M Mangena: Opening of Scientific Session of World Medical
Association

12 October 2006

Theme: Health as an investment: Leadership and Advocacy

Dr Otmar Kloiber, Secretary-General of the World Medical Association
Dr Kgosi Letlape, Chairperson of the South African Medical Association
(SAMA)
Dr Lasie Mogudi, President of the South African Medical Association
Dr Aquina Thulare, Secretary-General of the South African Medical
Association
Distinguished guests
Ladies and gentlemen

The theme of this session refers to health as an investment. The biggest
investment that any government can do is to assist its people to lead healthy
lives. The World Health Organisation defines health as "a state of complete
physical, mental and social well-being and not merely the absence of disease or
infirmity."

In developing countries, poverty exacerbates and intensifies the devastating
impact of HIV, tuberculosis and malaria. These diseases continue to wreak havoc
within resource-poor communities and perpetuate a cycle of malnutrition, low
levels of literacy and low productivity yields. This is further aggravated by
limited access to health and other social services.

If I were to pick a current positive trend in health policy, it would be the
growing recognition of the centrality of health to all development. Globally,
there is a much wider appreciation of the links between health and development
and between poverty and ill-health.

In order to launch a determined attack on both poverty and ill-health, the
need for wide-ranging partnerships is imperative. Top funding agencies and
developed nations are strongly supporting health initiatives as drivers to
development. At the G-8 Summit recently, leaders of the world's wealthiest
nations debated urgent global issues and gave prominence to health issues in
their global agenda. They promised to go much further in the fight against
infectious and parasitic diseases.

Medical research produces public good. Every medical advance, every life
improved and every disease successfully treated, has its origin in research.
Increased funding is required to support medical research for identified
priority areas. In return, funders must demand excellence in the use of the
scarce resources available and no effort must be spared in ensuring that basic
medical science translates into clinical application in the shortest possible
time.

In developing countries, business and industry and not only pharmaceutical
and healthcare companies have an important role to play in strengthening
government efforts to develop better health systems. There is a strong case for
their engagement in this area as there is a moral and a humanitarian obligation
for a spread of industry sectors from media and technology to food and beverage
companies to work with governments, academic institutions, non-governmental
organisations (NGOs) and community based organisations to tackle health-related
challenges.

At the World Economic Forum in 2002, Kofi Annan challenged leaders of the
world to help mobilise global science and technology to tackle the interlocking
crises of hunger, disease, environmental degradation and conflict that are
holding back the developing world. It is therefore essential for medical
science research to be informed by current challenges when developing future
vision. It is also important for researchers to be mindful of the distortions
created by lack of funding, insufficient human resources and apathy.

My department is mandated to develop a robust research and development base
to address questions relating to the improvement of the quality of life of all
South Africans. This includes conducting the type of research aimed at
strengthening our public health system, including those of our neighbouring
countries.

South Africa has a proud record in scientific research and development and
stands tall on the African continent in this regard. This makes it all the more
important for our scientists to bring their skills to bear on the important
challenges that face us as Africans, especially as regards investments in
medical research aimed at bolstering public health systems of the developing
world.

South Africa's National Research and Development Strategy articulates the
high incidence of diseases of poverty and makes it incumbent upon our research
community to utilise its capacity to develop effective technologies to combat
such diseases. Taking up the challenge from the national Research and
Development Strategy and the national Biotechnology Strategy, my department has
established a Policy Framework for Science and Technology Interventions in
Health Innovation. Our Health Innovation Framework can be seen as a
programmatic research and development intervention for the development of new
drugs, vaccines, devices, diagnostics and new techniques in process engineering
and manufacturing.

The department will concentrate its resources on two research pathways,
namely, the development of new technologies and interventions and the
advancement of basic knowledge of biology and human behaviour. We do this in
conjunction with other major players in health research such as national and
provincial Departments of Health, the Medical Research Council and higher
education institutions.

The national Biotechnology Strategy highlights the important contribution
that biotechnology can make in the area of human health. As a department, we
have invested in biotechnology with the intention to develop, amongst others, a
number of new forms of female-controlled protection against sexually
transmitted infections. These include recombinant vaccines, monoclonal
antibodies and the development of vaginal microbicides. Given that microbicide
research is on the Department of Health's comprehensive plan for addressing the
HIV pandemic, our main concern as the department supporting the related
Research and Development(R and D) is to ensure that clinical trials on these
new products are conducted as ethically as possible.

To address issues pertaining to malaria, earlier this year my department
launched the South African Malaria Initiative, which is a national consortium
of researchers working together to harness their expertise to address the
crippling effects of malaria through advanced research.

Human capital development is a fundamental pillar to the success of the
national R and D strategy. For human resource development to flourish, we need
to develop a sustainable strategy for the creation and nurturing of centres and
networks of excellence. South Africa plays a leading role in the New
Partnership for Africa's Development (NEPAD) and the establishment of such
centres or networks of excellence are a part of the objectives to achieve one
of the goals of an African Renaissance. Investments in developing these
continental research networks are critical to the development of a high calibre
medical education and training cohort that is not only relevant to Africa's
disease burden, but will also find application globally.

As an example, the centre of excellence for biomedical tuberculosis (TB)
research, which is a collaborative network involving the University of the
Witwatersrand and the University of Stellenbosch, is doing research on all
aspects of TB diagnosis, testing and treatment, from a molecular and a clinical
point of view, including genomics and proteomic studies of the TB bacterium and
its interaction in humans. With the third highest incidence rate, and second
highest mortality rate in the world, South Africa is facing a tuberculosis
problem of such magnitude that the disease has been declared a national health
emergency.

Although some improvements could be made in controlling TB through the
reform of existing programmes, it is widely acknowledged that a quantum leap in
the quality of tools for the diagnosis, prevention and treatment of TB will be
required if there is to be any hope at all of eradicating this devastating
disease in its various forms. The incidence of extreme drug resistant (XDR)-TB
shocked us all into realising that we urgently have to find new ways of
treating and eradicating tuberculosis.

The HIV and AIDS and TB co-epidemic plaguing this country has exacerbated
the problem enormously and a key programme initiated by my department in
collaboration with the Department of Health and Eskom was the establishment of
the South Africa Aids Vaccine Initiative (SAAVI) in 1999. SAAVI was mandated to
develop and test an appropriate HIV Vaccine for Southern Africa.

This initiative has grown from a small core group of researchers into a
large biotechnology consortium involving approximately 180 people who work on
various aspects of developing and testing novel HIV vaccines. The positive
spin-offs are multiple. They include the development of a significant human
capital in biotechnology and the development of novel techniques that can be
transferred to other applications.

Since the early days of our bilateral relations with the United States in
science and technology, where we prioritised health, we now have more than 110
National Institutes of Health (NIH) projects taking place in partnership with
South African institutions and research teams. We are actively developing these
links with more than 50 other countries with which we have bilateral agreements
in science and technology.

Diseases of poverty, with TB, HIV and AIDS and malaria as the frontrunners,
have a new focus within the European Union as reflected in the 6th and 7th
Framework Programmes and the European and Developing Countries Clinical Trial
Programme on Poverty Related Diseases. These developments reveal a commitment
from Europe to enhance the quality of life of people in developing countries.
These partnerships will not only yield more new treatment modalities, but will
also develop our researchers through collaborative work with European
scientists and strengthen our own national system of innovation.

South Africa is at the crossroads. Some of our best researchers are involved
in cutting edge research that is globally competitive and yet the question of
poverty related diseases remains overwhelming. We need to address this anomaly.
This problem is exacerbated by the urgent need to develop our youth to become
healthcare givers and visionary innovative researchers of the future.

The human sciences encompass studies of humankind that include human
origins, structure, functioning, inherited characteristics and behaviours of
individuals and communities. Together, these broad areas of knowledge form the
basis of the humanitarian ethics applied in the science of medicine. Medical
science itself forms the basis of a modern caring society in which the young
are nurtured, the adult kept strong and healthy and the elderly and the sick
given relief and rest.

The need for new knowledge becomes increasingly apparent as medicine becomes
more specialised and our world more complex. This is the call to which women
and men in the medical fraternity need to respond, either as healthcare workers
or researchers opening new frontiers. This future is in your hands. Our
contributions as government are but a platform for your greater journeys and
more fruitful endeavours in making our world a better place to live in.

Thank you for your kind attention.

Issued by: Department of Science and Technology
12 October 2006
Source: Department of Science and Technology (http://www.dst.gov.za)