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Kenya is exploring a new way of treating infections that no longer respond to antibiotics as health experts warn that antimicrobial resistance is making some bacterial infections increasingly difficult and expensive to treat.

The country is working with Slovenia to explore the use of bacteriophages. Presidential health adviser Dr Wilson Aruasa says these are viruses that attack bacteria as an alternative to antimicrobial treatment for infections that are increasingly becoming resistant to antibiotics.

Aruasa said AMR is not only a human health problem but also affects animals and crops.

He said Kenya adopted a One Health approach, which brings together human, animal and environmental health because the three are connected.

“All of them require the use of antibiotics,” Aruasa said during a two-day Slovenia–Kenya Phage Summit that was held at the Kenyata National Hospital in Nairobi.

He said about six in every 10 patients who go to hospital are put on antibiotics, sometimes before the exact cause of their illness is known.

“Sometimes even before we understand what the problem is, we've ended up in a situation where we have antimicrobial resistance,” he said.

Resistance happens when bacteria change and medicines that once killed them or stopped their growth no longer work effectively.

The result is that patients may need stronger or several medicines, stay longer in hospital and incur higher treatment costs.

The two-day summit was convened by ICPE, an intergovernmental non-profit organisation in Slovenia.

ICPE adviser Jure Tomc said the two countries are already working on a project with the University of Nairobi to use phages against bacterial infections in tomatoes, and this can be extended to infections in humans and animals.

He praised the steps Kenya and Slovenia had covered in the use of phages, adding that ICPE will continue to support such collaborations and promote the use of phages in human, veterinary and agriculture.

Kenyatta National Hospital senior director of clinical services Dr Joel Lessan said hospitals are increasingly encountering bacteria that are resistant to commonly used antibiotics.

“Some of them have actually been found to be very resistant,” he said, adding that doctors sometimes have to combine different medicines to treat such infections.

“At the end of it, the costs go up. The outcome sometimes are not very good.”

Aruasa said AMR is estimated to kill up to 37,000 people in Kenya, making it a major public health concern.

With some bacteria becoming resistant to the available antibiotics, researchers are looking at other ways of fighting them.

Aruasa said one of the approaches being explored is phage therapy. He added that phages are viruses that naturally attack bacteria, and scientists can identify and select particular phages that target specific disease-causing bacteria.

“Phages are already found naturally in the human body. The idea is to identify the ones that can attack a particular harmful bacterium, produce them in sufficient quantities and use them in a controlled way,” he said.

Dr Frenk Smrekar, co-founder and chief executive of Slovenian biotechnology company Jafral, said phage treatment could be useful in cases where antibiotics no longer work.

He said the approach could also be used alongside antibiotics and could have applications beyond human health, including farming and other areas where bacterial infections are a problem.

But the problem of AMR does not stop at hospitals. Antibiotics are also used in animals and agriculture. When bacteria develop resistance, the problem can move across people, animals, food and the environment.

The partners are also looking at possible applications in livestock, poultry and fish farming.

Experts, however, stressed that phages are not a replacement for good hygiene, disease prevention or responsible use of antibiotics.

Dr Stella Kiambi, a One Health and AMR expert at the Food and Agriculture Organisation of the United Nations, said phages could become one of the tools used to reduce the need for antibiotics, particularly in farming.

“Phages actually pose a very promising strategy” as an alternative to reduce antimicrobial use on farms, she said.

Aruasa said the country is working with Slovenia, whose institutions have experience in phage production, with the long-term goal of developing Kenya's capacity to manufacture them locally.

The work will involve hospitals, universities, agricultural institutions and environmental agencies.

Kenyatta National Hospital is leading the implementation, with various institutions involved in the wider One Health effort. They are Moi Teaching and Referral Hospital, Ampath, Moi University, the University of Nairobi, the International Livestock Research Institute and the National Environment Management Authority.

Aruasa said local production will take time because any phage product must go through safety, ethical and regulatory approvals.

The health adviser estimated that Kenya could have the capacity to produce phages locally in five to seven years if the necessary processes are successfully completed.

“For Kenya, the aim is, therefore, not simply to find another medicine but to reduce the pressure on antibiotics, while developing new ways of dealing with infections that are becoming harder to treat,” he said.

He added that prevention, responsible use of antibiotics, stronger laboratory systems and research into alternatives such as phages will all be needed if Kenya is to slow the spread of antimicrobial resistance.