COVID-19 research and science infrastructure in South Africa

Abstract

Biomedical laboratory and field scientists, as well as social scientists, in South Africa and elsewhere on the continent, responded to the challenges of COVID-19 with speed. African-wide experience with infectious disease, and the networks and infrastructure to conduct new research and implement field trials, were part of the global effort to contain the pandemic. But in order to contribute, scientists necessarily set aside ongoing research, including on some of the most persistent infections -HIV, TB, malaria. This situation highlights the precarity of science research programmes and the challenges of sustaining research capacity when agendas, funds and acknowledgements reinforce global inequalities.It has been more than 3 years since the first cases of COVID-19 in South Africa, and over a third of the population has been fully vaccinated and transmission has slowed. It continues to do so, offering us time to draw breath and to reflect on how, as a country, we have navigated the pandemic and stalled the worst economic impacts at household level for many South Africans. Since then, there has been growing awareness of the costs of preventive interventions to contain the pandemic for those most vulnerable to infections, and the economic repercussions of these interventions. [1][2][3][4] At the same time, we now have the opportunity to reflect on how, by utilising existing strengths in science infrastructure, resources, networks and skills, South Africans played a major role in curbing the spread of infection. In this Commentary, we discuss policies and early public health interventions across Africa in response to the pandemic, then turn to the role of scientists in developing biomedical interventions. In doing so, we draw attention to the importance of science capacity, and the distribution of power in research as well as policy.The epidemiological picture of the pandemic, here and elsewhere on the continent, remains somewhat unclear, the consequence of varied capacity within and between countries to case find, maintain records, and report administrative data. The limits of information on cases reflect people's reluctance to present for diagnosis among populations with poor access to medical care, due to distance from services and lack of right to receive care, the latter particularly for people without IDs or marginalised from society for structural reasons. Counter directives to shelter in place and avoid social interactions, such as queuing, that might increase transmission of COVID-19, also discouraged people from presenting to clinics. In addition, the relative youth and low density of populations in some countries and local areas likely reduced infection rates, severe morbidity and mortality.