[CAPE TOWN] Clinical research in South Africa is in serious decline because of two decades of "disinvestment" — leading to an ageing workforce, "chronic underfunding" of its Medical Research Council and "grossly insufficient" funding for research professorships, says a report.
Lack of government funding is driving South African researchers into working on diseases of the affluent, for the pharmaceutical industry, or the HIV and TB agendas of external donors, says the Academy of Science of South Africa.
Over half of the country's expenditure on clinical research comes from the private sector, according to the report published last month (22 April).
The last two decades have seen a "largely unplanned, but cumulative, disinvestment in publicly funded programmes resulting from the withdrawal of the health departments of provincial governments from this sector, the absence of discounts for research tests from the business model for the National Health Laboratory Service, chronic underfunding of the Medical Research Council ... and the lack of funding streams to universities that might in principle have been applied to meet the overall shortfall in support.
"There is little likelihood that continuation of the present situation is compatible with rebuilding and sustaining solid research capacity in the clinical domain," adds the report, by the Academy's panel of health scientists and scholars.
A tenth of South Africa's state expenditure goes on public health services, which the report applauds, but adds that the proportion going to research is "much too little" — 0.15 per cent of gross domestic product (GDP).
The report calls for, amongst other things, a national funding scheme for clinical research, with two per cent of GDP committed to research and development (R&D), of which 20 per cent should be allocated to health research.
"The government has already committed itself to investing two per cent of the GDP on R&D. We are just below one per cent and rising. So there is commitment, which must be accelerated," Bongani Mayosi of the University of Cape Town, and panel chair, told SciDev.Net.
Kirti Narsai, head of scientific and regulatory affairs at the Pharmaceutical Industry Association of South Africa, said the government needs a focused approach to health research, especially public health issues.
"Government needs to attract institutional, non-governmental organisations and private sector funding to work in partnership with academic institutions to increase levels of clinical research in South Africa," she said.
"A decline in clinical research decreases the number of people the pharmaceutical industry can employ who are interested or have experience in doing clinical research," added Narsai.