Programme Director,
MEC Dr Sibongiseni Dhlomo,
Mr Taylor Ruggles – US Consul General,
Durban Prof Salim S. Abdool Karim – MRC,
President Dr Carl Dieffenbach – Director: Division of AIDS, NIAID,
Dr Robert Eisinger – Deputy Director: Office of AIDS Research,
NIH Dr Nancy Knight – Director: CDC – South Africa Office,
Dr David Allen – The Bill and Melinda Gates Foundation,
Distinguished guests,
Ladies and gentlemen.
Good morning!
It is indeed an honour for me to address this very important research Summit on HIV and TB jointly hosted by the National Institutes of Health (NIH) and the South Africa Medical Research Council (MRC).
At the outset allow me to thank NIH for its partnership with South African researchers in general and with the partnership with the MRC in particular. We value this collaboration immensely and I am hopeful that this collaboration will expand over the next few years.
Since my appointment in 2009 I made it very clear that all our policies in the Department of Health must be evidence based.
Science and scientific evidence alone must guide our practices. Of course we will also look at whether what the scientists tell us should be done, can be done from an operational point of view, that it will benefit the most number of patients and that we can afford to implement it! These things are done in many countries in the world – however, we cannot implement policies that are not scientifically based!
This research Summit is timeous as we are discussing HIV, TB and AIDS-related cancer research as we approach the 2015, which as we know is the deadline for the Millennium Development Goals (MDGs). I don’t need to tell this distinguished audience that reducing the burden of disease from HIV and TB are critical for South Africa and indeed many developing countries to our ability to reach the MDG targets. Human development in any country - rich or poor - cannot be sustained with high levels of diseases.
In South Africa, an estimated 50% of maternal and under 5 mortality is HIV-associated; TB has been noted as the most frequently reported cause of death on death notifications – of course we know that many of these deaths are HIV associated! In addition, TB is now listed as one of the top 5 causes of under-5 mortality! So it is clear that unless we deal decisively with HIV and TB we will not be able to turn the tide of TB- and HIV-related mortality among women and children in this country.
I am however, very optimistic that with the advances in science over the past decade in particular, we have been able to get new diagnostics for TB (the Genexpert) and new drugs for HIV (in particular the fixed dose combination). However, much more needs to be done with respect to new TB drugs, including better drugs for drug resistant TB as well as HIV.
Ultimately, we would like to see faster progress on vaccines to ensure that we are able to prevent TB and HV infections!
My hope for more and faster progress in research is reflected in the need for this Summit and the anticipated outcomes of this two day meeting:
- to foster new collaborations between the United States (US) and South African researchers and institutions; and
- to leverage NIH and South African investments in biomedical research to generate new approaches to decreasing the burden of disease from HIV-, TB- and AIDS-related cancers.
We have a proud record of high quality research in South Africa. This is because we have excellent researchers as well as strong political commitment to research in our country. Indeed research from South Africa is praised the world over and has also resulted in many global policies and guideline changes – that benefit patients all over the world, but especially in developing countries.
I know that with the large number of research projects that we have had and continue to have, I cannot be exhaustive, but allow me to mention a few research studies conducted by South African researchers and done in our country that has had global as well as local impact:
- The CHER and SAPIT studies found that HIV related deaths can be reduced by up to two thirds if treatment is started early in babies and in TB-HIV co-infected patients respectively – these findings have changed clinical guidelines internationally;
- The research on the Prevention of Mother-to-Child Transmission (PMTCT) with regard to both pre- and post- exposure, breastfeeding and on how to decrease nevirapine resistance using the Combivir tail;
- The first proof that Medical male circumcision is effective in preventing HIV conducted in Orange Farm;
- The discovery of how humans make broadly neutralising antibodies, which has had a marked impact in the HIV vaccine field;
- Testing of TB vaccines and the first made-in-Africa HIV vaccine (unfortunately we are still far from a vaccine for both diseases but are learning many valuable lessons even when candidate vaccines don’t work!);
- First in the world to show that a microbicide works;
- We conducted field trials on the Genexpert.
As a consequence of the many research studies done in South Africa and elsewhere on the continent in particular, we have been able to change our HIV treatment guidelines and implement the Genexpert technology in facilities across the country. South Africa has the somewhat unenviable reputation of having the largest HIV treatment programme in the world.
It also has the largest rollout of the Genexpert technology. This is not entirely surprising as we also have significant disease burdens from these two diseases! I wish to emphasise that I see the partnership between policy makers, implementers and researchers as a very close one. Policy makers need to understand the promise and potential of new science. Implementers need to be able to articulate their research needs.
Scientists must be able to answer questions that will make difference to people’s lives today and tomorrow! By tomorrow I mean that researchers need to start today to think about tomorrow’s challenges and start researching them!
I am sure that the President of the MRC, Prof Abdool Karim will say more about how we are repositioning the Medical Research Council, but as I conclude can I make a few remarks about the MRC. I would like to see a world class MRC, not just an MRC for South Africa but one that has world class scientists and one that does world class research!
This obviously means that we need to build this capacity in the MRC and I look in particular to the partnership with the NIH to develop this capacity. I am sure that through this research Summit we will be able to strengthen the collaboration between the NIH and the MRC so that in say 3-5 years we can say that we have indeed built a world class MRC in South Africa.
In conclusion, I wish to thank our visitors in particular for their generous support and wish you well in the deliberations that are to follow.
I thank you!
