Francis M. Ndungu

Francis M. Ndungu

Affiliated to Research

Kenyan immunologist at KEMRI-Wellcome, Kilifi, and KI affiliate. I study why malaria immunity fades, to help build better vaccines, and love training the next generation of scientists.

Visiting address: B2:03, Karolinska Universitetssjukhuset Solna, 17176 Stockholm
Postal address: K2 Medicin, Solna, K2 Infekt Färnert A, 171 77 Stockholm

About me

  • I'm a Kenyan immunologist, and I've spent my career asking one question: how does our immune system learn to fight malaria, and how can we help it do better?

    I'm based at the KEMRI-Wellcome Trust Research Programme in Kilifi, a small town on Kenya's Indian Ocean coast and one of the best places in the world to study malaria. I lead a research group here and have chaired the Bioscience Department.

    I trained as a science teacher at Kenyatta University in Nairobi, then took a detour into parasites with an MSc in Medical Parasitology. That detour became a career. I moved to London for a PhD and postdoctoral work at the MRC National Institute for Medical Research, then came home to Kilifi in 2008 to study immunity where malaria actually happens.

    Today I also collaborate with Karolinska Institutet (working with Anna Färnert's group since 2013), the University of Oxford, Pwani University and the University of Glasgow. Along the way I've published more than 85 research papers and won funding from CEPI, the NIH, EDCTP and the UK Medical Research Council.

    Away from the lab, I co-founded the Tunaweza Education Trust ("tunaweza" means "we can" in Swahili). It helps bright children from poor families go to secondary school.

Research

  • Why do some people stay healthy when malaria strikes again, while others fall ill? That's the puzzle my group works on. Our immune system remembers infections it has met before, but with malaria that memory is often patchy and fades quickly. We want to understand why, and use that knowledge to design better vaccines. We work mainly on malaria, and since 2020 also on COVID-19. Our research is built on two special resources in Kilifi: - Groups of local children whose health and immunity we have followed for many years. - Carefully controlled studies in which adult volunteers, who have had malaria before, receive a small dose of the parasite under close medical care. This lets us see, in real time, which immune responses actually protect. Our main questions: - Memory: How long do antibodies and "memory" immune cells last, and what makes them wake up and respond when they are needed? - Brakes on immunity: Repeated infections can tire out the immune system or switch it into "brake" mode. How does this let the parasite slip through? - Vaccines: What does a protective immune response look like after malaria vaccines (RTS, S and R21) and COVID-19 vaccines? - The bigger picture: How do worm infections, low iron and HIV change the way people fight malaria? Together with Karolinska Institutet, we compare people in Kenya, who meet malaria again and again, with Swedish travellers and migrants, who may meet it only once. Setting the two side by side shows us what repeated infection does to immune memory, and what a single infection leaves behind.

Teaching

  • I started out as a trained science teacher, and I've never really stopped teaching. In Kenya, I teach immunology of infectious diseases at Pwani University in Kilifi. Further afield, I have taught on the IDA immunology course in Cape Town, South Africa, sharing what we've learned about immune memory in malaria with young scientists from across the continent. I'm especially proud to have co-founded AfriBOP, a hands-on training course for early-career African scientists studying parasites and the immune system, where I also teach. I've also helped run career-development workshops for emerging African science leaders. Much of my teaching happens in the lab. I have supervised or co-supervised 8 PhD students, 13 MSc students, research interns and 3 postdoctoral fellows. They have come through the Open University, Oxford, Glasgow, Freie Universität Berlin and Karolinska Institutet, where I have co-supervised four PhD students with Anna Färnert and hosted them in Kilifi for their fieldwork. Many of my former students now lead research of their own in Kenya, the UK and beyond. For eight years (2014–2022) I coordinated research degrees at KEMRI-Wellcome, helping make sure our PhD students got training that met international standards. I'd love to contribute to teaching at KI in immunology, infection biology and global health.

Articles

All other publications

Grants

  • Medical Research Council
    1 February 2022 - 30 November 2026
    Plasmodium falciparum malaria causes an estimated 500 million cases per year and hundreds of thousands of deaths annually. Substantial morbidity and mortality occurs in Africa. An effective vaccine is needed, and vaccine development is essential to provide an effective sustainable and cost-effective control of disease. Rational vaccine development would be based on clearly described mechanisms that lead to clearance of parasites and the correlates of immunity. The current lead vaccine, based on the first falciparum gene ever cloned, delivers ~30% protection over 4 years. An understanding and identification of the underlying mechanisms that lead to naturally acquired immunity has the potential to inform rational vaccine design. We need to identify the antigenic targets for protective immune responses
    and the threshold required and functional properties. The study of naturally acquired immunity has been conducted using observational field studies to date, based on surveillance of naturally exposed children. However, adults living in endemic areas acquire resistance to infection and/or disease with repeated exposure to malaria causing parasites. To understand how this immunity impacts infection, we recently conducted a deliberate infection study using parasite stages that are infective from the mosquito, sporozoites. Out of a total of 142 volunteers, 33 were observed to be malaria parasite free and remained uninfected throughout monitoring for infection in the study. These studies in non-endemic volunteers, with 100% developing infection, have recently been used to investigate pathophysiological mechanisms of disease utilising the stage of the parasite responsible for disease, blood stages i.e. deliberate infection with parasite infected red blood cells. We now propose to deliberately infect volunteers who we found to be previously malaria-free with parasite-infected red blood cells that directly results in the signs and symptoms associated with disease. We intend to evaluate pathophysiological mechanisms of disease and determine the contribution and mechanisms of immunity resulting from the disease stage of infection. We will adopt a biomarker and systems immunology approach to identify mechanisms associated with disease outcome including detailed characterisation of biomarkers of immune activation including endothelial activation and microvascular function
    typing of antibody specificities and function, analysis of cellular immunity
    and analysis of the metabolome. This study will define mechanisms associated with disease in the context of pre-existing immunity and help inform targets for the next generation blood-stage vaccines. Technical Summary Plasmodium falciparum malaria causes substantial morbidity and mortality in Africa. A high-efficacy vaccine is essential. The current lead malaria vaccine confers ~30% protection over 4 years and is based on the major antigen on the surface of pre-erythrocytic sporozoite parasite stages. An attractive strategy to build on this partial efficacy is a multi-stage vaccine including immunity against blood-stages of the parasites. However, there is no analogous single major antigen for blood stage parasites, and vaccines based on several different blood stage antigens have not been successful. Adults in endemic areas acquire immunity to blood-stage parasites after repeated malaria exposure. Identifying the underlying mechanisms of naturally acquired immunity has the potential to inform rational vaccine design e.g. antigen selection. We recently completed controlled human malaria infection (CHMI) studies in Kenyan adults using cryopreserved sporozoites (PfSPZ) and identified 33 out of 142 volunteers who remained uninfected by sensitive blood PCR for malaria parasites. The PCR negative volunteers are likely to have high levels of acquired immunity, and imply an excellent model for vaccine development. However the protection may have resulted either from immunity to pre-erythrocytic or to blood-stage parasites. The distinction is critical for further study and vaccine design. We now propose a blood-stage challenge experiment for these previously protected volunteers since this will bypass pre-erythrocytic stages to determine the contribution of blood-stage immunity and mechanisms. We aim to: (a) test whether a key component of malaria immunity is through an immune response to blood-stage infection
    and (b) test whether individuals who are especially immune are able to control higher inoculums of parasites
    and (c) define immunological mechanisms associated protection and/or disease pathogenesis to inform the development of the next generation of blood-stage malaria vaccines.
  • Host immune responses to SARS-CoV-2: correlating kinetics with the natural history of infection
    European & Developing Countries Clinical Trials Partnership
    1 July 2020 - 31 December 2023
  • Determining Correlates of Naturally Acquired Pre-Erythrocytic Immunity to Plasmodium falciparum Malaria in an Experimental Human Challenge Model
    European & Developing Countries Clinical Trials Partnership
    1 April 2019 - 30 September 2024
  • Accelerating the development of next generation malaria vaccines through development of innovative trial designs in malaria-endemic areas.
    Wellcome Trust Ltd
    1 November 2015 - 30 April 2023

Employments

  • Affiliated Scientist, Department of Medicine, Karolinska Institutet, 2020-
  • Adjunct Lecturer, Pwani University, 2010-
  • Group Leader, Malaria Immunology, Kenya Medical Research Institute - Wellcome Research Programme, 2008-
  • Affiliated to Research, Department of Medicine, Karolinska Institutet, 2025-2028

Visiting research fellowships

  • Honorary Visiting Research Fellow, University of Oxford, Honorary Visiting Research Fellow at the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford., 2015
  • Adjunct Lecturer, Pwani University, Adjunct Lecturer appointment., 2010
  • Affiliated Research Scientist, Freie Universität Berlin

Editorial work

  • Malaria Journal, Associate editor, 2026
  • Frontiers in Immunology, Associate editor, 2022

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