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The mission: How Glenda Gray became 'the closest thing South Africa has to Tony Fauci'

Prof Gray

Professor Glenda Gray almost single-handedly secured 500 000 doses of the Johnson & Johnson Covid-19 vaccine for South African healthcare workers. A fearless advocate for doing what is right above all else, Gray explains why she stands on principle.

In September last year, on the roads that traverse the wide, open spaces of the Karoo, Dr Glenda Gray found peace for the first time in months.

The soundtrack of countless road trips before – Bob Dylan, Leonard Cohen, The Cure and Talking Heads – played over the speakers as she powered her car along lonely roads in search of time. Time to think, time to switch off, time to breathe.

"When you are driving, you can't be on the phone. You can't be busy on the laptop," she says.

Gray (58, she is a single-parent) and her three children – Chloé (28), Rebecca (23) and 17-year-old son, Joab – had packed the car and headed off to Johannesburg to attend a small celebration of her mother's 90th  birthday, stopping at her favourite aunt, Nieu-Bethesda – an eight-hour drive from her spacious and airy Cape Town home.

What draws her back to this small Karoo village, where she often seeks refuge? "It's the open sky," she answers.

A storm had knocked out the town's electricity – an act of God that forced her to take a break. On the way back, they drove through Upington, adding hundreds of kilometres to their journey home.

"I needed to drive," she said.

'The closest thing South Africa has to Tony Fauci'

News24 met Gray at home this week to speak about her life, her work and, perhaps most importantly, the mad dash to secure Covid-19 vaccine doses from Johnson & Johnson for the country's healthcare workers after a decision was taken by health officials not to distribute 1.5 million doses of the Oxford/AstraZeneca vaccine as a result of low efficacy in new studies.

Gray, the president of the South African Medical Research Council and a world-leading HIV/AIDS researcher, was a staunch advocate for the rollout of antiretroviral treatments for HIV patients 20 years ago - and, as a paediatrician by training, has focused the majority of her career on preventing mother to child transmission.

She works 14-hour days, with Zoom calls at odd hours to accommodate scientists from around the world.

In recent weeks, she almost single-handedly convinced Johnson & Johnson to part with 500 000 doses of its Covid-19 vaccine, and scrambled to put together plans to use the vaccines as part of a research study, saving valuable time by cutting down regulatory approval requirements.

She has devoted most of her life to her work and research, which has earned her multiple international awards, including being listed as one of Time's 100 most influential people in 2017 and one of Forbes Magazine's 50 most powerful women in the world last year. She has been awarded the Order of Mapungubwe, and won international awards alongside her friend and mentor, Professor James McIntyre, for the perinatal HIV research unit they established at Chris Hani Baragwanath Hospital in Soweto in 1996.

She is, as her peers have told News24, the real deal.

"She is the closest thing South Africa has to a Tony Fauci," said McIntyre, a reference to the renowned US scientist, who is now leading the Covid-19 response under President Joe Biden.

Professor Linda-Gail Bekker, a friend and colleague of Gray's since the mid-1990s, and an outstanding researcher in the field of HIV/Aids in her own right (she is also co-principal investigator on the South Africa leg of the Johnson & Johnson Covid-19 vaccine trial), described Gray as "authentic".

"I think she's responded with her typical humanity, but also a sense of doing the right thing, and being urgent about it," Bekker said of Gray's work in response to Covid-19.

"She has courageously moved ahead, regardless of the politics, and against better judgement in some ways. But that's what's brilliant about her: she moves the field forward, there is no timidity about it."

If Gray had any faults, Bekker said, it was a tendency to shoot from the hip, which she made up for by being approachable and open to hearing ideas contrary to her own.

But the most important thing to Gray, she said, was "the mission".

"The project, the trial, the programme. Now it's been day and night working. She is a soldier for work, a Trojan for work – and she has been at it, hardcore, for days now. I am amazingly in awe of that. She often puts the mission ahead herself or her family, because that's her passion."

McIntyre, head of the Anova Health Institute in Johannesburg, has known Gray for nearly 35 years and says she has always been the same energetic person, full of ideas and fun, and just as willing to lay down in the middle of a road in protest now as she was 20 years ago.

"She is fearless, and she has never abandoned her principles," he said. "She took on numerous health ministers, and even presidents, at the height of the HIV denialism period, just as she did last year, and has never backed down. Her value is enormous, not only as the head of the MRC, but also as an example to others in her field."

Growing up in Boksburg and confronting Nkosazana Dlamini-Zuma

Gray was born in Boksburg on the East Rand and grew up "on the wrong side of the tracks", she says.

She describes her father as a "maverick" and a progressive man, who was whip-smart, but a heavy drinker and who loved raucous parties. Her mother became a Baptist minister later in life. The couple had six children.

"I know what it's like to buy on the book,"she said, referring to credit arrangements at local stores, adding that her father often involved himself in "crazy schemes", which meant she and her siblings grew up poor.

Her father, though, understood and knew the value of the education.

"We were scholarly and eccentric; we didn't fit the typical profile of where we lived. We were odd."

A self-described troublemaker, Gray sits barefoot on a couch in the living room of her house in Kenilworth, Cape Town, after making tea. There is a flash of the forceful Gray when she orders one of her dogs, Owen, to get off the couch.

The walls are bedecked with post-modern art. Above the lintel, a piece that appears to depict a power station and landscape features in pastel colours that can only be South African is somewhat overshadowed by a "sharp left" blue and white road sign that sits above a flat screen television, where an episode of Ru Paul's Drag Race was paused – eight minutes in.

A pottery caricature resembling the boy-reporter Tintin sits on a shelf next to a small Buddha figure. A copy of Taschen's 40th  Anniversary edition of Pop Art sits on the coffee table.

Gray remembers their neighbours in Boksburg coming to borrow a cup of sugar, just to have a peek inside the house to see who Gray's father had brought home in an effort to help them, often people of colour.

Gray took on odd jobs to support herself through medical school, working at Joshua Doore, ABC Shoe Store and waitressing at restaurants.

"I always knew I was going to be a doctor. I guess when I entered medical school at the University of the Witwatersrand in 1981 and as I got into clinical years, I knew that I liked the kids in the hospital, I liked playing with them, going to the wards," she recalls.

At Chris Hani Baragwanath Hospital, she watched the HIV/Aids epidemic "explode": from three in a 100 people infected to three out of 10 "in the space of two or three years".

She would go on to advocate for life-saving treatment to be made available by the South African government, which was in the throes of Aids denialism that potentially cost hundreds of thousands of lives.

She has contributed to work credited with reducing mother to child transmission of HIV significantly.

She tended to expectant mothers, who were HIV positive, while she herself was pregnant with her first child.

"Your stomachs grow together," she said, but the difference in circumstances was stark.

"We bonded because we were young mothers together and you feel tremendous empathy and anguish for them because you know what it's like to be a mother…and having to watch my baby die…it must be the most the devastating thing that any woman would have to go through. And we saw that, we witnessed it."

In the mid-90s, she was invited to attend a World Health Organisation conference on HIV/AIDS. She was 33 years old, but reveals that she lied about her age, saying she was 38, so that people there would take her seriously. "I was 38 for like five years," she said.

She recalls an "altercation" with then health minister Nkosazana Dlamini-Zuma in a bathroom at an Aids conference in the 1990s, after the minister said AZT (an intravenous treatment that prevented mother to child transmission by more than 60%) was too expensive.

Laughing, she recalls how American cable news channel ABC sub-titled her first TV interview, due to her strong "East Rand" accent. "But I learned to speak slower and more clearly, after a while," she laughs.

The phasing out of the lockdown was 'nonsensical and unscientific'

Like most South Africans, she spent the first days of the pandemic locked down at home. When the pandemic hit, she scrambled across the globe to get her two daughters – who were abroad – home. They arrived back from India and Thailand in the nick of time, just as the borders were closing. They buckled down together.

She helped plan and plot the country's way out of the pandemic after her appointment to the Ministerial Advisory Committee (MAC), which was formed to assist the minister of health, but fell out of favour in May, when she slammed the government's phased out approach of the lockdown as "nonsensical and unscientific".

She was then excluded from a newly constituted MAC in September and left out of the MAC on Covid-19 vaccines, despite her work in leading one of the biggest coronavirus vaccine trials in the country.

But it was almost serendipitous, she explains, as it allowed her "to focus on the job, to focus on the science".

Gray worked hard to secure the country's participation in the global Johnson & Johnson Covid-19 vaccine trial, leveraging connections with the company made through her work in managing trials of the company's HIV vaccines.

But, she reveals, J&J almost pulled the plug on the South African leg of the trial, because the first wave had ended, and Covid-19 was not spreading.

Despite this, Gray insisted, "the second wave is coming". Gray took a chance, and it worked in the country's favour.

Unbeknown to either Gray or Johnson & Johnson, a new, more transmissible variant would soon trigger a second wave that dwarfed the first and has caused headaches for other vaccines.

"Serendipity," she says.

Scrambling to find enough vaccine

The result of her pushing ahead, and lobbying hard to keep the South African leg of the Johnson & Johnson trial going, means the overall efficacy number of the vaccine's phase three trial results was driven downward. But, she says, the South African hospital admissions data was crucial in the company obtaining long-term data that showed the vaccine was 80% effective in preventing death and severe illness after two months.

It also gave the world vaccine trial data on people infected with the new variant, crucial data that could help with the development of new vaccines if the coronavirus mutates into something even more dangerous.

"Johnson & Johnson are lucky that they trialled in South Africa. Most of the data they have on mortality and hospitalisation come from us."

Gray's intervention when she stepped in to assist the government, when the rollout of the Oxford- AstraZeneca vaccine was cancelled, drew praise from colleagues.

"She deserves a medal. It really was phenomenal," says Professor Francois Venter, head of the Ezintsha Health Unit at the University of the Witwatersrand, who served with Gray on the MAC before he was also sidelined.

Venter says it is widely accepted in scientific circles that the vaccine rollout would not have happened as quickly as it did if it wasn't for Gray.

When government canned the AstraZeneca vaccine, Gray contacted the Johnson & Johnson managing director (Paul Stoffels) directly. She had a plan and needed his help.

"I told him how badly healthcare workers here had been affected and that it was devastating – the deaths, the lack of PPE (personal protective equipment) - he'd seen it from our data and he also saw how this vaccine worked in South Africa."

Gray, with the help of Health Minister Zweli Mkhize, managed to secure half a million doses of the Johnson & Johnson vaccine, which arrived just two days after South Africa's initial rollout was set to begin.

"It was a mad dash to get the vaccines here, we had to charter the plane... it got here at 23:00, the guys worked all night to get the vaccines out. The whole night they were texting, 'First truck out, second truck out', even in the airplanes. It was beautiful."

As the vaccines arrived at the airport in Cape Town, Gray was there to meet the plane – grabbing doses and jumping into an ambulance to vaccinate the first batch of health workers, including President Cyril Ramaphosa and Mkhize.

"I was frazzled by that stage," she says.

She stood next to Ramaphosa as he received his jab at the Khayelitsha District Hospital in Cape Town.

Her career had made a turn of 180 degrees, from fighting a president during the HIV/Aids epidemic, to helping another president get vaccinated during a pandemic.

"It was wonderful to see the president being vaccinated and to see the minister being vaccinated. But, for me, what was even greater was that we had moved vials all over the country and, at any moment, healthcare workers were also going to get their shot."

Respected in her field and a role-model for youngsters

Gray was an Aids activist before she was an Aids researcher, working with the Health Workers' Association, and her partner in crime was the current director in the Office of Aids and TB Research at the SAMRC, Dr Fareed Abdullah.

The two go back decades and, when Abdullah became the head of the Aids programme in the Western Cape and started administering antiretroviral therapy to pregnant women, against the wishes of the government, he needed an ally at his side.

"I knew that I needed the scientists to stand up and defend the programme," Abdullah told News24. "I called on Glenda, and other scientists that she was collaborating with, to advise the provincial health department," he said, adding that Gray was able to "speak truth to power".

When the SAMRC board wanted to investigate Gray last year, after her stinging criticism of the government's lockdown strategy, Abdullah sent a letter of support to the board, telling it the organisation was lucky to have her at the helm. And when the Covid-19 pandemic struck, Gray was able to pivot the institution "at breakneck speed" to respond – leading trials and advising policy decisions to tackle the virus.

"We reiterate that Professor Gray's leadership at the SAMRC has been outstanding. During her tenure, she has prioritised the training and career growth of African female scientists, established grant opportunities for historically disadvantaged universities and raised the profile of the SAMRC internationally, thus attracting enormous funding opportunities for South African scientists. She is a role model for young scientists and is highly respected within the organisation," the letter read.

"I told everyone I'm sitting this pandemic out", in the hope she could burrow away and focus on academia, she remembers.

Instead, she became South Africa's most efficient and recognisable scientist. We're in good hands.

By Kyle Cowan and Azarrah Karrim - report.

Original Article available on News24