Apparently I am very lucky — the lift to the 12th floor of the building in the sprawling hive of Chris Hani Baragwanath Hospital is working today.
This is good because I am carrying a picnic lunch for Dr Glenda Gray, the CEO and president of the Medical Research Council, whose work in the Perinatal HIV Research Unit of Wits University is legend.
She is based here when she is in Joburg and I come bearing roll mops, curried fish cakes, artichokes, a baguette and carrot cake — from the Gourmet Grocer in Birdhaven of course — so that we can maximise her time. Also she likes fish.
I step out of the elevator into a stylish, bright white set of offices with a killer view of Soweto. On the balconies a green-fingered doctor has created a verdant oasis that has supplied an impressive bunch of roses for the canteen.
I confess I had a grittier version of the circumstances at Bara in mind. But perhaps I am just looking at a visual representation of the actual situation facing public health in SA. Pockets of excellence and steep structural challenges when the system fails you.
It is something Glenda confirms in her gentle but authoritative manner when discussing the Covid pandemic.
We are in a really good position for the surveillance. So South Africa has beautiful data, we have a lovely death register
“We are in a really good position for the surveillance. So South Africa has beautiful data, we have a lovely death register.”
I interrupt her to comment that she is the only person I have ever heard speaking of the death register in these glowing terms.
She laughs and continues: “Even very well developed countries can't say the same thing about their data. This is the death register that was established by the MRC that showed Thabo Mbeki that HIV is causing Aids. So we monitor mortality every week, year in, year out. We’re able to say, based on 20 years of experience, how many people should be dying each week.
“So during HIV, suddenly there was this extraordinary amount of young women and 25-year-old guys dying. And he was saying HIV doesn't cause Aids and there's no problem. And this team could say: 'Actually you have it wrong!'”
She has never been afraid to speak truth to power — her activism in the HIV/Aids campaign was born from her experience in the maternity unit at Bara. Once an activist, always an activist — as has been demonstrated by her outspoken representations to the government during this pandemic.
She continues, explaining: “So this database means we can check for unnatural deaths. We can check this for under five-year-olds and old people and can see how our life expectancy is changing. And suddenly we were seeing that with every outbreak, the death rate followed suit. This was important because we underreported death in southern Africa due to Covid.
“So in fact, we have one of the highest mortality rates in the world — about the fifth highest and really the reported data is something like 100,000 deaths. What this tells us is that we’re very good at surveillance. We know we can do the tests, help develop vaccines because of our work on the HIV vaccine, but we have one of the highest mortality rates in the world, which means that our services are not resilient.
“We ran out of oxygen and ICU beds. Everybody knows someone who's died of Covid, or more than one person. We are prepared at some level because we have been dealing with the HIV pandemic and the TB epidemic, but we're not prepared in terms of the resilience of our health system to absorb the increase in infections that we might see from an outbreak.”
She is adamant that the only solution is to root out corruption. I shift the conversation — what is inspiring about her work at the MRC?
We're not prepared in terms of the resilience of our health system to absorb the increase in infections that we might see from an outbreak
“It's fun and exciting because you get involved in a whole range of things — diagnostic devices, precision medicine, the fourth industrial revolution. For example at a global level, there's a shortage of penicillin. It is such an entry-level antibiotic and it's so cheap that you never make a profit, and so we have a global shortage.
“So we're thinking, can you develop a modular unit with a beta-lactamase [an enzyme made by bacteria] producing unit — so that you can actually make penicillin in South Africa and supply the local market, and that's innovation! It’s just a little modular unit, to make an antibiotic, but it is quite revolutionary.”
She is so enthusiastic. “So to take things like penicillin, things that people need, and to apply innovative interventions. The African genome is the least well discovered, we hardly know anything about it and we know that particularly for noncommunicable diseases, like hypertension, diabetes, cancer, the pharmacokinetics are different, and so we might not have the best drugs.
“So the more we know about the African genome, we can make specific medicine — precision medicine. So you bring in the fourth industrial revolution to answer things that matter to young Africans on the African continent.
“It's really exciting. We established this whole genome-sequencing institute at the Medical Research Council, it is the first time we have done the whole genome sequencing on the African continent — that's something that's quite exciting and local to South Africa. Science is really exciting!”
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.