Science, citizens and democracy: the need to listen to …

Tonight the Daily maverick will organize a discussion with Professor Shabir Madhi, a world class scientist and a vaccinologist who has been increasingly critical of aspects of the strategy followed by the Minister of Health, Zweli Mkhize and President Cyril Ramaphosa. As Professor Salim Abdool Karim noted, “Different points of view are good and are part of the scientific process.”

But one has a feeling that Madhi is having to raise his voice because he and other experts are not being heard or are not properly involved.

Some of the arguments of critical health experts can be found with aspects of the current strategy on Covid-19 here, here, here and here.

I would summarize them, as compactly as possible, as follows:

Because the closure of South Africa was not accompanied by an immediate and strategic expansion of Covid-19 testing to identify and isolate those infected, community transmission has become irreversible, containment is now impossible. In addition to this, the delay in implementing significant humanitarian aid measures has meant that millions of people cannot comply with the blockade even if they want to.

The blockade was a partial success. He pointed out the severity of the crisis and bought us some time to prepare for emergency health services. But as a result of its deficiencies, the blockade is now incurring a disastrous economic cost (some say R13 billion a day) and an unprecedented social cost, almost starvation among millions, but without producing the health results for which it was intended. .

Therefore, it is better to significantly relax the lock while simultaneously increasing it. Public health measures that have been shown to have an impact in reducing transmission. This also requires a reconsideration of the mass testing strategy and steps to ensure its integration with other SA health threats, such as HIV, tuberculosis and even measles.

South Africa has now been in a National Disaster State for two months, which gained almost unanimous support from the start. But one of the dangers of talking about a “war” in Covid-19 has been that those with different points of view can become enemies. It is vital to remind the President and his Cabinet and, possibly, most importantly, the people who advise them that they have great power to filter what their directors hear: all voices and expert opinions count.

• So, it is necessary to repeat some truths here:
• Covid-19 is a completely new virus, our knowledge of it and of the medical and social response, grows and sometimes changes every day, we are in what the New York Times calls a “Global “trial and error” played in lives“; so there is nothing wrong with doing it wrong, as long as we have a system that allows us to learn, adjust and adapt.
• That makes truth, transparency, and accountability important.
• A different opinion is neither unpatriotic nor contrary to national effort, but it can be an essential check on the soundness of a strategy.
• No one in the scientific community or in government should put their egos above the national interest.

Experts who are being educated but constructively critical of the current National Command Council (NCC) strategy are not Covid-19 deniers; critics of the blockade aspects are not a right-wing Christian fundamentalist fringe, like those protesting in parts of the United States; They are not anti-government or racist and, let’s say, even an opposition political party is entitled to a different point of view (as long as it does not opportunistically exploit its difference to create division or confusion).

Instead, they are patriotic scientists and some of our best scientific experts.

The claim that they are not being listened to is cause for concern and a contradiction to the government’s boast that their response is being driven solely by science, because the scientific method involves peer review and constant discussion until a hypothesis.

For this reason, South Africa needs a system, independent of government or business interests, that continually evaluates the evidence, emerging scientific knowledge, and feeds this intelligence into our covid-19 strategies.

It would be better if the current Ministerial Advisory Committee (MAC) at Covid-19 were to become an independent scientific advisory committee capable of proactively supporting the Minister of Health and continually evaluating national and international evidence for their relationship to our strategy. Its deliberations and findings, the models on which it works, the evidence and the information on which it is based, should be publicly available.

It is not acceptable that the model on which the government has based its decisions has not been published for scientific scrutiny by people outside the inner circle and that some of the main modelers have been silenced by having to sign confidentiality agreements (NDA ). This is bad for the quality of the models and bad for public understanding and public trust.

Linked to this, it is vital that the Covid-19 information center, which President Rampahosa said is based on the CSIR, is urgently accessible to the public, and that the process and the personalities that inform decisions in areas as diverse as education, the economy, food and water security and what we are allowed to buy becomes transparent and public.

Until about a week ago, President Ramaphosa’s leadership and bravery had earned him near-universal support, from the poorest of the poor to the richest of the rich. Without fuss and endless fuss, an undeclared social pact was born with the goal of saving lives and saving South Africa.

But that pact is now clearly frayed: the evidence of noncompliance with certain aspects of Level Four of the blockade is a vote of diminished confidence; The wave of legal action against the government is evidence that trust is breaking and that citizens have returned to the old ways of trying to assert and protect rights against a recalcitrant government.

No sensible person disputes that in order to defeat Covid-19, we must make sacrifices and accept a reasonable limitation on our rights. However, an increasing number of people are concerned that they do not understand (and the government does not share) the scientific evidence base for certain decisions, such as tobacco prohibition.

The fact that the NCC, whose military nickname goes to the head of some of its members, feels that it does not need to justify its decisions is evident in the arrogant and rude response from the Director General and Cabinet Secretary Cassius Lubisi to the April 27 letter from attorneys Nazeer Cassim and Erin Richards, who had asked for clarity on:

“Possible risks of constitutional and democratic malfunction arising from what appears to be the questionable establishment, structure, and functions of the NCC, as well as the government’s notable lack of transparency about the agency.”

Let’s be clear. There are difficult days ahead when we will see death, disease and panic. But if a critics’ bona fide questioning pattern takes root, it will be bad news for national unity in the response to Covid-19. Ultimately, it will leave the government with a choice: a continuous blockade forced by brute force and fear, or an honest senseless blockade only in default.

It’s also not what we want, and the worst thing is that with either option, Covid-19 would be the winner.

In times of crisis, freedom of expression and freedom of the media to amplify voices is a necessity, not a luxury. It establishes one of the crucial links between society in general and the decisions that the government makes on behalf of our collective.

In South Africa that freedom is embedded in our Constitution.

It is arguable that it was the suppression of freedom of expression by doctors and the media in China that got us into this Covid-19 mess in the first place. Not, as denialist Trump would say, as a result of a Chinese government conspiracy to manufacture a virus, but a conspiracy to silence its own health professionals and the media.

Today, as we enter a more intense phase of the Covid-19 epidemic, with numbers and deaths now increasing much fasterThis is one of the most important lessons that South Africa should take on board.

Right now we need the sum of all our considerable scientific wisdom and experience, not the best of some of them, and the silencing or stigmatization of inconvenient voices.

We must resort to all our strengths because a lot is at stake.

Our politics, democracy and the future of our children are at stake.

If the government of President Ramaphosa cannot mitigate the worst damage of Covid-19 or prevent the total collapse of our economy, it will fall to populist and corrupt elements that hang over the wings, currently without a stage or relevance.

Our economy is at stake.

It is not the economy that is already broken, that is already unfair: we do not want to recover it. But the foundation and architecture that our current industries and corporations provide millions of people fortunate enough to work in, and for millions more than inclusive economic policy, such as recently promised twice by President RamphosaYou must get to work.

At stake are tens of thousands of lives at risk from SARS-Cov-2, particularly of older people and people who, often due to socioeconomic inequalities and diseases of poverty, have pre-existing diseases that predispose them to Covid-19. .

However, the lives of thousands of children are also at risk. Although they are not at risk for severe Covid-19, they are indirectly affected by the lack of immunization against life-threatening vaccine-preventable diseases; who are at risk of malnutrition as confinement forces more households below the poverty line, and whose education is compromised by the closure of schools.

At stake, therefore, is nothing less than our dreams of a democratic, socially just and equitable South Africa; and the future of our children.

We lose all this and run the risk of becoming a failed and conflictive state, where those who have will always be at war with those who do not have, and where those who do not will be the forage of demagogue and populist thieves who promise heaven only to deliver hellDM

Join the webinar, click the link below to register: