ZWELI MKHIZE
In the past week, my office has been inundated with media requests for comments regarding Prof Glenda Gray’s public utterances on government’s decision relating to the lockdown.
The article referred to has some of the utterances that have been directly attributed to Prof Gray, as follows:
- “We are seeing children with malnutrition for the first time (at Chris Hani Baragwanath Academic Hospital). We have not seen malnutrition for decades and so we are seeing it for the first time in the hospital”
- “…but the de-escalation, month on month, to various levels is nonsensical and unscientific.
- “We believe, as scientists, that we give and are giving the government good advice and why they decided not to take the advice or engage readily with the scientists is unknown. Why have experts if you don’t care what they think?”
- “This strategy is not based on science and is completely unmeasured. It’s almost as if someone is sucking regulations out of their thumb and implementing rubbish, quite frankly.”
- “We punish children and kick them out of school and we deny them education. For what? Where is the scientific evidence for that?”
For the benefit of the public, it is important to mention that the Ministerial Advisory Committees are not unusual within the Department of Health. The National Health Act makes provision that advisory or technical committees may be appointed as may be necessary to achieve the health objectives as provided for in the act and its regulations.
As it stands, the department continues to benefit from experts who are specialised in various fields of health through their participation in different Ministerial Advisory Committees. To illustrate this point, these are some of the committees that are in place: the Ministerial Advisory Group on Immunisation, the Ministerial Advisory Committee on Organ Transplant, the Ministerial Advisory Committee on Health Pricing, the Ministerial Advisory Committee on Prevention and Control of Cancer and the Ministerial Advisory Committee on NHI.
Over the years, the role of the advisory committees has proven to be useful in providing support to the Health Ministry by offering advice on various matters in line with their terms of reference. These advices are presented to the Minister who considers them. Thereafter the minister may elect to engage other stakeholders or departmental officials on such advice for further research or input. This advice is then accepted or rejected based on the holistic view that the minister will consider as the Member of the Executive responsible for Health.
This has not been any different with the Ministerial Advisory Committee on Covid-19. This committee was appointed on the 26th March 2020. The terms of reference are very specific: “the MAC on Covid-19 is an advisory committee and does not have delegated powers to act on behalf of, or to commit the minister or Government to any actions”. They further state that “each member will act with the highest professional and ethical standard at all times”.
It is important to highlight that to date, the MAC on Covid-19 has provided the Ministry of Health with 50 advisories. Also, all these advisories presented have been accepted. The minister has utilised these in the implementation of the Department of Health’s response to Covid-19. These advisories have also been included in presentations to various stakeholders and more importantly, the National Coronavirus Command Council (NCCC), chaired by President Ramaphosa. Throughout this period, the NCCC has welcomed these presentations. In fact, the president has consistently acknowledged and commended the scientific data made available by the Department of Health through the MAC. This data is taken into account as part of broader consultations and inputs from other departments, different provinces and various stakeholders including business and labour.
I have seen it fit to give this detailed background in order to highlight that at no point has the Department of Health or government as a whole ignored and not responded to the advice of the Ministerial Advisory Committee on Covid-19. The statement made by Prof Glenda Gray is at the least devoid of the truth. Having read the article, I have been taken aback by the obvious inaccuracies it contains which have in my view, caused unnecessary sensationalism and doubt on the work and effort of the government in dealing with Covid-19.
We will keep emphasising this, as government we do not claim have it all figured out when it comes to Covid-19. No country does. The president has constantly and correctly stated that we are in uncharted waters. But we are committed to doing everything in our powers to protect the lives of our citizen.
I must pause to mention that I have also been stunned by media queries on why I appointed Prof Abdool Karim as chairperson of the Covid-19 and “sidelined” Prof Glenda Gray. Save to state the obvious that such appointments are a prerogative of the minister, I find such a question disingenuous as there is nothing that disqualifies Prof Abdool Karim to chair this MAC. In this regard, I continue to urge members of the media that during this period we must be made to respond to issues of substance and not matters that seem to want to sow division within the Covid-19 MAC and cause mischief.
It is therefore important to publicly place on record that Prof Glenda Gray made factually incorrect and unfounded statements:
FALSE: “We are seeing children with malnutrition for the first time (at Chris Hani Baragwanath Academic Hospital). We have not seen malnutrition for decades and so we are seeing it for the first time in the hospital
FACTS/RESPONSE: There has been a reduction in the number of cases of malnutrition that have been seen at Chris Hani Baragwanath Academic Hospital POPD and the total admissions during the month of March and April 2020, when compared to the previous 4 years. To illustrate this, in April 2019 there were 2 885 patients seen and 500 admissions.
However, in April 2020 there were 834 patients seen and 146 admissions. I have been advised by the department’s officials that at a subsequent Covid-19 MAC meeting, Prof Velaphi, the Head of Paediatrics at the hospital, raised this concern and asked why Prof Gray would mislead the public by giving inaccurate information. In response, Prof Gray merely stated that she had relied on what she had heard from “other colleagues”. However, these colleagues were not disclosed. This emphasises the warning we have been to the media and public not to just rely on anecdotal evidence. This ends up causing unnecessary anxiety to our citizens.
FALSE: “We believe, as scientists, that we give and are giving the government good advice and why they decided not to take the advice or engage readily with the scientists is unknown. Why have experts if you don’t care what they think?”
FACTS/RESPONSE: Since the establishment of the MAC, 50 advisories have been given to the Minister of Health, all of which have been accepted. Ironically, last week Prof Gray, as chairperson of the Research Subcommittee was part of the team that was preparing an advisory to the Ministry of Health in relation to the lockdown. This advisory had not been submitted to the Minister of Health when Prof Gray elected to speak to the media. There was a platform that had been created but this was overlooked even before making input through the Department of Health channels. She elected to do so through the media.
FALSE: “This strategy is not based on science and is completely unmeasured. It’s almost as if someone is sucking regulations out of their thumb and implementing rubbish, quite frankly.”
FACTS/RESPONSE: There are existing structures in government that have taken into account various factors, including scientific, socio economic, etc. The comment that government thumb sucks its decision not only undermines the joint work and effort that the NCCC, cabinet and government as a whole has been engaged in. But it is also unprofessional and unbecoming conduct from a member of the MAC who has direct access to the Ministry and the Department. In my view it undermines and brings into disrepute the institution that Prof. Gray works for which is an entity of the Department of Health, the MRC.
FALSE: “We punish children and kick them out of school and we deny them education. For what? Where is the scientific evidence for that?”
FACTS/RESPONSE: The Department of Basic Education has been engaged in various consultations with its stakeholders on the correct approach to take in the process of opening schools. The minister has also presented the Department’s strategy in the correct forums and is exercising her executive powers based on information and evidence before her to recommend to government on how to proceed. It can never be Prof Gray’s place to make such comments without being aware of the details, the advice and the process the Department of Basic education has followed.
Divergent views by scientists are healthy and welcome. The MAC provides this platform for robust engagement of these top scientists who are leaders of various respectable institutions and organisations.
However I must urge all those who are contributing to the thought process and science behind the decisions ultimately undertaken by Government to desist from potentially destructive behaviour and continue to engage constructively with government as they are mandated.
As head of the Medical Research Council, Prof Gray has access to the minister and the Department but never once raised this matter directly with ourselves, yet she has never failed to raise other issues of concern beforehand.
It must be understood that regulations are influenced by inputs from the public and her views would have been considered had she made submission in a normal way when public comments were called for. It is exactly for this reason that government has been bold enough to even make amendments to some regulations based on public inputs. However, Prof Glenda Gray chose not to use this platform.
We may not always agree but we will listen and consider input brought to us. We have said that government will not fight this pandemic alone. We need partners in our society to assist us with advice and even mobilising social behaviour in order to manage the spread of this virus. It is for this reason that we appreciate various social partners who have pledged their support to this cause. We will continue to work together until we conquer this coronavirus battle.
(Dr Zweli Mkhize is Health Minister of South Africa)
