellcome trust has been our long term partner and funder. So it brings together a UK university, a Kenyan research institute and a UK based international funder of research.
Q: How has science in Africa evolved during the past 30 years?
KM: I am always a bit nervous about answering questions about 'in Africa' in anything - it is a bit like saying 'in Europe', and I suppose you would say that science in Italy might have evolved rather differently from science in Norway. Africa is a big place, and my experience has particularly been, in the last 20 years, in Kenya. Having said that there are some generalities and I guess the biggest one is the massive underinvestment in science historically. So the biggest change over 30 years if you go to meetings or look at publications from Africa is the emergence of African leadership in science that has been happening. It is picking up speed now and it is a process that we are very happy to be involved with.
Q: So what will happen now?
KM: I suppose it depends on whether you mean 'now' in general, in science in Africa, or 'now' in relation to malaria. I think they are linked obviously. I am personally very optimistic about progress, both in Africa generally and in health research. I think what is happening in many African countries with regards to child health is very encouraging. Childhood mortality is dropping in many places; I hope we will see continued improvement, and introduction of new interventions - particularly the development of health systems and services. That is tied very closely with the whole economic and political development of countries which, again, I am very optimistic about. I have lived in Africa for half of my life and I feel very optimistic about the way things are going to develop in the future.