Health research in South Africa has been plunged into crisis with the abrupt termination of US grants, with more expected in the coming days and weeks. Professor Ntobeko Ntusi, head of the South African Medical Research Council, tells Catherine Tomlinson from Spotlight about efforts to find alternative funding and to preserve our health research capacity – and what the priorities are.
Though exact figures are hard to determine, indications are that more than half of South Africa’s research funding has been coming from America in recent years.
“In many ways the local health research landscape has been a victim of its own success, because for decades we have been the largest recipients of both official development assistance funding from the US for research (and) also the largest recipients of National Institutes of Health funding outside the US,” said Ntusi.
Determining the exact amount is challenging, because the money came from several different American government entities, distributed across various health research organisations. But most of it was from the NIH – the largest funder of global health research.
Ntusi said that in previous years, the NIH invested on average of about $150m into SA health research every year.
By comparison, the SAMRC’s current annual allocation from government is just under R2bn. “Our baseline funding, which is what the National Treasury reflects (approximately R850m), is what flows to us from the Department of Health,” he said, adding that they also have “huge allocations” from the Department of Science, Technology & Innovation.
How the SAMRC is tracking terminations
Ntusi and his colleagues have been trying to get a clearer picture of the exact extent and potential impacts of the cuts.
While some US funding flows through the SAMRC, the bulk goes directly to research units from international research networks, larger studies, and direct grants. Keeping track of all this is not straightforward, but Ntusi said the SAMRC has quite up-to-date information on all of the terminations of US research awards and grants.
“I've been communicating almost daily with the deputy vice-chancellors for research in all the universities, and they send me updates,” he said.
Of the approximately $150m in annual NIH funding, “about 40%…goes to investigator-led studies with South Africans either as (principal investigators) or as sub-awardees, and the other 60% (comes from) network studies which have mostly sub-awards in South Africa”.
Figures he shared with Spotlight show that large tertiary institutions, like the University of the Witwatersrand, the University of Cape Town, and the University of Stellenbosch, could, in a worst case scenario, lose more than R200m each, while leading research units like the Desmond Tutu Health Foundation and the Centre for the Aids Programme of Research in South Africa could each lose tens of millions.
The SAMRC figures indicate that while many grants have already been terminated, a substantial number have not been ended.
Where will new money come from?
Ntusi said the SAMRC was co-ordinating efforts to secure new funding.
“We have been leading a significant fundraising effort, which…is not for the SAMRC, but for the universities which are most affected and also other independent research groups. As the custodian of health research in the country, we are looking for solutions not just for the SAMRC but for the entire health research ecosystem.”
Strategically, it made more sense to have a co-ordinated fundraising approach rather than repeating what happened during Covid-19 when various groups competed against each other and approached the same funders, he added.
“Even though the SAMRC is leading much of this effort, there’s collective input from many stakeholders,” he said, noting that his team was in regular communication with the scientific community, the Department of Health, and Department of Science, Technology & Innovation.
The SAMRC is also asking the Independent Philanthropic Association of South Africa and large international philanthropies for new funding. Some individuals and philanthropies have already contacted the SAMRC to find out how they can anonymously support research endeavours affected by the cuts.
Can government provide additional funds?
Ntusi said the SAMRC was in discussions with National Treasury about providing additional funds to support researchers through the crisis.
The editors of Spotlight and GroundUp recently called on National Treasury to commit an extra R1bn a year to the SAMRC to prevent the devastation of local health research capacity, arguing that much larger allocations have previously been made to bail out struggling state-owned entities.
Over the past decade, the government has spent R520bn bailing out state-owned entities and other state organs.
How will funds be allocated?
One dilemma is that it is unlikely all of the lost funding could be replaced. This means tough decisions might have to be made about which projects are supported.
Ntusi said the SAMRC has identified four key areas.
The first is support for post-graduate students. “A large number of postgraduate students… are on these grants and it's going to be catastrophic if they all lose the opportunity to complete their PhDs,” he said.
Second is supporting young researchers who may have received their first NIH grant and rely entirely on that funding for their work and income. This group is “really vulnerable (to funding terminations) and we are prioritising their support…to ensure we continue to support the next generation of scientific leadership”.
A third priority is supporting large research groups that are losing multiple sources of funding. These groups need short-term help to finish ongoing projects and to stay afloat while they apply for new grants – usually needing about nine to 12 months of support.
The fourth priority, Ntusi said, was to raise funding to ethically end clinical and interventional studies that have lost their funding, and to make sure participants are connected to appropriate healthcare.
Ultimately, he said they hoped to protect health research capacity that will enable South African researchers to continue to play a meaningful and leading role in their respective fields.
“If you reflect on what I consider to be one of the greatest successes of this country, it's been this generation of high-calibre scientists who lead absolutely seminal work – and we do it across the entire value chain of research,” he says. “I would like to see… South Africa (continue to) make those meaningful and leading pioneering contributions.”
See more from MedicalBrief archives:
US stands to lose from funding cuts for top-notch SA research
State turns to mining firms, Discovery to plug HIV and TB funding gaps
SA scientists reel as US freezes research aid to ‘country of concern’