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Missing a beat

Where is health research in South Africa’s 2030 plan?

South Africa’s development plan, unveiled by the head of the National Planning Commission and former finance minister, Trevor Manuel, on 15 August, will keep researchers busy for some time.

The 500-page tome, ‘Our future – make it work’, emphasises the message that investments in science, technology and innovation are essential to drive South Africa’s development. Except that for some reason it seems to have missed a beat on the topic of health.

While health challenges are mentioned briefly as a target area for research, the 25-page health chapter focuses on training healthcare workers and healthcare delivery, and scarcely mentions research.

Improvements in training and delivery of healthcare services are clearly necessary for the country, but ignoring research is a grave omission. A strong South African health system needs top-level research to service the needs not only of its own population, but that of other developing countries as well.

South Africa, moreover, is already benefiting from the global investment in research on diseases that disproportionately affect the poor—such as tuberculosis, HIV/Aids and malaria. A recent example is the Howard Hughes Medical Institute’s TB and HIV centre in Durban, funded in 2008 by a ten-year, US$70 million grant. We need the government to tell us where it stands in relation to such developments and what its own health research strategy is.

Still, there is much to commend in ‘Our future – make it work’. The plan proposes more research in most areas of national priority—from climate change, migration and energy efficiency to industrially important sectors like farming, fishing and mining—although it does not give numbers for the suggested increases. And that is even before we reach chapter 9, which considers the national science and innovation system.

However, just increasing R&D funding isn’t enough, the plan says. It urges better use of resources and lighter, more flexible institutions that are better at working together. Its vision for 2030 is: “A wider system of innovation that links universities, science councils and other research and development role players with priority areas of the economy.”

This will require universities to focus on their strengths—not all can become leaders in cutting-edge research, the plan says. But nor can the top universities continue with business as usual. A higher proportion of women and black academics remains a priority and this will affect the allocation of funds.

While better education has to be offered to all South Africans regardless of their background, the country also needs more highly skilled individuals. By 2030, the plan says, a quarter of all university enrolments should be at postgraduate level.

The prominent role given research in nearly every chapter of the plan makes its omission in the health chapter stand out more. Sadly, this reflects the disconnect between funding for health research and funding for other research disciplines in South Africa. The Medical Research Council sits under the department of health, beyond the reach of the science minister.

This division has contributed to a shortage of clinical researchers that threatens South African drug discovery and development. The national plan should have noted this shortfall, and made training in and funding of health research a priority. It’s a real shame it doesn’t.