Medical Research Council Achievements, Performance & Budget Presentation to: Parliamentary Portfolio Committee on Health 16 April 2013 Professor Salim S. Abdool Karim President: MRC

2 Overview Mission of the MRC Research Highlights of 2012 Strategic goals & performance Revitalisation of the MRC Financial state: Budget Conclusion

Mission of the MRC Generating New Knowledge for Policy and Practice to Improve the Health of the Nation 3

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Highlight of 2012: MRC features in State of Nation Address It was with good reason that we were delighted when late last year, studies from the Medical Research Council, the Lancet medical journal and others began reporting a dramatic increase in life expectancy… 5

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One of South Africa’s proudest achievements: People living >10% longer than 5 years ago - due to AIDS treatment Deaths in children <5yrs: ↓ 43% (42 per 1000 live births in 2011) Adults deaths: ↓ 20% (40% premature deaths in 2011) Life expectancy: ↑ by 6 years (60 years in 2011) Bradshaw D, Dorrington R, Laubscher R. Rapid Mortality Surveillance Report Medical Research Council Research highlights of

MRC shows mother-to-child transmission of HIV reduced to 2.7% in 2011 MRC’s Health Systems Research Unit undertook a national HIV survey to assess mother-to-child transmission In 2011, only 2.7% of newborns acquired HIV from their mothers down from 25% ten years ago Presented at the International AIDS Conference, Washington 2012 Research highlights of

MRC’s Strategic Goals in line with NSDA 9

MRC’s Strategic Goals continued… 10

Quarterly indicators in Annual Performance Plan: 3rd Quarter Report Strategic Objective Programme Performance Indicator Report Frequency 1st quarter 2nd quarter 3rd quarter 4th quarter Q1 to Q3 perform- ance Annual target per indicator Health research is undertaken Peer reviewed journal articles produced Quarter 179 (50) 136 (100) 101 (60) X (118) Health research is supported Health research projects supported Quarter 44 (8) 21 (8) 9 (4) X (10) 7430 Research results for policy Policy briefs published Quarter 1 (4) 1 (6) 2 (3) X (7) 420 International research co-operation Collaboration agreements signed Quarter 10 (8) 19 (10) 34 (5) X (14) 6342 ( ) denotes quarterly target MRC Organisational Performance: 2012/3 Q1-Q3 11

Auditor-General Internal Control Dashboard: 2012 MRC Dashboard 12

Informing the change needed Revitalisation of the MRC 14

Revitalisation of the MRC: Remedying 3 key problems Declining scientific stature of medical research –Sub-optimal intramural research productivity, few articles in the top medical science journals and low article citation rates MRC not fulfilling custodianship role in medical research in SA –19% of baseline budget allocated to Universities for all medical research - compromising clinical research –Number of intramural units > Number of extramural units (intramural expansion, duplication, poor integration, incoherence) MRC intramural units spend ~90% of their budgets on salaries –losing leadership role as MRC becomes increasingly dependent on donor funding and donor agendas 15

Activities implemented to revitalise the MRC 1.Prioritising in-house research to focus on the 10 most common causes of death and disease in South Africa 2.Increasing extramural funding to universities and medical schools in order to rebuild their health research 3.Creating new funding approaches for the development of new drugs, vaccines and diagnostic tests 4.Improving the efficiency and effectiveness of the MRC’s administrative systems 5.Improving peer-review and the quality of MRC research 6.Improving the MRC’s laboratory and space utilisation 7.Improving research support functions eg. medical journals 16

Financial State of the MRC in 2012 MRC baseline grant grew + 3.5% pa in last 4 years Dire financial state MRC budget has been shrinking in last 4 yrs Heading for repeated budget deficits MRC Budget < 10% of NIH funding to SA 17

Source 2013/14 Total for Funds are meant for MTEF allocation from Treasury via NDoH Annual BaselineR326m R1,037m MRC baseline government allocation Additional fund-raising 1. Additional funds directly from treasury - Competitiveness Fund R90m R340m Predominantly for fixed-term grants for research and infrastructure in Universities (Flagship projects) 2. Additional funds directly from treasury R0m R100m Funds to match Gates contribution 3.Gates FoundationR30m R100m For technologies in HIV and TB 4.Grant from DSTR29m R122m For technologies in HIV, TB & Malaria 5. NHRC: NDoH Scholars Programme R15m R45m PhD Training Total Additional Funds R164m R707m ~R300m needed to double the MRC’s baseline budget Financial state of the MRC ( ) 18

Summary of income for MTEF period (excluding VAT) 19

Overview of Total MRC Budget 19 20

Conclusion 1.MRC made major research contributions in 2012 – even receiving a mention in the “State of the Nation” address 2.On track for clean audit (Financial & Performance) in 2012  Revising Strategic Plan in 2013 – new strategic goals & targets  Raising standards to World-class – focus on impact 3.Revitalisation of the MRC well underway  Increased funding for new drugs, vaccines and diagnostic tests  Re-organisation of intramural research to focus on high impact  New funding for Universities – rejuvenating health research in SA 4.Fund-raising: Need ~R100m more p.a. to reverse ↓budget 5.Generating new knowledge to improve Health of the Nation 21