Page 81 - 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

said, ‘We felt that we were part of the myriad and multiple forces that were in some
way assisting to bring about democracy.’ Thus, the Health Systems Research Unit
103
(as it was known once it gained autonomy from CERSA in 1999) became a selective,
informal adviser to government at all levels in the interests of the country’s emerging
health system.
Complementing it in this role was the Health Policy Research Unit, which had been
in existence at Witwatersrand University since 1987, but which secured the status of
an MRC external research unit and the financial support that came with this only in
1997. As its name implies, it took as its chief task doing research and disseminating
it to inform and interrogate the new government’s policy-making on health matters
across the board, from policies to allocate health funding and costing primary health
care to those regulating medical schemes and the rollout of ARVT. Disseminated both
formally and informally, its findings were influential. As one of its senior staff noted
cannily in 2010, ‘A lot of policies that are being or have been advanced or adopted as
government policy bear an uncanny resemblance to Centre for Health Policy thoughts
and opinions expressed in many of its publications.’ Thus, whether onstage or
104
behind the scenes, the two research units – along with other research units with a
public health orientation – made significant if piecemeal contributions to fashioning
the country’s new health-care system.
With two telling exceptions – the Traditional Medicines Research Unit and the
Cochrane Centre Research Unit – the other 21 research units set up with MRC
backing in this period were all external to the Council, and nested within university
departments, a sure sign of the specificity of their focus. That, while three-quarters
of them were located at historically advantaged (i.e. predominantly white) institutions,
the fact that a quarter were at historically disadvantaged (i.e. black) institutions like the
University of the Western Cape (UWC), the University of Transkei and MEDUNSA
was the first fruit of the MRC’s deliberate policy after 1994 to ‘creatively change
research priorities in South Africa’ by strengthening research at such institutions.
105
Of the 21, 5 were chiefly clinical in orientation, among them the Diarrhoeal
Pathogen Research Unit established at MEDUNSA in 1996, which made it the first
MRC external unit at a historically disadvantaged institution. With its focus on a
group of diseases widespread in Africa but hitherto under-researched, it epitomized
the new direction in research which the MRC sought to nurture. The clinical trials
which it conducted on Rotarix, a rotavirus vaccine, led to the inclusion of this vaccine
in South Africa’s Expanded Programme on Immunization, to the life-saving benefit of
thousands of under-fives, who had in this way been protected against acute rotavirus
gastroenteritis. Indeed, so taken with the efficacy of this vaccine were Diarrhoeal

74