Page 45 - 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

in the margin of his copy of the minutes, ‘Medtech lost them all!’ Yet, in pushing
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the MRC towards financial ignominy in this way – ‘If matters had been allowed to
continue in the previous vein, the MRC would by now have faced insolvency’, he
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concluded in 1993 – the Medtech fiasco made necessary a comprehensive reordering
of the MRC’s research priorities.
Even before the introduction of framework autonomy, however, there were signs
of the new directions in medical research which Brink and his team regarded as being
of high priority if the Government’s attempts to reform apartheid were to proceed
successfully. For example, in 1986, just ahead of the Government’s abolition of the
influx control legislation restricting the movement of Africans into the country’s
urban areas, the MRC was asked by the renamed Department of National Health
(DoH) to assess the likely impact of urbanization on health and to identify means to
alleviate any deleterious effects. With demographers predicting a flood of a million
Africans into cities and towns in ‘white’ South Africa annually, alarm bells were clearly
ringing loudly in the corridors of power. Tellingly, one of the researchers in the MRC
study concluded that it was aimed more at reassuring white urban-dwellers that the
Government recognized the need to ensure that urbanizing Africans ‘would not spread
infectious diseases to whites’.
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Probably for both reasons, when the group of progressive epidemiologists within
the Institute for Biostatistics who were charged with undertaking the project argued
that its focus should be broadened so as to include non-communicable diseases
too in a comprehensive, urban community-based inquiry, Brink agreed without
hesitation. Consequently, they rapidly established the Centre for Epidemiological
Research in Southern Africa (CERSA) as the Institute’s epidemiological arm and,
with the promise of a substantial grant of R1 million per annum for ten years from
the DoH, enthusiastically began to extend their research in all directions. ‘We were
generalists and trained to address the breadth of public health issues’, recalled their
dynamic leader, Dr Derek Yach, who had recently returned home from Johns Hopkins
University with an MPH degree. ‘We didn’t know what we were not supposed to be
doing. So we were often at the cutting edge.’ In the words of one of his collaborators,
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Yach ‘brought an enormous breath of fresh air to the MRC which was very parochial
then’. He ‘had a talent for bringing people together from different aspects of health
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policy, research and service delivery and, importantly, from different disciplines’.
‘He generated lots of ideas, was strategic and many of us benefited by being in his
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slipstream’, added one of his research assistants. Prozesky, under whom he served,
summed him up as ‘a mover and change agent … [who] excels in setting up new
initiatives, often using unconventional means and approaches to achieve his aims …

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