WHY ‘SORRY’ WAS GRAYED OUT
Scientist breaks her silence on lockdown row
For the first time, Glenda Gray, Wits professor of paediatrics, South African Medical Research Council (MRC) president and member of the Covid-19 ministerial advisory committee, has revealed why she could not, on principle, apologise for questioning the government’s handling of the lockdown even at the risk of being suspended.
After a brutal week in May, during which she was attacked from all sides, a board member advised her to apologise in writing to make the backlash “go away”.
“If I say ‘I’m sorry’ and I’m silenced, then what about the nurse or the doctor who then becomes too scared to speak out if they see what happens to me? If I have this huge voice and I’m silenced, then what about everyone who comes after me?” Gray thought on her darkest weekend.
Her fighter instincts sharpened over 20 years at the forefront of the Aids epidemic as one of the world’s best HIV scientists and clinicians, she could not back down.
Her voice is indeed powerful. Gray was named among Time magazine’s top 100 most influential people in the world in 2017, and this year Forbes Africa named her among the top 50 most influential women in Africa. She was awarded the Order of Mapungubwe in 2013, SA’s highest honour.
For protecting babies against HIV and advancing Aids treatment she is also a co-recipient of the Nelson Mandela Health and Human Rights Award, among a list of other accolades.
On Saturday May 17, Gray criticised the government in an interview for not taking the advice of scientists and for the phased lockdown strategy and rules.
“It’s almost as if someone is sucking regulations out of their thumb and implementing rubbish,” she said.
Among the concerns she raised was that: “We are seeing children with malnutrition for the first time [at Chris Hani Baragwanath Academic Hospital]. We have not seen malnutrition for decades.”
The health department released a statement saying that the malnutrition numbers were inaccurate, citing total admissions for Gauteng, not just children, which were lower in April 2020 than in April 2019.
Gray says she raised the spectre of child malnutrition based on figures which two paediatricians at the hospital gave her and was surprised that she was called a liar rather than an alarmist. “I would hope that I was wrong!” she says.
“To this day I haven’t seen all the numbers or the hospital admissions and whether the first week of May [eight admissions out of 18 in a normal month] was an aberration.”
At the time, the personal attacks intensified and on Saturday May 23 Gray was so distressed she could not sleep or eat. “I covered myself with a blanket and in this meditative state lay in my room, trying to think: should I say sorry? What should I do?
“When I opened my eyes there was a message from Jimmy Volmink [Stellenbosch University dean of medicine and health sciences] stressing the importance of academic freedom and the support I had and telling me to have courage. I knew then that I couldn’t say that I’m sorry.”
By the Monday, more than 250 scientists and academics and the Academy of Sciences of SA had rallied to defend her and the principle of academic freedom of speech. “They were brilliant,” says Gray, thankful for the outpouring of support, led by intellectuals like Wits vice-chancellor Adam Habib.
On Tuesday, the MRC board reversed its decision to investigate her conduct, stating that its president and CEO had not breached any of its policies for the comments she had made in her personal capacity.
“When I told my kids the charges were dropped, we were sobbing. They had seen me falling apart,” Gray says, looking composed this week in her Cape Town office with a distant view of Table Mountain, despite working up to 18 hours a day.
Efforts to reduce suffering
Countless cups of coffee, three children, two dogs, one cat and a garden keep her on track, after Covid-19 wakes her up at night in a panic about the safety of health workers. This A-rated scientist has a big heart.
Professor Linda-Gail Bekker, director of the University of Cape Town’s Desmond Tutu HIV Centre, says: “The first thing one realises about Glenda is that she is entirely motivated in her efforts to reduce pain, suffering and ill health in her fellow humans, particularly if children are involved.
“She does this by applying the best science she has at her disposal, and doing so fearlessly.”
Gray, who heads the research subcommittee for the 50-member ministerial advisory committee, was raising widespread frustrations about whether science was shaping lockdown rules when she came under fire.
She says: “There was increasing dissent happening … I was not the most vociferous and I was not the first.
“The punishment must fit the crime and this was blown out of proportion,” says Gray.
Wits professor Francois Venter, who is on the ministerial advisory committee, says of Gray: “Lately she has spoken truth to power on Covid, where so many people were scared to say the glaringly obvious.”
If being a troublemaker means struggling for equal rights then the 57-year-old Gray, a fan of Bob Dylan’s early music, has always been one.
As a junior doctor in the late ’80s, she defied the segregation of apartheid hospitals and allied herself with all health workers, not only doctors.
She joined the Health Workers Association and fought for workers’ rights, smuggling the association’s provincial leaders, disguised in white coats with stethoscopes, into the hospital, jumping the turnstiles to get to management, ending in arrest.
Starting as a paediatrician at the hospital’s neonatal unit, Gray gravitated to caring for the babies of HIVpositive mothers at a clinic run by professor James McIntyre.
Together they founded the Wits Perinatal HIV Research Unit at Baragwanath in 1996, now globally acclaimed for researching and pioneering HIV prevention and treatment.
Venter says: “She was in the HIV battle trenches throughout that dreadful period of HIV denialism. In the midst of it all, she was a brave researcher, singlemindedly driving the prevention of perinatal HIV infections, and then later anti-HIV vaccines.”
By the ’90s, every third child being born to HIVinfected women was positive and the wards were getting worse and worse, says Gray, who was doing whatever she could to expand treatment.
Her daughters were born in the ’90s and her son later, but they did not slow her down.
One American researcher remembers Gray shocking scientists by breastfeeding her son while doing a presentation.
“I try to practise what I preach,” laughs glamorous Gray, who is not inhibited by social conventions.
When mothers with HIV in Soweto demanded to be included in treatment trials, Gray fought for them. After a Wits ethics committee refused an antiretroviral
“If I say ‘I’m sorry’ and I’m silenced, then what about the nurse or the doctor who then becomes too scared to speak out if they see what happens to me?”
treatment study, Gray stepped in.
“I drove the women back to the ethics committee at Wits with their babies and children. The children were crawling and running around. A mother told the committee: ‘If I can get treatment for two years and have two more years with my child, I want it!’,” Gray remembers. Permission was granted and she made sure they got extended treatment.
“It was my first treatment trial and you would see life being breathed back into people,” she says.
Gray supported the Treatment Action Campaign, launched in December 1998. She lay down in the street outside Baragwanath with TAC activists to demand access to treatment and protest against Aids denialism.
She was pivotal in setting up the prevention of mother-to-child HIV transmission programme in
Soweto and backed the TAC’s court case to roll it out to all pregnant women with HIV — saving hundreds of thousands of babies from infection.
The past president of the International Aids Society, Bekker, says that Gray advanced the understanding of mother-to-child HIV transmission 15 years ago and for the past 10 years or so has been “on a mission to discover a viable HIV vaccine”.
“Where the science is thin or shaky she is passionate about filling the gaps. This is where she has really made an outstanding contribution in my book. To this end Glenda has helped to put South Africa on the map as the ‘go to’ for global HIV-prevention research.”
Gray, who has contributed to more than 300 publications, is the co-principal investigator and director of international programmes of the HIV Vaccine Clinical Trial Network, which conducts over 80% of HIV vaccine clinical trials.
What she wishes for in her lifetime is an “HIV vaccine to protect women and babies”.
In pursuit of this, she has driven the expansion of HIV clinical trial capacity beyond SA to Mozambique, Zimbabwe, Malawi and Zambia in the past three years.
Since she was headhunted for the MRC in 2013, she has led the institution to six successive clean audits and revolutionised its research funding.
Grants have been ring-fenced for historically disadvantaged institutions and awarded to black, female and young researchers and women who are mid-career scientists, successfully building research capacity and leadership.
The past chair of the Board of the Global Alliance for Chronic Diseases, Gray also runs a non-communicable diseases unit at the MRC and, under the Covid-19 pandemic, the whole team has been reoriented to tackle the coronavirus.
Current research includes surveying sewage to try to predict ahead of time which areas will become “hotspots”.
“In the first few days after lockdown we diverted and freed up R100m for Covid surveillance, diagnostics and therapeutics,” says Gray. “We moved all the travel money; after all, how much travelling will we be doing?”
Once, at the airport, back when flying was common, Gray was stopped by security who wanted to know why she had a skull and skeleton hand in her hand luggage. An award given to her by Wits included these replicas from our early human ancestors, now on display in a cabinet.
Scientists like Gray protect our species. SA has an impressive cadre of them including medical advisory committee head professor Abdool Salim Karim, Quarraisha Abdool Karim (his wife), Lerato Mohapi, Bekker, Venter, the late Gita Ramjee, who lost her life to Covid-19, and many more whose work saved lives during the worst of the Aids epidemic.
They have the incisive skills and battle hardiness to get to grips with another pandemic, and we need them. Now more than ever.