Glenda Gray: South Africa’s doctor extraordinaire
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South Africa is a country of polarities and extremes. Unless you are one of the highly privileged, it can be a tough environment. Against this backdrop, incredible stories of courage, resilience, compassion and creativity emerge.
In a special article for TTU, she describes the remarkable leadership of Professor Glenda Gray. She is one of the country’s most effective and outspoken medical leaders. Dr Gray’s courage to speak up and take action, in spite of the personal consequences, has saved countless lives.
Barbara Walsh, is director of Metaco Consulting in South Africa. She is the co-founder of the global platform Teams & Beyond.
In March 2020, South Africa’s Government imposed an extreme lockdown to slow the spread of the virus and protect the health system.
The impact was severe.
The economy plunged, unemployment soared, and a significant portion of the middle class fell toward poverty.
Early in May 2020, as a five-stage plan to slowly lift the lockdown was announced, Dr Gray spoke out.
She is a leading member of the South African government’s Medical Advisory Committee. She has been at the forefront of the country’s medical response to the pandemic.
Challenging Government strategy
She was concerned about issues such as malnutrition, not seen for decades, which was now prevalent at public hospitals. She felt that the economy should open up, and measures such as handwashing and sanitizing, mask wearing, social distancing and prohibitions on gatherings would be sufficient.
Professor Gray publicly challenged the Government’s strategy, by saying: “This strategy is not based in science and is completely unmeasured, almost as if someone is sucking regulations out of their thumb and implementing rubbish, quite frankly. In the face of a young population, we refuse to let people out.
“We make them exercise within three hours a day and then complain that there’s congestion in this time. We punish children and kick them out of school, and we deny them education. For what? Where is the scientific evidence for that?”
A furious response followed with the Health Minister, Zweli Mkhize, saying that Gray had “made factually incorrect and unfounded statements” and the Acting Director-General of the Department of Health calling for an investigation into her conduct.
The South African Medical Research Council (SAMRC), where Gray is President and CEO, issued an apology for her statements.
Over 250 of South Africa’s top medical scientists initiated a petition and lobbied support for her. The Department retreated and the Minister stated that the matter was closed. The SAMRC cleared her of any transgressions.
The Minister and Professor Gray have subsequently been working well together, as both have acknowledged.
No time to waste
Fast forward to February 2021 as the South African variant was spreading rapidly in the country.
As the first batch of Oxford/AstraZeneca vaccines arrived in the country, Gray was called by her colleague, Professor Shabir Madhi. He is the lead investigator in the local AstraZeneca trial. He said the vaccine appeared to have low efficacy against the locally dominant 501Y.V2 mutation of the virus.
The new single dose Johnson & Johnson vaccine appeared to be more effective.
There was no time to waste with the AstraZeneca vaccine just about to be rolled out, and rapidly rising infection rates.
Gray, who co-chairs the Johnson & Johnson vaccine trial in South Africa, got straight on the phone to the Chief Scientific Officer at Johnson & Johnson, Dr Paul Stoffels. She convinced him to do the near impossible, given the shortage of the vaccine, to source an initial supply for the country’s health workers.
He did it in days.
To avoid approval delays in South Africa, it was agreed that the J&J vaccine would be distributed as part of an implementation research study.
Over the next few days, with little sleep, the team led by Dr Gray managed to get protocols and permits completed. This cleared the way for the first batch of 80,000 vaccines to arrive, be packed and distributed to centres around the country.
“We only missed two days,” she explained. “Our health workers deserved this vaccine. It was amazing to see the gratitude on their faces.”
Speaking truth to power
Of the first to take the J&J vaccine were the Health Minister Zweli Mkhize and President Cyril Ramaphosa. They both wanted to prove by example that it is safe for everyone.
Dr Gray is no stranger to speaking truth to power.
She told the South African Daily Maverick: “As one gets older, it becomes increasingly important to continue acting as an activist because if we have influence and we keep quiet then that is bad.”
She has been an activist all her life as her biography shows.
The fifth of six children, Glenda Gray grew up in a poor, racially segregated neighbourhood. Her family frequently invited black friends to visit them - an anomaly during apartheid. She developed awareness of what being disadvantaged meant which fuelled her abhorrence of the injustices in an unequal system.
Whilst studying medicine at university, she joined a group working to desegregate South African hospitals, helping organize strikes and documenting brutalities against detainees.
She learned to live with controversy, risk and consequences and despite being targeted and threatened, continued to speak out.
Ground-breaking HIV research
Gray began to specialise in paediatrics and started an HIV preventative community education project. By the time she completed her studies in 1993, HIV had become the most common cause of death at the huge hospital in Soweto where she worked.
With a colleague, Gray co-founded a perinatal clinic seeking to prevent mother to child HIV transmission during birth. Their work was supported by the women they worked with and despite international criticism of their methods, their ground-breaking research saved hundreds of children.
Gray went on to advise Nelson Mandela’s newly elected African National Congress on HIV and helped draft a national AIDS plan.
However, Gray soon found herself in another battle. The then President, Thabo Mbeki, and his Health Minister refused to acknowledge that HIV caused AIDS, favouring tribal medicine instead. They tried to put a stop to the research and refused to provide hospital treatment.
Gray had to find another way. So, with no funding and notwithstanding extreme governmental resistance, threats and surveillance, she arranged for shipment of antiretroviral drugs from the USA. She then continued clinic treatments.
In 2001, Gray was part of the Treatment Action Campaign team which filed a lawsuit against the government demanding the right of treatment to HIV-positive pregnant women.
In 2002, Mandela presented Gray and her colleagues with the Nelson Mandela Health and Human Rights Award - flying in the face of the ANC government. This helped keep the issue and lawsuit in the public eye. The court ruled in their favour soon after.
Courage, humility and resilience
Gray says: “If you ever feel unsafe, the best thing anyone can do for you is to put you in the spotlight. Then people can’t do anything mischievous to you. It was a brave, brave thing for Nelson Mandela to do.”
Last year, a journalist asked Glenda Gray what, among her many titles and achievements, she would like to be remembered for. Her response speaks volumes: “For finding an HIV vaccine. If I could achieve anything, it would be to be known among the many scientists who failed and failed and failed, and eventually succeeded in finding a vaccine for HIV”.
She paused and added, “but I’d also settle for being known for helping find a vaccine for Covid-19.”
She considers herself “lucky” for having had the chance to contribute.
One could argue that luck was probably the least part of it.
Glenda Gray has tremendous courage, humility, resilience, compassion with deep concern for the wellbeing of humanity, the ability to connect at all levels a strong purpose with drive and focus, and an insatiable desire for learning. These are just some of the qualities that enable her contribution and achievements.