Professor Jeffrey Mphahlele, Vice President for Research at the South African Medical Research Council
Moderator: Tian Johnson
Complied by: Anna Matendawafa – with inputs from Wilfred Gurupira & Maaza Seyoum
Webinar Recordings & Supplementary Materials:
Date: 13 August 2020
Professor Jeffrey Mphahlele has since October 2014 been the Vice President for Research at the South African Medical Research Council(SAMRC). Mphahlele is an elected member of the Academy of Science of South Africa and National Research Foundation C1-rated researcher. He is affiliated to Sefako Makgatho Health Sciences University (formerly MEDUNSA) in Pretoria, where he previously served as an academic for over 20 years in various capacities: Professor and Academic Chair of the Department of Virology and National Health Laboratory Service (2005 to 2014); Co-Director of the SAMRC/Diarrhoeal Pathogens Research Unit, which is a World Health Organization Rotavirus Regional Reference Laboratory for Africa (2010 to March 2018); and Head of the South African Vaccination and Immunisation Centre (SAVIC) (2005 to 2014). Mphahlele’s research interests include epidemiology and genomics of infectious diseases, vaccination control of infectious diseases, and strengthening immunization services and policies. He trained, supervised, and mentored several Ph.D. and Master’s students as his contribution to developing the next generation of scientists. Mphahlele serves on several boards and governance structures: Vice-Chair of the European and Developing Countries Clinical Trials Partnership (EDCTP) Association, Vice-Chair of the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R), Vice-Chairperson of the National Health Laboratory Service, member of the South African Health Products Regulatory Authority (SAHPRA) and member of the Poliomyelitis Research Foundation Board of Directors.
Professor Jeffrey Mphahlele gave an overview of his time at the MRC “Medical Research Council” both before and during COVID, some of the lessons that he has learned during the time of COVID, and guide in terms of what strategic developments that are on the research landscape coming up that advocates in civil society should be aware of.
QUESTIONS AND ANSWERS
*This section contains a transcribed account of the Question and Answer Session
Some scientists in the recent months have the need to keep community engagement separate. Where would you place the role of communities in that ecosystem of research.
So it would be best if you separated the science from the public discussion because sometimes, a public discussion can be based on non-scientific information. Still, the whole reason we do science is to benefit the community, so if you do science and if it can not help the community, it’s a waste of time, it’s a waste of resources, so there must be an overlap, there must be an interface between science and community and that is my view. Perhaps it might depend on what kind, you know, scientific debate or scientific discussion you are referring to. But for example, the things that I have mentioned as part of scientific debates or public debates are essential to put science and community view together.
Thank you for that. Prof, you have been the Vice President for Research at MRC for nearly seven years now. What is the one personal reflection that you take from that time of leadership? And has the advent of COVID shifted that lesson in any way?
Absolutely. Since my time at MRC, I’ve been working as a scientist, but I see my role more as an advocate. And in other ways, science advocate, because I’m trying to make sure that scientific evidence that is emerging can be applied, especially you know, to save lives. If, for example, I know that non-pharmaceutical interventions do work, I need to preach that. And I think that has been the most important lesson that I’ve learned. Because that is not just generating information, it is about applying the knowledge to benefit the community.
Prof, the SAMRC weekly publishes death numbers, can you briefly introduce us to these numbers and what we should be looking for as civil society.
Yeah, I can talk about it crudely, because it involves a lot of science and several steps, so what happens is that we do have a unit that is dealing with these burden of the disease, so they have got a link with the Department of Home Affairs and Statistics SA. So what they do, they look at the number of deaths which are reported to the Department of Home Affairs, and they also look at Stats SA numbers, and they try and reconcile the Stats, and they can come up with these statistics that they publish. The most important part is the fact that they have been doing this for many years. As a result, they understand the number of deaths expected at any given time and for example, they can make some projections for the period that we are in terms of the number of deaths expected. So it became clear what we had when we were in the middle of this Covid-19 pandemic. Then the number of deaths is higher than what is expected. Because you have got this historical data, you can raise the alarm cause you can see that you know, the numbers are shooting beyond the maximum level you expect. So in short, I think that’s how they look at the numbers, and that’s how they have been able to raise the alarm to say that we have got numbers, there are more excess deaths than what we expect.
What are your thoughts on the role of Pharma in research during pandemics?
The Pharma does have a role, and they do exercise this role. Obviously, during the pandemic, they do have a social role, a corporate social responsibility; they exercise this at times. And like academic and science funders, they do fund research. What may not be necessarily apparent to the general public is that many pharmaceutical companies have their funding, research funding schemes that researchers can actually apply for, and have access to money. That money is invested in doing research. They play a role in uplifting research in the community, and it’s not like they are not doing their research; their inhouse research they are continuing.
Prof what are your thoughts on the use of BCG revaccination in Covid-19 research?
Yes, look, it’s part of research, and we should be aware that researchers are trying all kinds of avenues to come up with solutions to fight the epidemic. So BCG was proposed as one of the vaccines that could actually protect other diseases. The other vaccine that was proposed is the Polio vaccine. Some American academics say the Polio vaccine, especially the oral Polio vaccine, can be useful for preventing Covid-19 but look at the moment; it’s still research. It hasn’t been proven as an efficacious tool. So we, I think this is part of the diversity of views that I spoke about, that it’s not like you need to kill it, but if you think the strategy is not working, be prepared to change. Be nimble enough because if you don’t, you will continue to act in the wrong direction.
How would we measure the impact of an emergency response? i.e. what sort of metrics would we use for impact measurement?
Yes, an excellent question. I think what comes to my mind is that the number of lives saved if you look at Africa, I think most of us in the communities do compare that COVID-19 hasn’t had the same impact in terms of the number of deaths like we have seen in other European countries and USA maybe even some South American countries. So that is probably really a measure of an impactful emergency response that whatever you put in place, it was good, even if it was not perfect. Still, you have been able to save lives, but the flip side of it could be that you saved lives. But you know, people have lost hope, and they call me suffering, and people might die, you know of hunger than COVID-19 diseases. Unfortunately, this is part of what I mentioned: when you balance that position and cater to all the realities, it’s often tricky.
The clinical trials registry still shows active trials on Hydroxychloroquine. Does that show how debatable or one sided the prevalent stance of this drug is?
Yes, and I have mentioned it because I know that the debates are not over; researchers still believe it works. They have not been given enough space to show that it works because negative sentiments clouded the research about the drug, so it will still appear in the clinical trial registry because there are some debates on Hydroxychloroquine. Hence, the discussion is not over. We need to watch the space
What makes you proud about SAMRC’s tangible contribution or claim to transforming research? What data if any can you share to support that claim.
It certainly is an excellent question, and I never thought about it, but anything that I can share is not going to be related to COVID-19. Because of the contribution as the MRC has made to the COVID-19 response, I would say that the results are still in progress, we funded or co-funded the vaccine trial, but the trial is still going on. If we find, if we have a vaccine, I think that would be something that I say, here is a tangible product that the MRC has contributed to. So, for COVID-19, there is a lot of research that MRC is funding; we have been able to repurpose funding to almost over R100,000,000 to fund different research components in the country. Honestly, the clinical trial is a perfect example because people connect to that, and it has been highly publicized. There are many other pieces of research that they are funding, but research has been continuing because it takes time. So, where we transformed people’s lives if you look at our track record as the organization, we have been able to fund research at Universities. We have been able to come up with or instead fund research that was part of other vaccines’ clinical development, say Rotavirus vaccine; it was tested here in South Africa. First African country and Pneumococcal vaccines as Shabir Madhi has always been, the leader with the other researches, and so on. So there are several kinds of research that I have mentioned not necessarily related to COVID-19, but certainly, MRC has got a proud legacy even in the area of HIV, you know, ARVs and so on. So the only thing is that when you conduct, you can calculate it is very expensive, and not a single local funder like MRC was funding, we will be able to fund everything, so we co-fund in most cases.
In closing could you speak to us on going forward, these conversations will continue weekly for the next year so the platform will always be there, and we would certainly be reaching out to you over those few months to engage further. Having had this engagement now what would you say is perhaps the singular most important role in your view that civil society can and should be playing in the context of COVID-19 research
Yeah, I think we need to be open to collaboration because researches will always bank on communities to do research. We may not necessarily require participation, but usually, research looking at drugs, vaccines, and stuff like community participation is crucial. I would say that be open to collaboration. Be prepared to raise your voice if you feel that things are not done the right way. Researchers are only humans even if you know; they are different role-players as watchdogs of doing research its still possible that somebody can overlook some steps. So if you are a member of the community or member of an advocacy group, if something is not right, feel free to come out and say it, not in a way, but I will say. Say it, constructively. But you know, researchers are used to it, so I don’t think if you criticize us, we will take it personally. So Tian, for me, that is the most important message I can leave for this group. Be prepared to engage and collaborate.
What is the SAMRC’s role in contributing to the country’s readiness to deal with such emergencies?SA has clearly not been ready for this emergency, not that it’s been unexpected. Now that we’ve experienced it what should go into comprehensive readiness for such readiness?I’m concerned about Prof’s use of language – “using communities…”. Does that kind of language matter to him in the context of research conduct or not?What is needed then to ensure trials done in SA with good products benefits or are accessible to SA communities