The SA Medical Research Council (MRC) has abandoned what the Academy of Science of SA described as an “impulsive and high-handed” investigation into Prof Glenda Gray, MRC president and ministerial adviser on COVID-19, for comments she made in her personal capacity about the government's handling of the pandemic, writes MedicalBrief.
Gray, an internationally acclaimed HIV researcher and chair of the research sub-committee on the ministerial advisory committee (MAC) on COVID-19 that provides scientific input to Health Minister Zweli Mkhize, had criticised the government’s lockdown regulations and claim that childhood malnutrition cases were increasing at Chris Hani Baragwanath Hospital. This prompted a sharp rebuttal from Mkhize at the weekend, and a demand from acting Health director general Dr Anban Pillay, who called her a “liar” that the MRC board investigate her conduct, to which the board initially agreed with what appeared to be alacrity.
On Monday, the MRC board apologised to the Ministry of Health and the MAC for Gray's comments, saying it would institute a fact-finding investigation into the "damage" the comments may have caused. It said that, with immediate effect, Gray and the staff of the SAMRC were under strict instructions not to interface with the media until all issues relating to the comments were resolved.
However, on Tuesday morning, in a brief statement, the MRC board said it had discussed the matter with Gray and found she had not breached any of the MRC’s policies.
"We did not find transgression of these policies by Professor Gray. The board has decided that it will not be instituting any further investigation on this matter. The board encourages Professor Gray, the Minister of Health and the Ministerial Advisory Committee to resolve the issue of statements made in the media amicably in the best interests of all parties and the nation," Dr Alfred Thutloa, head of corporate communications at the SAMRC, said.
The about-turn followed an outcry from public commentators, researchers, academics, and organisations, both locally and abroad. Daily Maverick described the response of the scientific community in backing Gray as "unprecedented". The MRC move was criticised by organisations such as the South African Gastroenterology Society and the Perinatal HIV Research Unit at Wits University.
More than 300 leading scientists and academics, included deans of faculties, other MAC members, former Unisa vice-chancellor Barney Pityana and University of the Witwatersrand vice-chancellor, Prof Adam Habib, came out in support of Gray.
Three top academics, in an editorial in the SA Medical Journal said Mkhize should distance himself from the actions of Pillay. Wits vice-chancellor Adam Habib, former University of the Free State vice-chancellor Jonathan Jansen and the University of KZN's Professor Jerome Singh, wrote that South Africa's swift and "praiseworthy scientific response to the pandemic" had been tarnished" by Pillay's response, which "crossed the line".
"Essentially, the acting DG wrote to the Chairperson of the MRC Board on 21 May 2020, alleging that the MRC President had made ‘a number of false allegations against government’, which the DoH ‘consider as very serious’.Noting that the ‘MRC is an entity of the National Department of Health’, the acting DG urged the Board to investigate ‘the conduct of the President on this matter given the harm it has caused to South Africa’s COVID response’.
"Such a move is vindictive, disproportionate and reflects an intolerance to criticism. There is a fundamental difference between holding someone accountable and conducting a witch-hunt. If one were cynical, it could be argued that the DG’s action is a choreographed chess move to precipitate the MRC President’s removal. Such an intervention amounts to executive interference in the governance of the MRC.
"Perceived victimisation of the MRC President will lead to a backlash from the scientific community, including the resignations of fellow MAC members, in protest and solidarity. It will also cost the MRC Board its credibility and undermine the institution. This should be avoided at all costs. The country needs unity and solidarity now, more than ever. The acting DG needs to unconditionally withdraw the complaint he lodged against the MRC President with the MRC Board, as a matter of urgency."
Gray had been supported also by the Academy of Science of SA (Assaf), and the committee of heads of organisations of research and technology, who issued statements supporting scientists’ right to publicly express their opinions. Assaf president Jonathan Jansen is quoted as saying that public reaction and professional pressure against the board’s “impulsive and high-handed (response)”, resulted in the decision to halt the probe against Gray.
“This is a victory for science, democracy and the public good. The scientists should now be allowed to get on with the vital work of managing a pandemic that threatens the health and lives of many thousands of South Africans,” Jansen said.
Business Day reports Gray thanked the board for “having acted with the requisite urgency in its deliberations over this matter”. “I also re-affirm my commitment to doing all I can to the best of my ability to contribute to the national effort against COVID-19 and remain at the disposal of the Minister of Health and the MAC in this regard. I also want to thank all those who have reached out to me personally during this unfortunate and trying time and especially to those who insisted on upholding the principles of academic freedom, which can only be of benefit to our country and all its people.”
Mkhize considers the Professor Glenda Gray matter closed and denied that academic freedom and freedom of expression are under threat. News24 reports that Mkhize told MPs he got a call from Gray, who said she wanted to discuss the matter and would retract her comments. "Let's leave the issue at that," he said.
Noting the fears expressed about the government clamping down on academic freedom, Mkhize said: "There is no basis to suggest any interference with academic freedom." He said any academics and scientists are "very welcome to express their views", but when there are factual inaccuracies, it must be corrected.
Mkhize had earlier rejected Gray’s comments that the government was not taking advice on handling the COVID-19 crisis, says a Polity report.
The reports quotes Mkhize as saying that the government had based its COVID-19 responses on 50 advisories provided by the ministerial advisory committee on COVID-19, of which Gray is a member. He said the government did not claim "to have it all figured out" in grappling with the coronavirus, noting that President Cyril Ramaphosa had constantly stated that South Africa like many other countries around the world, was in uncharted waters.
Mkhize defended the continued closure of schools in response to the virus, saying the department of basic education had been engaged in various consultations with its stakeholders on the correct approach to take in the process of reopening them. "It can never be Prof Gray’s place to make such comments without being aware of the details, the advice and the process the department of basic education has followed," the health minister said.
Divergent views by scientists were healthy and welcome, Mkhize is quoted in the report as saying, adding that the ministerial advisory committee on COVID-19 provided a platform for robust engagement among top scientists who were leaders of various respectable institutions and organisations.
"However, I must urge all those who are contributing to the thought process and science behind the decisions ultimately undertaken by government to desist from potentially destructive behaviour and continue to engage constructively with government as they are mandated," he added.
Professor Linda-Gail Bekker, a medical researcher based at the Desmond Tutu HIV Foundation, came out in support of Gray, describing her as a “national treasure”. She is quoted in a Groundup report as saying that Gray had raised important issues for the “common good” and in the “best interest of the country”. The response should not be a witch-hunt but a discussion so that the government, including (Minister) Mkhize, can find the best way to respond to the epidemic. She emphasised that scientists must have the freedom to speak their minds.
Nathan Geffen, GroundUp editor says in the report: “I don’t agree with everything raised by Glenda Gray in her interview with News24. It seems she made at least one factual error. But some of the points she made are spot-on and important contributions to the debate on how we respond to COVID-19.
“Gray is a highly respected scientist and she should feel free to speak her mind, to criticise, without fear of losing her position as the head of the MRC. Of, course she should also expect to be criticised in response, and Minister Mkhize has written an emphatic response to her criticisms, as he is entitled to do.”
But, Geffen writes, Pillay’s letter is troubling.
“First, this appears to be improper interference. The MRC is a statutory body, but its board must have independence from government.
“Second, Pillay wrote: ‘Subsequently, I have also received calls from persons regarding Prof Gray’s conduct at the MRC on other matters which I will share once I receive more details from them.’ This suggests the health department is willing to dredge up staff grudges against Gray, which exist in any large organisation, to try to get rid of her.”
Geffen writes that if Pillay succeeds in getting rid of Gray, it will not only result in the MRC losing the services of a first-class scientist, it will likely damage the morale of the institution for a long time to come. It will also alienate leading public health experts, many of whom are sympathetic to Gray, from government. He says South Africa cannot afford that during this pandemic.
“In 2001, an MRC study on mortality was leaked to the media. The study showed how HIV was killing hundreds of thousands of South Africans. The report was one of the most important published in the MRC’s history and it contributed to ultimately changing government policy for the better in 2003. But its findings conflicted with the Aids-denialist ideology of then President Thabo Mbeki and his health minister Manto Tshabalala-Msimang.
“So, they pursued a witch-hunt for the leaker of the document.
Geffen writes that there are similarities with what’s happening now.
He writes: “In both situations, instead of engaging with the content of what emanated from the MRC, the government opted for revenge.
But he says: “I don’t want to overstate the similarities though. President Ramaphosa and Health Minister Mkhize are trying very hard to respond to the COVID-19 crisis even though government is making mistakes. So, a comparison with Mbeki and Tshabalala-Msimang is not entirely fair. Also, COVID-19, because of the speed at which it’s unfolding and our lack of knowledge about it, is a much harder problem to deal with than Aids was in 2001, when the solutions were relatively straightforward. What needs to be done now is not at all obvious and reasonable people, like Gray and Mkhize, will disagree with each other.
“But those disagreements are not necessarily a problem, even if they reach the public domain. On the contrary, this is an opportunity for a healthy public debate. Mkhize, Pillay and the other people in charge of the country’s response to COVID-19 need to participate in that debate, with thicker skins, and without rancour.”
An ANC veteran also came out in support of Gray. Medical practitioner, Aslam Dasoo, in a letter to fellow ANC veterans reproduced on the City Press site, said “Gray and her colleagues’ frank appraisal of the damage caused by the continuation of the lockdown … is a view shared widely in society for good reason”.
Dasloo adds: “Every objection to Gray’s comments – and there are many, the most strident coming from senior politicians and officials – has been to her speaking outside of the ministerial advisory committee, but there’s not a single cogent objection to the content of her utterances to be found.”
Mark Heywood, writing in Daily Maverick writes, meanwhile, there is something in the substance of Gray’s comments that risks being overlooked.
He writes: “To try to plug this hole I interviewed several of South Africa’s leading paediatric specialists and child-health researchers, to better understand what Gray had been getting at. ‘Was she crying wolf?’ I asked.
“Their unanimous response was that, although it is not yet reflected in patient numbers or records, there will be a significant increase in child malnutrition as a consequence of COVID-19 and food insecurity following the lockdown.
“According to Lori Lake, one of the editors of the Child Gauge: ‘It’s difficult to put together any meaningful numbers simply because admissions and hospital attendance are down because of lockdown… the logic is clear that given the increase in the food basket price, given the increased number of people in need of income support, that children are going to be bearing the brunt of this and are particularly vulnerable.’ Professor Haroon Saloojee, professor and the head of the division of community paediatrics at Wits, was able to provide more detail. He confirmed that paediatric admissions at CHB in April 2020 were down 66% from January to March but that this was due to the lockdown: “Like everyone else, we’ve reduced non-emergency admissions. Before COVID-19, CHB admitted 15-25 cases of SAM a month, said Saloojee. However, in the first week of May ‘we did see a spike of eight cases’, which raised alarm, but this has not persisted through the rest of the month.
“However, Saloojee stressed that the picture was far from complete. Asked whether there are likely to be cases of SAM in the pipeline. ‘My answer is clear: we know that there will be an increase in food insecurity and hunger will impact on children’s nutritional status and higher rates of SAM can be expected across the country. Hospitals, such as Bara, are a poor proxy of the real situation. There is a real possibility that malnourished children and others with other conditions are dying at home during the lockdown. We will only know the truth when we examine mortality statistics much later.’
“Saloojee points out that Gray was wrong in claiming that SAM was new. He says that while in the late 1990s they saw very little SAM at CHB, this changed with the advent of HIV when it rose as high as 13% of all admissions before, in the era of Antiretroviral therapy (ART), reducing to a stubborn 5%.
“Finally, Professor Ashraf Coovadia, the head of department of paediatrics and child health at Rahima Moosa Mother and Child Hospital, responded that: ‘In short, I believe she is right, we just don’t know the scale of the problem; but what’s complicating the picture is the low numbers coming into hospitals in the last two months as a result of the lockdown.’”
And, Heywood writes, the “low numbers” is arguably “where we find the sleight of science contained in Minister Mkhize’s reprimand. An uninformed reader could mistakenly think that the drop in numbers at CHB is because child health and nutrition has miraculously improved. Sadly, it is not.”