Page 43 - 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

restructuring and change of direction’ towards research which placed greater
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emphasis on community health research so as to improve the health of all. Research
should therefore be ‘linked as closely as possible to health service intervention and
implementation’. 11
Accelerating this reorientation was the Government’s introduction in 1987 of so-
called framework autonomy for the country’s state-supported scientific and cultural
institutions, in a bid to cut expenditure in the face of its deepening debt crisis. What
framework autonomy meant was that, in return for greater flexibility in how it spent
its budget, a council’s budget would be trimmed, leaving it to find other sources of
funding to finance innovation and expansion. What a senior administrator called the
‘golden years’ thus ended, ‘the fun run stopped and bad times hit us. Knowledge of
the business world became a pre-requisite … The MRC had to come down from its
safe ivory tower [and] compete in the open market … with a decreasing budget.’ The
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old culture of being able to fall back on the state for additional financial assistance is
‘behind us’, warned the MRC’s chief financial officer glumly.
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At short notice, therefore, the MRC had to rethink its allocation of research funds.
In Van Heerden’s words, this meant that ‘the relevance of its research in a South
African context must be reviewed, funds available to the organisation must be managed
with great circumspection, and the activities of the organisation must be consciously
directed to the implementation of research findings. Unproductive research projects
must be replaced with those showing a greater productivity and scarce resources must
be optimally utilised to increase output.’
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On this criterion two internal research units and one external unit were closed,
plans to set up an Institute for Psychiatry were shelved and the site earmarked for this
sold, 89 MRC staff (i.e. 21 per cent of the total staff complement) were retrenched
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and all vacant posts frozen. ‘We closed down facilities, we scaled down. We right-sized,’
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recalled Prozesky. The MRC found itself ‘in the doldrums’. Contract research was
increasingly sought to generate funds to contain the shortfall.
What had made the financial plight behind these cutbacks even more pressing
was the MRC’s disastrous attempt to generate income according to the framework
autonomy prescription by setting up Medtech, its own company to market its research
products, in 1988, with a plush conference centre of its own at ‘Medicina’. By 1992,
however, Medtech was in dire financial straits and had to be liquidated, leaving the
MRC with no option but to write off the company’s debt of R2.7 million. This debacle
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‘turned a precarious situation into a crisis’, Prozesky recorded with dismay. ‘There
was no cash flow, there were no reserves … I had terrible sleepless nights.’ When
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the item ‘Reserve Funds’ was being discussed by the Board, Prozesky noted ruefully

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