Page 56 - A Widening Idea of Health and Health Research - The South African Medical Research Council from Creation to COVID

On and over the Brink: The MRC, 1985–1994

a way forward, especially as it had been endorsed by the African National Congress.
This certainly made it easier for the MRC to defend itself against suggestions at this
time that it was ‘a luxury ivory tower institution’ which should rather be incorporated
into the DoH or the National Research Foundation. By making it ‘pay particular
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attention to the health needs of the poor, disadvantaged and other vulnerable groups
whose health needs are often overlooked’, the MRC believed, ENHR would achieve a
‘greater focus on applied aspects to help policy development’. Its focus on ‘the health
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problem instead of the research methodology’ (as in curiosity-driven research for the
sake of research) gave it greater potential to improve health conditions on the ground
speedily, argued Prozesky. If this meant replacing staff more at home in laboratories
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than in the field or on computers, the newly emerging dispensation required this in the
interests of the health of the majority of the population. ‘We needed a different type of
employee’, he explained frankly.
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To implement ENHR, in 1993 the MRC assigned all the research entities which
it supported, both internal and external, to one of four research clusters (community
health, laboratory and clinical research, health technology research, and support
groups), each under a group executive whose primary task was to give a common,
ENHR-shaped direction to research by the entities in pursuit of this objective.
Never ‘lose sight of the horizon, of the longer-term goal, to become a myopic solver
of immediate problems’, Prozesky advised MRC researchers. ‘The only difference
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between fundamental and applied research is the length of your vision.’ 59
Although embracing ENHR fully required retrenchments and a ‘drastic
restructuring and change of direction … [to fashion] a more streamlined and compact
organisation’, as Prozesky described it, by 1994 he was enthusing (perhaps somewhat
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wishfully) that ‘already many stifling interdisciplinary and occupational barriers are
coming down to yield fluid multidisciplinary networks that militate against the previous
compartmentalization of our research efforts’. Whatever the distance between this
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aspiration and its realization, by reshaping the research structure which had been in
place, unchanged, at the MRC for a quarter of a century, integrated national health
research (as the MRC rebranded ENHR in 1995 to characterize it more accurately)
made even more radical surgery there conceivable subsequently.
This loosening up of the structures of the MRC was made easier by the passage in
1991 of a new South African Medical Research Act as part of the Government’s bid
to equip its science councils for the very different South Africa around the corner.
Not only did the Act expressly commit the MRC to promoting the improvement of
the health ‘of the population of the Republic’ without any qualifications, but it also
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separated the positions of president and chairman (sic) of the Board, which Brink

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