Page 128 - A Widening Idea of Health and Health Research - The South African Medical Research Council from Creation to COVID

Slimmer, but Not Lacking Gray Matter: The MRC, 2012–2021

repeatedly stymied such bilateral projects. ‘You need both entities to put money into
it’, explained Gray. ‘Then there’s skin in the game for both … Both programmes [can
then] do joint calls.’ 85
The results of collaboration with institutions in better-resourced countries was
usually quite different, however. Here, the tide of well-endowed, jointly funded projects,
which had begun to flow after 1994, continued apace at the initiative of state-funded
research institutions in Europe and North America like the US National Institutes of
Health and the UK MRC, of philanthropic bodies like the Gates Foundation and the
Wellcome Trust, and of pharmaceutical companies like GlaxoSmithKline and Novartis.
In every case it was a combination of the MRC’s location in a disease hotspot which
also afforded access to the rest of Africa, its own capable research infrastructure and
network, and its proven capacity for efficient financial and administrative management
which saw it become what one senior administrator called ‘an organisation of choice to
work with by international organisations … [which] like to be connected to successful
organisations … If you become trustworthy, you are able to attract the big players’ –
86
and the MRC’s record showed it to be just that. For these reasons too, the big players
included several international pharmaceutical firms, for which the MRC was the key
to what Mbewu had called ‘one of the major clinical trials sites in the world’.
87
Unsurprisingly, many of these joint projects focused on leading diseases like HIV/
AIDS and TB. Evidence of this is to be found in, inter alia, the extent to which these
diseases featured in the MRC’s annual publication count, as this recovered to reach
over 1,250 per annum in 2020–1 after the deep cutbacks in staff by Karim in 2013.
The MRC’s world-class research units in these fields were the biggest contributors to
this count. For its less eminent research units, their status internationally is perhaps
fairly captured in a frank assessment by a unit director who acknowledged, ‘We’re not
leading research in these areas – we’re commenting on it, we’re up there with them,
engaged with them, but we’re not necessarily in front.’ 88
The MRC’s positive reputation internationally is also attested by its being
asked to host the WHO’s International Classifications Collaboration Centre for the
African Region, by the request to advise the Indian Council of Medical Research on
its remodelling, and also by its membership of several international bodies which
were established in these years, like the Global Antimicrobial Resistance Research
and Development Partnership, the Joint Programme Initiative on Anti-microbial
Resistance, the Healthy Life Trajectories Initiative against child obesity, the Global
Alliance for Chronic Diseases (which Gray chaired in 2017–18), and the prestigious
Heads of International Research Organizations. ‘In these gatherings you meet your
peers and you forge relationships which help your scientists and their scientists’, Gray

121