Page 77 - 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

of the high levels of violence and trauma in the new South Africa. Characteristic of
such public health-inclined research units, the unit’s first big project was to initiate
the South African Stress and Health Survey (SASH), the first wholly representative
epidemiological study of common mental disorders in Africa. The resultant data
was used to inform the national health policy then being formulated by the new
government. As the unit’s perspicacious director, Dan Stein, pointed out, there could
be ‘no health without mental health’.
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Under CERSA, mental health issues had been bracketed in the same division as
those relating to substance abuse, but in 2001 research on the latter was taken over by
an internal MRC research group in its own right, the new Alcohol and Drug Abuse
Research Group, so serious were the problems of substance abuse becoming. For
instance, ‘Of those who lie on post-mortem slabs’, the head of an MRC project on
travel research had reported in 1995, ‘only a quarter were sober’, while two years
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later it was estimated that, on average, each adult in South Africa drank nearly ten litres
of pure alcohol per annum. With regard to drugs, the loosening of South Africa’s
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border controls from 1994 had significantly increased trafficking into the country,
earning Cape Town the title of ‘the drug abuse capital of South Africa’ because
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of the easy availability there of dagga, cocaine and, by the mid-2000s, ‘tik’ (crystal
methamphetamine). Of course, the abuse of either drugs or alcohol had equally dire
results. Comparing the two, a researcher in the new research unit spoke of alcohol
causing damage ‘cm. by cm. while tik does it km. at a time’.
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Even before its elevation into an independent research group, the Alcohol
and Drug Abuse Research Group’s predecessor had taken the usual first step in
such projects, quantification, by helping to set up the South African Community
Epidemiology Network on Drug Use (SACENDU) in 1996 to collect data from
over sixty treatment centres on the number of alcohol- and drug-related cases
handled there per half-year. This data was then used by authorities and NGOs to
plot changing trends in substance abuse, the populations most at risk from this,
and the factors conducing to such risk, and then to shape policy and interventions
accordingly. So telling was the information gathered from this surveillance that
the research group was soon commissioned by the Southern African Development
Community to develop a similar system to monitor substance abuse in its member
countries so that neighbouring states could be aware of what was happening in this
regard across their borders.
Closer to home, South Africa’s 2003 Liquor Act drew extensively on research
by the research group, especially in the clauses regulating licensing, levies, sale and
labelling. Indeed, so significant was the research group’s input then that when, in

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