Racist medical history should not feed fears around Covid vaccine

I have a dear friend and former classmate from my time in the US named Lisa Fitzpatrick, who is also an infectious diseases doctor, a medical epidemiologist and public health specialist. Earlier this year she volunteered to participate in the phase 3 Moderna mRNA-1273 Covid-19 vaccine trial in order to publicly demonstrate her confidence in the science of vaccinations and to offer a counter-narrative to the fear and mistrust which often accompany discussions about vaccination — especially in the US today.

As an African-American medical doctor, Lisa has extensive experience of the levels of mistrust in the American medical establishment by members of that country’s black community. It has been, after all, less than 50 years since the infamous Tuskegee Syphilis Study was concluded by the Centers for Disease Control and Prevention and the US Pubic Health Service; a diabolical experiment in which 600 African-American men were recruited in Alabama in 1932 and told they would be receiving free health care from the state in exchange for their participation in the study.

Instead, the 399 participants who had latent syphilis were neither given their diagnosis nor treated at all, and the study, which was meant to last six months, instead went on for 40 long years.

Not a single participant was treated for his illness — even after penicillin was found to be an effective treatment for syphilis. Instead, all were fed placebos and “observed” by doctors in order to establish the consequences of untreated syphilis — which included a range of effects from mental illness and heart disease to physical disability and death.

Aside from normalising the vaccine development process for her patients, peers and the communities in which she does outreach and engagement, Dr Fitzpatrick’s mission is also to transform discussion of the Covid-19 vaccine — and its development and delivery — from a political discourse into a scientific one. For members of the black community, her aim is also to demonstrate the active participation of black scientists and researchers in the vaccine development process as well as to emphasise that her own participation in the trial is voluntary and that the entire process will be a safe one.

The latent fear of medical experimentation on black bodies by those in the medical establishment is not a new one, nor is it limited to the history of medical research in the US.

In April this year, when two French medical doctors suggested during a televised interview that a coronavirus vaccine be tested “ … in Africa, where there are no masks, no treatment or intensive care, a little bit like it’s been done for certain Aids studies, where among prostitutes, we try things, because we know that they are highly exposed and don’t protect themselves”, the dark spectre of medical experimentation on black African bodies was raised once again.

I need not elucidate the history of Sarah Baartman between these pages, nor need I remind you that as recently as March this year, a report by the Commission for Gender Equality uncovered 48 cases of forced sterilisation by hysterectomy in major public hospitals in Gauteng and KwaZulu-Natal, all of which targeted black women who were mostly HIV-positive.

I dwell on this sample of the multiple instances of medical malpractice against black people in Africa and the US to emphasise that while it may be easy to condemn those who are suspicious of the raft of Covid-19 vaccines which are about to hit the global pharmaceutical market and be deployed by governments everywhere, their fears are neither context-free nor born of a vacuum.

I also agree with chief justice Mogoeng Mogoeng when he says he is fully entitled to his own opinions, his religious beliefs and his misgivings with respect to the Covid-19 vaccine. Indeed, the chief justice is better placed than most to understand the freedoms afforded him by both the constitution and the Bill of Rights.

But justice Mogoeng is also the head of one of the three arms of the state — a position of huge sociopolitical influence, and alongside the president of the republic and the speaker of the National Assembly, one of the three highest political offices in our country. His words have meaning beyond the personal — as he must surely have grasped after nine years as head of SA’s apex court. As long as he holds office, he must walk the tenuous line between personal conviction and public proclamation.

I don’t believe it is unfair to say that, in his recent remarks on the potential efficacy of a Covid-19 vaccine, he has erred on the wrong side of that line.

We are entering a treacherous period in the global battle to overcome the coronavirus pandemic, one in which we will be exposed on multiple fronts — from the financial and geo-political to the scientific and medical. Public leadership is going to play a critical role in our ability to confront these multiple challenges head-on and armed with the correct information.

While it may be tempting for many leaders in our country to give in to their worst fears about the months to come — and to make public pronouncements to that effect — I hope very much that the majority will instead follow Lisa’s example and lead with empathy, understanding and a proper appreciation of the science behind this critical vaccination drive.