The cancer centre at the Kenyatta University Teaching, Referral and Research Hospital (KUTRRH).
Kenya is beginning to turn the tide against one of its deadliest cancers,
with more patients now being diagnosed early enough to receive curative
treatment.
A partnership between the University of
Manchester, The Christie NHS Foundation Trust and the Kenyatta University
Teaching, Referral and Research Hospital (KUTRRH) has, over the past three
years, introduced structured screening, expanded diagnostic capacity and
trained thousands of frontline health workers.
The programme, piloted in five counties, is
already showing results: a shift from late-stage diagnosis — when care is
largely palliative — to early-stage detection, when treatment can save lives.
PROF KEITH BRENNAN, who leads the
collaboration, says the change marks a breakthrough in a country where
oesophageal cancer has long been detected too late.
Beyond screening, the initiative has
strengthened local expertise, built institutional capacity and opened the door
to future advances such as genomic research and precision medicine.
In
this interview, Prof Brennan explains what has worked, the challenges faced,
and what it will take to scale the gains nationwide. He spoke to Star’s Victor Simani.
QUESTION: I understand the partnership began in 2020 and has been
underway since then. What brings you to Nairobi this time?
ANSWER: Our first major project is coming to
a very successful conclusion. We undertook a large study on oesophageal cancer,
and we’re now at the stage of reflecting on what comes next. My visit is about
building on that success — asking how we sustain the partnership, strengthen
it, and scale what we’ve achieved into the next phase.
How do you measure success in this partnership?
The clearest measure of success is
that we have developed and deployed a functioning screening programme for
oesophageal cancer in Kenya. We’ve implemented it across five counties —
Kiambu, Nyeri, Kirinyaga, Kisii, and Meru — and we’re already seeing a shift in
the stage at which patients are diagnosed.
Previously, most patients presented
at Stage 3 or 4, when treatment is largely palliative and focused on
end-of-life care. Now we’re seeing more patients diagnosed at Stage 1 or 2,
when curative treatment is possible. That shift alone represents a profound
impact.
Another major achievement has been
capacity building. We’ve trained Community Health Assistants (CHAs) and
Community Health Promoters (CHPs) to conduct disease awareness surveys — not
only for oesophageal cancer, but in ways that can be applied to other diseases.
In total, 15,000 CHPs were trained in oesophageal cancer awareness, enabling
outreach to virtually every household in those five counties, including rural
and remote communities.
We’ve also trained 14 surgeons in
endoscopy so they can detect early cancers, and two pathologists to analyse
tissue samples and confirm diagnoses. This ensures the entire diagnostic
pathway is locally strengthened.
Importantly, we’ve witnessed the
remarkable growth of Kenyatta University Teaching, Referral and Research
Hospital (KUTRRH). When I first visited, it was just opening. Today, it is a
thriving referral and research institution, training medical students and
contributing nationally. Our partnership has supported its development as a
research hospital.
Why focus on cancer, and specifically oesophageal cancer?
The focus on cancer originated from
a request by former President Uhuru Kenyatta. It was a priority raised at the
highest level of government.
The specific focus on oesophageal
cancer came from KUTRRH itself. It is the fourth most common cancer in Kenya
and, at the time we began, the leading cause of cancer deaths. We listened
carefully to our Kenyan partners — both government and hospital leadership — and
shaped the programme around their priorities. That’s fundamental to a true
partnership.
Prof Keith Brennan, who leads the collaboration between the University of Manchester, The Christie NHS Foundation Trust and the Kenyatta University Teaching, Referral and Research Hospital (KUTRRH).
Did Kenyan healthcare personnel have opportunities to train
in the UK?
Yes. Clinicians and researchers
trained in Manchester, including at The Christie NHS Foundation Trust, one of
the UK’s leading cancer centres. But the exchange has been two-way. UK
colleagues have also come to Kenya to provide training locally. Many of those
who trained in Manchester returned to Kenya to train others, multiplying the
impact.
How do you ensure this is a long-term investment rather than
a short-term project?
Sustainability has been central. The
training of community health workers has been integrated into Kenya’s national
cancer training framework, which ensures continuity. Screening uptake
continues, showing that awareness is embedded.
The bigger question now is scale.
We’ve demonstrated success in five counties — but Kenya has 47. We will be
discussing with the Principal Secretary for Medical Services how to expand from
a successful pilot to a national programme. How do we replicate this across the
remaining 42 counties? That’s the next frontier.
What key skills are being transferred to Kenyan healthcare
personnel?
First, public health research skills
— conducting surveys to understand what communities know about diseases and
services. That knowledge shapes effective interventions.
Second, the communication strategy.
We’ve learned that radio is particularly effective in reaching communities,
with newspapers also playing an important role. Understanding how best to
disseminate health messages is critical.
Third, service delivery innovation.
Screening services must go to the people, not the other way around. Mobile
endoscopy services have proved essential. The same approach could apply to
mammography and other screenings.
Looking forward, genomics is a major
priority. Oesophageal cancer incidence is higher in the Rift Valley and Western
Kenya than in Eastern Kenya, suggesting environmental influences. Genomic
research may reveal whether something harmful is present — or something
protective is missing — in certain regions. That knowledge could inform
prevention strategies.
Genomics can also identify the
specific genetic mutations driving these cancers, enabling precision medicine.
Targeted therapies are often expensive, but genomic evidence provides the
justification for their use and improves treatment outcomes.
What challenges have you faced?
Kenya’s devolved healthcare system
has required us to negotiate agreements with each county individually. We
couldn’t rely solely on national approvals. It was more complex than we
anticipated, but we worked collaboratively and succeeded.
Financially, we’ve been well
supported through funding from the UK’s National Institute for Health and Care
Research, which has enabled the programme to operate effectively.
Is this truly an equal partnership?
Absolutely. The partnership was
initiated at Kenya’s request. The focus on oesophageal cancer came from the
hospital. Kenyan clinicians and researchers have been deeply involved in
shaping the research agenda from the beginning.
Five years from now, what would success look like?
I would like to see a national
genomic sequencing centre established in Kenya, ideally embedded within KUTRRH.
Currently, sequencing capacity is limited. A national facility would transform
research and patient care.
I would also like to see the
screening programme expanded to all 47 counties, and extended to other major
cancers such as cervical, breast, and prostate.
Most importantly, I want screening
services to be community-based and mobile. Late diagnosis remains one of the
biggest barriers to survival. If we bring services directly to communities, we
can dramatically improve outcomes — not only for oesophageal cancer, but for
cancer care across Kenya.