Medical Research Council on Impact of HIV/AIDS; Traditional Healers; Vaccines: briefing

Meeting report

ARTS, CULTURE, SCIENCE AND TECHNOLOGY PORTFOLIO COMMITTEE
3 September 2002
MEDICAL RESEARCH COUNCIL ON IMPACT OF HIV/AIDS; TRADITIONAL HEALERS; VACCINES: BRIEFING

Medical Research Council Briefing
Medical Research Council on impact of HIV/AIDS on Economy and Productivity
Medical Research Council on South African Aids Vaccine Initiative
Medical Research Council on Traditional Healing, Research & Development

SUMMARY
The Committee was informed that over six million people were infected with HIV/Aids. This rate was expected to rise to 7.8 million in 2006. The number of deaths would increase in 2010 before stabilising. At present two-thirds of infected people did not show visible symptoms but the number of those in the final stages of illness was rapidly growing. It was envisaged that the projected number of deaths in 2000 and 2010 would be mostly of young and active people. The Committee was informed that the Aids pandemic would deal a devastating blow to the economy due to perennial absenteeism, sickness and death.

The Committee heard that seventy five percent of HIV/Aids victims resided in sub-Saharan Africa. The HIV/Aids rate in South Africa in 1990 was one percent which had dramatically moved to twenty five per cent of the population in 2000. There had been a marked change in age pattern whereby young adult mortality rates were three and a half times higher in women and fifty percent for men.

MINUTES
Ms Tsheole proposed Mr Dithebe for acting chair and was seconded by Mr Opperman. Mr Dithebe assumed the chair and introduced the team from the Medical Research Council (MRC), he invited them to address the meeting.

Briefing by Dr Anthony Mbewu
Dr Mbewu of the Medical Research Council, executive research directorate briefed the Committee on the corporate structure of the Council and its functions. He said that at present the Council did not have a President but that the Board was in the process of replacing the former President who had taken up an appointment with the University of Natal.

Dr Mbewu informed the Committee that although the Council was autonomous in its research activities, it was nonetheless a parastatal hence it was obligated to report back to the government. Government provided 60% of the Council's budget and that the rest was sourced from contract donors.

Dr Mbewu pointed out that the Council's priority areas in research were in HIV/AIDS, TB, Malaria, Women's Health and nutrition. The key thrust for the Council was transformation and that this involved addressing the issue of racial disparity in health research groups. He pointed out that the Council was involved in human resources capital development to ensure the retention of staff and to stem the exodus of professionals out of the country.

Dr Mbewu informed the Committee that the Council was expanding its activities to the provinces and that it was acting as a clinical platform for traditional medicines. The Council was involved in the programme for African Research Exchange and Fellowship to share experiences and where necessary transfer technology.

In recognition of the vital role research plays in development, the government had tripled the budget vote for the Council to R150 million. He added that the Council has received additional funding for its priority programmes the research field on Aids, Malaria, TB, and violence and injury. He revealed that Council's contract income had grown exponentially and that Council was collaborating in the Nepad framework to unlock research potential throughout the continent.

Dr Mbewu informed the Committee that the Council's core function was the development of systems research in order to understand the environment and modalities of implementing research findings. He said Council ensures that research findings are translated for the benefit of all levels of the population. He added that Council is actively engaged in the advocacy for the promotion of research activities and that in this respect Council held a road-show seminar in Guguletu on women's day to advance this goal. He concluded his briefing by noting that Council's Annual Report for the year 2001/2002 was still awaiting the Minister's approval and that therefore it could not be released to members at present.

Briefing by Dr Debbie Bradshow
Dr Bradshow addressed the Committee on the issue of the impact of HIV/AIDS on the economy. She revealed that seventy five percent of Aids victims reside in the sub-Saharan Africa and that the prevalence rate in South Africa 1990 was one percent which had dramatically moved to twenty five percent of the population in 2000. She said that there had been a marked change in age pattern whereby young adult mortality rate is three and a half times higher in women and fifty percent for men.

Dr Bradshow informed the Committee that at present over six million people were infected but that this rate was expected to flatten at 7.8 million in 2006. She noted that at this point in time there would be more people sick in bed and that the number of deaths would pick in 2010 before stabilising. At present two thirds of infected people were not visible but that the number of those in the final stages of illness was rapidly growing. She noted that the projected number of deaths in 2000 and 2010 would be mostly that of the young and active people.

Dr Bradshow was concerned about the impact this epidemic would have on the economy. There would be more people hospitalised and that the incidence of absenteeism either through death or sickness would rise. The morbidity rate would reduce productivity and that costs would increase. In the health sector there would be an influx of HIV related admissions hence pressure on bed occupancy. Already there had been an increase in TB cases due to the incidence of HIV/AIDS. In the education sector, she said that there were many teachers who were sick and dying and that a high rate of learner dropout as a result of being affected by HIV had been witnessed.

Dr Bradshow pointed out that core issues related to HIV were poverty alleviation, rural neglect, and capacity development. She concluded that the Council's priority was to find ways and means to cope with the increasing number of orphans. There was an urgent need to carry out more sectoral impact studies.

Briefing by Dr Tim Tucker
Dr Tucker informed the Committee that the South African AIDS Vaccine Initiative (SAAVI) was formed in 1999 by the South African Government to co-ordinate the research, development and testing of HIV vaccines in South Africa. SAAVI is based at the MRC and was working with key national and international partners to produce an affordable, effective and locally relevant preventive HIV/AIDS vaccine.

Dr Tucker continued that SAAVI also contributed to international scientific knowledge through its focus on the development of sub-type C HIV/AIDS vaccines, which was prevalent in southern Africa region. Most vaccines that had been tested in clinical trials to date had been developed for the subtype B virus and that it was not known yet whether HIV/AIDS vaccines developed using genes from one subtype of HIV would protect against infection with another subtype.

Dr Tucker informed the Committee that SAAVI involved more than 150 people and was the largest product-oriented biotechnology research and development programme in Africa. He added that SAAVI aimed to succeed, along with other global partners, in ridding the world of the Aids pandemic.

Dr Tucker pointed out that SAAVI's activities were a multimillion-dollar concern and therefore required significant long-term funding. At present SAAVI was funded primarily by the South African Government and Eskom but that in addition, there are other donors. These are the US National Institute of Health (NIH), The European Union, the international AIDS Vaccines Initiative and others.

Briefing by Dr Motlaleputa Matsabisa
Dr Matsabisa informed the Committee that the MRC was involved in the traditional healing research noting that about eighty percent of the population consulted traditional healers countrywide. Traditional healers play a major role as health care givers at a community level. He said that the Council was concerned that industry tended to exploit traditional healers innovation for commercial purposes.

Dr Matsabisa pointed out that the Council hoped to harness traditional medicines for the equitable utilisation of the general populace. The Council also wanted to facilitate research in traditional medicine and where appropriate assist with commercialisation of indigenous knowledge. In this respect, he pointed out that Council was involved in the validation of traditional claims with a view to empower communities on quality medication.

Dr Matsabisa informed the Committee that Council was concerned with the hygiene and efficacy of traditional medicines and to help the healers access scientific research infrastructure. He pointed out that traditional healers cannot be wished away and that therefore Council was engaged in an effort to integrate them into the mainstream health system. He noted that Council aims at developing a professional cadre of traditional healers and that therefore it was necessary to create an enabling environment for them to interact with western scientists.

Dr Matsabisa informed the Committee that Council was assisting the healers with documentation methods to encourage them to report on the adverse effects of their medicines. He added that Council was also facilitating a cross referral of patients between the healers and tertiary health centres. Council was committed to an equitable and fair share of research products in this area.


Discussion
Ms Tshivhase (ANC) asked why the Council had not shown interest in the Limpopo province where a host of traditional healers reside.

Dr Matsabisa replied that cases represented in the data involved situations where the healers came to the Council themselves. He however clarified that the Council worked with traditional healers throughout the country and that there was a meeting planned between Council and healers from the Limpopo province.

Ms Tshivhase said that the Minister of health had indicated that infection rates had declined but that the statistics presented by the Council seem to suggest otherwise.

Dr Bradshow replied that what normally happens was that when the pool of people that were exposed to infection gets saturated, the prevalence rate tended to stabilise and that South Africa was moving towards this phase. By the year 2005/6 the incidence of Aids would show a decline.

Ms Tsheole (ANC) appealed to the Council to refer to children bereaved through HIV/AIDS merely as 'orphan' and not 'Aids orphans.' She asked if indigenous plants used for healing have been patented.

Mr. Matsabisa replied that plants could not be patented but that what was patented is the indigenous knowledge. He assured the Community that the Council was ever vigilant in ensuring that traditional healers are accorded due recognition and legal protection for their inventions.

Ms Tsheole asked if the Council collaborates with the Agriculture Research Council to ensure the sustainable utilisation of herbs that were used for medicinal cure of diseases.

Dr Matsabisa replied in the affirmative. He pointed out that the Council was running a number of projects in conjunction with ARC for the development of herbal medicine.

Mr Opperman (DP) referred to the 1996 statistics presented by the Council to the Committee and asked if these were the latest figures so far.

Dr Bradshaw explained that Statistics South Africa was currently working on a comprehensive programme to release the latest data and that this process should be over and the report made available before end of the year.

Mr. Opperman asked if the Minister had to agree with the Council's strategy and if there were in fact times when Council had to compromise in order to accommodate the Minister's policy position.

Dr Mbewu replied that the Council has had a very cordial working relationship with the government and that he did not recall a single time when Council had to sacrifice its professional position for political expediency.

Ms Mpaka (ANC) said that Council had assured the Committee that it was addressing the issue of employment equity yet no reference had been made to people with disability.

Dr Mbewu agreed with Ms Mpaka that indeed Council was still a long way to address issues of disability not only in employment but also in its research focus. He assured the Committee that Council was would address the matter.

Ms Mpaka questioned the efficacy of the methodology of sampling only pregnant women when it was common knowledge that there were many infected men and non-pregnant women.

Dr Bradshow conceded that this was not the best methodology but hastened to add that it was the easily available method. Council was in the process of trying out other methods such as community based reporting and that all these possible ways and means would be pooled to get the best results.

Ms Mpaka (ANC) asked how Council identified and rated traditional healers so as to infuse professionalism in these cadres of health care givers.

Dr Matsabisa replied that Council is not a rating authority for the traditional healers. He explained that the Department of Health is the one vested with this competence and that therefore he does not know the criteria they use for rating the healers.

Dr Pheku (PAC) termed the presentation ' most educative' and one that had given helpful insights into the disturbing incidence of the Aids epidemic. He then asked whether Council's position in research ethics took into account cultural values that inform traditional research methods.

Dr Mbewu replied that in fact issues of ethics is a compromise of different shades of opinion and that all role players contribute in the body of ethics that govern research methods.

Prof Mohammed (ANC) asked if there was a provision for the MRC's president to be a black professional.

Dr Mbewu replied in the negative. MRC's board appoints the president and at present the board was headhunting for the right candidate. He clarified there was no requirement for the president to be of a particular race. He pointed out that the only major requirement for such a candidate is that he should be a medical doctor.

Dr Pheku asked why there had been such a dramatic rise in TB cases.

Dr Bradshow explained that the rate of TB death was escalating due mainly to the incidence of HIV/AIDS.

The Chair asked when new data on the major causes of death would be made available to the general public.

Dr Mbewu replied that in 1998 the Department of Home Affairs introduced a new death notification method. He said that the Council was working in conjunction with Statistic South Africa to evaluate this new method before processing the national data on causes of death.

The Chair inquired how tele-medicine would benefit rural areas.

Dr Mbewu explained that the Department of Health is the leading agency in the tele-medicine innovation. The Department partners with the NRF, which is involved in evaluation. He said that the concept was still at its formative stages to be able to assess the accruing benefits. He, noted that this concept would enable rural people to access specialist doctors and equipment that would interpret images and relay back the findings over large distances without physically taking the patient to referral facilities.

The meeting was adjourned.