Page 125 - A Widening Idea of Health and Health Research - The South African Medical Research Council from Creation to COVID

A Widening Idea of Health: The SAMRC from Creation to Covid

About HIV, existing research units added further knowledge too in these years. For
example, the intramural HIV Prevention Research Unit contributed to an international
study in 2013 showing that using Depo-Provera raised the risk of women contracting
HIV, thereby strengthening the WHO’s warning about this in its guidelines on
progestogen-only contraception. 80
But, as the Pathogenesis and Treatment Research Unit made even clearer,
prevention required intervention at a socio-behavioural level too. Its phylogenetic
studies revealed that one important path for HIV infection was between older men
and adolescent girls. ‘Greater understanding of the sexual networks driving HIV
transmission’, argued UNAIDS, ‘could help in the design of programmes to reduce
HIV infection in adolescent girls and young women.’ Certainly the South African
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National Department of Health thought so, for this belief informed key programmes
in the country’s ‘National Strategic Plan on HIV, TB and STIs, 2017–2022’.
As for existing research units’ contributions to health care in the form of the
creation of new instruments and devices, several of these, with the encouragement of
the new MRC–Jembi Collaborating Centre for Digital Health Innovation, revolved
around developing digital health apps. These spanned tasks as diverse as providing
standard treatment guidelines for primary health-care sites using ‘a home grown
App developed by our own MRC’ (as the president described it ), creating a digital
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HealthConnect platform to allow the National Department of Health to manage
mobile health applications nationally, digitizing socio-demographic data for the
population of one rural area in KwaZulu-Natal so that cognitive ageing and dementia
could be monitored using tablets, and designing a wristband for infants to investigate
whether there was a correlation between their and their mothers’ physical activity
levels and their subsequent motor development and growth. Linking such diversity,
however, was the common aim ‘to provide quality health information and feedback
channels to individuals and health workers across Africa’, as a National Department
of Health official put it, in the interests of advancing universal health coverage.
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For all the talk of advancing health throughout Africa, the concrete results of the
MRC’s numerous attempts at collaboration with medical scientists in the rest of the
continent in this period were not substantial, apart from the Lubombo Initiative
against malaria in Mozambique, eSwatini (Swaziland) and South Africa. 84
Filled with anticipation, scientific delegations from African countries arrived
in Cape Town, were warmly hosted by the MRC with the encouragement of the
Government, and solemnly signed agreements to collaborate with the MRC in research
projects, but little of substance followed. The lack of equivalent funding from their
countries to match the funds allocated by the MRC and the high turnover of personnel

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