Page 28 - A Widening Idea of Health and Health Research - The South African Medical Research Council from Creation to COVID

Aanmatiging (Self-Assertion): The MRC, 1969–1985

became apparent in the 1970s. With nearly half of all white male deaths being caused
by heart disease and the age at which this was occurring falling noticeably, alarm bells
were ringing throughout what contemporaries began to call ‘the coronary capital of
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the world’, where mortality from heart attacks among white males aged 30 to 45
was the highest in the world. ‘Every hour at least one white South African dies from
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heart disease’, warned a specialist in Die Burger. ‘So many young men are dying at the
peak of their lives from heart attacks that something must be done to reduce the high
occurrence of coronary deaths.’ As a cardiologist himself, Brink was only too aware
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of the seriousness of what he described as ‘this terrible epidemic of heart disease’. 33
To address this crisis, financial support for two research units, focusing on molecular
and cellular cardiology and on ischaemic heart disease, was readily approved; a National
Heart Effort Appeal was launched to raise funds for a Heart Foundation to be set up
to engage in cardiac health promotion, initially with its headquarters at the MRC;
and in 1979 a systematic, combined Coronary Risk Factor Study (CORIS), along the
lines of the American Framingham Heart Study, was mounted in three towns in the
Boland to identify risk factors among whites living there. Having found hypertension,
lack of exercise, smoking and cholesterol elevated by diet, lifestyle and heredity to be
major causes of cardiovascular disease, 27 fieldworkers from the MRC, its equivalent
in the humanities, the Human Sciences Research Council, and the Department of
Health intervened to reduce these factors by testing and health promotion. Success
in doing so – by 1993 mortality among whites from heart disease had fallen by 35
per cent – became the basis for a massive cardiovascular education and lifestyle
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change programme among whites more generally, which subsequently targeted
other components of the population as they too were affected by the epidemiological
transition. ‘We are in a position to lead the world with regard to this research’, Brink
announced with no little pride.
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An even smaller group of Afrikaners to benefit from the MRC’s preferential attention
to health conditions affecting whites were those with porphyria, a hereditary metabolic
disease found especially among descendants of a 17th-century Dutch settler family. To
deepen the research done on the disease at UCT since 1957, in 1979 the MRC upgraded
the Porphyria and Renal-Metabolism Research Group at UCT into a fully fledged
MRC–UCT Porphyria Research Unit. When this unit was discontinued because of
the retirement of its director in 1983, its research was continued by another beneficiary
of MRC funding, the Liver Research Group at UCT. Its researchers led by Professor
Ralph Kirsch subsequently went on to identify the gene responsible for the commonest
variety of the disease in South Africa, variegate porphyria, thereby facilitating early
diagnosis of the disease and the treatment needed to curb its negative effects.

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