Page 73 - 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

should thus be given to the ‘laboratory bench, self-interested research’ of yesteryear
at the MRC, and more to whether it was ‘on important health problems of the day’.
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Even more insistent was the recommendation by an outside review panel that the
MRC’s focus must be ‘in line with national priorities’ and that research units working
in areas outside these should be ‘de-emphasised’. Reflecting on the difference from
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the norm in the 1980s, Prozesky observed: ‘Before … we used to research on our own,
publish it, and then sit back thinking that our job had been done. Now research must
be brought into policy-making and action, involving an extensive networking effort.’ 81
This criterion and two more strongly punted by Makgoba, transdisciplinarity
(which was encouraged by assigning research units to one of six thematic research
clusters) and international peer review of research proposals, became standard MRC
practice from the early 1990s, whether the proposal emanated from the new, tightly
focused research ‘thrusts’ it initiated in 1996 or the broader, composite national
research programmes or the lead programmes on high-priority research areas which
it drove from 1999. As a result, it is no surprise that most of the 34 new research units
created between 1994 and 2012 – 26 external and 8 internal – ticked these boxes, at
least on paper.
Broadly speaking, 13 of them could be described as within the field of public health,
a marked difference from the situation at the MRC in 1993, when Essential National
Health Research was adopted as its research lodestar. Not that this is surprising, given
the MRC’s reconceived mission after 1994: ‘To improve the nation’s health status
and quality of life through relevant and excellent health research aimed at promoting
equity and development.’ In the neat aphorism of the chair of two Government-
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appointed Science, Engineering and Technology Institutions (SETI) Reviews into the
MRC in 1997 and 2001, ‘The underserved should no longer be underserved.’
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Among the 13 ‘public health’ research units established in this period, three
directions can be identified.
Given the context of the ‘new’ South Africa, that one such direction was focused
on sections of the population whose health was particularly vulnerable is not
unexpected, for example the urban poor, women, mothers, infants and poor rural-
dwellers. Research by several of these units made a significant contribution to practice
in hospitals, for instance in how the implementation of the University of Pretoria–
MRC Maternal and Infant Health Care Research Unit’s recommendation that all data
relating to maternal, neonatal and child health care be integrated in a single Family
Health File cut perinatal mortality rates in rural Mpumalanga by 25 per cent, or how
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the criteria it spelt out for the safe care of mothers and babies in health-care facilities
were adopted as the national norm by the National Department of Health. For its

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