CONTESTACIONES Jurisdicción Concurrente

In spite of growing interest in the promotion of science, biotechnology research and community intellectual property protection, there has been too little research on the public understanding of science or on public perceptions of clinical trials in South Africa. The little research that has been done has been trapped to some extent in the ‘knowledge deficit’ tradition, focusing on how little knowledge the public has about science. Instead of simply investigating public knowledge about science ‘from the inside’ (how science works to produce knowledge) we need to start investigating how people understand the purpose and politics of scientific research and how it affects them. Current research understands poor public engagement with science in South Africa mainly as a problem of poor communication that can be addressed by telling people more about science, developing indigenous-language terminology, or phrasing sexual behaviour messages in a more culturally appropriate way. The problem could also, however, be seen as a broader

socio-political issue, linked to a history of popular experience of science in

South Africa, as elsewhere in Africa, that has resulted in a mismatch between popular and scientific understanding of the role and value of science in society.

In 1999, a survey was conducted by the HSRC to determine the level of public understanding of science in the country using modified international survey instruments (Blankley and Arnold, 2001). The data from the sample of 2 207 randomly selected adults were weighted to match the demographics of the national adult population. The data showed that 30% of respondents had never studied mathematics at school, 50% had never studied biological science and 55% had never studied physical or chemical science. Only about 20% had a pass in mathematics on leaving school and only 3% to 4% of the sample had ever studied mathematics or science at tertiary level. Race, age, gender and income level were correlated with levels of science or mathematics education: poorer, older black women were worst off.

Although the South African respondents showed interest in science (83% were interested in new discoveries in medicine), the study found that science was

REVITALISING CLINICAL RESEARCH IN SOUTH AFRICA 71

A STUDY ON CLINICAL RESEARCH AND RELATED TRAINING IN SOUTH AFRICA

a low-salience issue for most of them prior to the survey. Although 60% of the respondents believed that the positive benefits of science had outweighed any harmful effects, perhaps mirroring government statements on the usefulness of science, 68% felt that “science makes our way of life change too fast”, and 48% felt that “we depend too much on science and not enough on faith”. Analysis of the data suggested that there are some problems in applying a survey developed for wealthy western countries directly to South Africa: people who were most optimistic about its benefits also showed the most reservations about science, in contrast to US data. The authors of the study suggest this may have been a result of random or unconsidered survey responses, but it may be that different applications of science may present reasons for concern or optimism.

The HSRC study thus recommended more investment in science education especially for certain groups, and the use of radio programmes for science education among the general population (Blankley and Arnold, 2001). Public education could also be achieved through revision of school curricula, systematic use of popular science magazines and science centres for information dissemination, a National Health Research week and other initiatives discussed below. As the British experience has shown, however, simply disseminating knowledge about science will not necessarily foster trust in science or address all the concerns that the public might have about science and more specifically about clinical research. Blankley and Arnold (2001) warned that “Given current low levels of understanding [about science], there is the danger that public debates on issues such as HIV/AIDS, nuclear power or genetically modified organisms are likely to be guided, even swayed, by those with special interests or agendas.”

Studies of school performance in science indicate that the percentage of final-year school passes in mathematics and physical science higher grade have declined slightly in the period 1997–2000, while passes in the standard grade in these subjects have risen somewhat. The performance of African learners in these subjects has been particularly poor: in 2001, between 11% and 40% of candidates passed mathematics on SG or HG in the various provinces (an outlier being the 75% pass rate for Limpopo with 78 learners)

H O W T O F O S T E R G R E AT E R P U B L I C E N G A G E m E N T W I T H C L I N I C A L S C I E N C E

(Mouton et al., 2002). Numbers of both master’s and doctoral graduates have increased between 1989 and 2000, but the majority of graduates are still in the humanities rather than the sciences (Bunting, 2002 and Cloete et al., 2002, cited in Mouton et al., 2002).

A preliminary scoping study on the uptake of research in social development was recently commissioned by the Research and Development Uptake in South Africa (RADUSA) Forum, comprised of the NRF, the Southern African Research and Innovation Management Association (SARIMA), the CSIR, the Association of Commonwealth Universities (ACU) and Metalab. The report of this investigation, produced by the CSIR (Funke et al., 2008), may have limited value in measuring efforts to disseminate medical research information because it did not incorporate specific interviews with the MRC. People from a number of other science councils, government departments, higher education institutions and communities were sampled, but there were a few comments made about public views on science, specifically health information. Information about water quality or sexual behaviour provided by government agencies in the rural area sampled was not always acceptable to or trusted by community members. Information about healthy eating was not always relevant when people struggled to find enough to eat. The report concluded that “Government agencies and research organisations should be aware that cultural and linguistic barriers exist when they attempt to disseminate research and development findings to communities in need. These issues need to be addressed on a project-specific basis, and might also make for important areas for future research” (Funke et al., 2008).