Page 49 - 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

conference and briefing papers, CERSA staff took every opportunity to influence
policy-makers. ‘The use of researchers at the highest policy-making bodies is very
important’, Yach insisted, ‘since it is an opportunity to bridge the implementation
gap in the most direct way.’ He had been able to persuade Council, he declared, that
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implementation was ‘a legitimate function of a researcher’. 34
The buzz in what one CERSA researcher described as the ‘small progressive
bubble’ that was CERSA was infectious. ‘We were like kids let loose’, recalled one of
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her colleagues. ‘We tried all possible research methods without anyone to say you can’t
do that or it won’t work. We … were very practically inclined and very keen to use
methods we had read about … Very early on we developed sophisticated mixed-methods
approaches for practical research on priority problems with real-world impact.’ 36
Despite some opposition from more traditional researchers at the MRC who felt
that CERSA was suspect in both its approach and its underlying ideology – ‘they
couldn’t [even] spell epidemiology’, quipped a former CERSA staffer – its acceptance
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by Brink, Van Heerden and Prozesky saw it flourish and begin to affect other research
units. Consequently, in 1992 the MRC actually approved a multidisciplinary National
Urbanization and Health Research Programme to promote research on the impact
of urbanization on health across the board. Accurately, the editor of the prestigious
American Journal of Public Health (a South African epidemiologist who had gone
into exile because of his opposition to apartheid) observed that CERSA ‘has been the
spearhead and the leading edge of change within the MRC’. 38
Two research directions within CERSA, health systems and chronic diseases
of lifestyle, were sufficiently topical in a country in the midst of a political and
epidemiological transition to be formalized as distinct sub-divisions in 1992, but a
third, tobacco control, became a spiralling crusade led by Yach himself. Tellingly, while
the MRC had not permitted him to indicate his affiliation to it in his first foray into
this field in print in 1982, by 1988 it had changed its tune radically, issuing warnings
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against smoking on its ‘Medicina’ campus, publishing articles in the press and in the
South African Medical Journal on the dangers posed by smoking, and even producing
‘Smoking and Health in South Africa: The Need for Action’ as an official CERSA
technical report. In it, CERSA characteristically spelt out that the report was aimed
at bridging the gap ‘between research findings and implementation at community
level’. Indeed, such was the MRC’s new-found anti-tobacco zeal that when, in 1992,
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the Minister of Agriculture advised the tobacco industry to ready itself for attacks
by the anti-smoking lobby, Philip van Heerden publicly reproved him for ‘a highly
irresponsible statement … [which] should be strongly rejected as it just encouraged
the industry and smokers’.
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