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12 May 2020 | Story Prof Francis Petersen | Photo Sonia Small
Prof Francis Petersen.
In a rapidly changing, uncertain and complex world, the role that universities are playing as the engines of social mobility, as drivers of the economy and as generators of new ideas, is now more critical than ever.  Due to the universal nature of knowledge, universities are global in scope – a space that encourages new ideas, controversy, inquiry, and argument and challenges orthodox views, but they are also deeply entrenched in their local environment, influenced by socio-economic and political dynamics.  There is an expectation that universities should exhibit great levels of responsiveness and public accountability, with higher levels of trust in higher education, and between higher education and government, and higher education and the public.  The challenge for both higher education and government is to allow institutional autonomy without oppressive accountability.  

Over the past few years, the purpose of universities has been challenged in relation to their role in society, their advocacy for speaking truth to power, their continuous strive to be great universities without being elitist, and their ability to function in an age of populism. The Trump administration and, more recently, Brexit have demonstrated that there is a decline in the respect for evidence and advice from subject-specific experts.  It seems (as in the case of the Trump administration) as if empirical reality does not matter, nor does empirical reasoning form the basis of public policy – a political place that is becoming increasingly anti-intellectual.  Emotion and personal belief have been shown to carry more weight than objective facts and evidence in terms of influencing public opinion.  Fake news and ‘the alternative truth’ have also challenged the fundamental principles of a university – academic freedom and the generation of new knowledge in the pursuit of truth.

A digitally unequal society
The COVID-19 pandemic has shown deep fault lines in our society – stark poverty and inequality – that universities should engage with (and they do); however, they cannot eliminate it on their own, but can be part of the solution.  South Africa is the most unequal society in the world.  Before the COVID-19 pandemic, the South African economy was already in deep trouble, with sovereign downgrades by all the rating agencies and with an unemployment rate close to 30%.   The national lockdown, in an attempt to ‘flatten the infection curve’ and hence manage the response of the national health system to COVID-19 cases, has added to the pressure on the economy.  It is envisaged that a large number of people (estimated between 3 and 7 million South Africans) will lose their jobs after the national lockdown period, adding to poverty and an already high unemployment rate.  Even during the lockdown period, there are many South Africans living in crowded spaces, hence finding it difficult to practise social distancing, may not have running water and proper sanitation, and possibly do not have regular access to food.  

As schools and the post-school education and training sectors move online with their learning, it further shows how digitally unequal our society really is – access to connectivity, data, and an appropriate digital device is a challenge, and electricity is not evenly distributed or is non-existent in our society.  These institutions, within the environment of digital inequality, are ensuring that digital equity is maintained as far as possible.  Many churches, business leaders, and certain politicians have called for a different social pact between business, labour, and government to address the state of the economy – any such action, however, must be supplemented by concrete measures for social reform.

Regaining trust in universities
But perhaps this pandemic has also created an opportunity for science and evidence to regain credibility in informing government decisions and public trust, and for universities to demonstrate respect for evidence. During the initial stages (early March) of COVID-19 in South Africa, the epidemiologists and virologists have shown through confirmed data from the National Institute of Communicable Diseases (NICD) that South Africa was in the early phase of the infection curve – also interpreted to be the relatively low-risk phase of the curve; this would be the right time to apply the principle of social distancing.  It allowed certain organisations (such as universities) to pro-actively suspend part of their activities so as to minimise the number of people in their operational environment, well before the national lockdown was announced on 26 March – a decision based on science.

Through data and proper analyses, the NICD, other scientific bodies and the Ministerial Advisory Committee on COVID-19 provided evidence-based information to government and the public, from which meaningful decisions could be taken.  The South African government has made it perfectly clear that decisions around COVID-19 will be made based on the science associated with this pandemic – a stance to be applauded.  Hence, the risk-adjusted approach of ‘opening up’ the economy through easing the lockdown measures but constantly monitoring the infection curve is an excellent example of risk management while continuously assessing the risks.

Universities, science laboratories, and pharmaceutical companies around the globe are hard at work to develop an effective vaccine for COVID-19, which is another opportunity to demonstrate how science can assist in protecting people from this terrible virus. Universities are making advances in personal protective equipment (PPE), the development of new technologies for non-ICU provision of oxygen to COVID-19 patients, more advanced methods of testing (for the virus) to reduce turnaround times, and various other scientific studies.  

This platform is giving universities a renewed impetus to use science and scientific developments to advance societal agendas such as climate change, poverty and inequality, public health and social justice (ethics of care) – and more immediate – assisting in re-building a strong South African economy.  It is an opportunity for the public and politicians to regain trust in universities, but it is also an opportunity for universities to profile their public intellectuals so that the value of science and evidence-based output is part of policy debates and informed decision-making.  However, in doing so, universities must strengthen their relationship with society at large, be inquiry-driven, and at the same time be learning and co-creating.

Prof Francis Petersen is Rector and Vice-Chancellor of the University of the Free State.

News Archive

Higher than expected prevalence of dementia in South African urban black population
2010-09-22

 Prof. Malan Heyns and Mr Rikus van der Poel

Pilot research done by University of the Free State (UFS) indicates that the prevalence of dementia, of which Alzheimer’s disease is only one of the causes, is considerably higher than initially estimated. Clinical tests are now underway to confirm these preliminary findings.

To date it has been incorrectly assumed that dementia is less prevalent among urban black communities. This assumption is strongly disputed by the findings of the current study, which indicates a preliminary prevalence rate of approximately 6% for adults aged 65 years and older in this population group. Previous estimates for Southern Africa have been set at around 2,1%.

The research by the Unit for Professional Training and Services in the Behavioural Sciences (UNIBS) at the UFS and Alzheimer’s South Africa is part of the International 10/66 Dementia Research Group’s (10/66 DRG) initiative to establish the prevalence of dementia worldwide.

Mr Rikus van der Poel, coordinator of the local study, and Prof. Malan Heyns, Principal Investigator, say worldwide 66% of people with dementia live in low and middle income countries. It is expected that it will rise to more than 70% by 2040, and the socio-economic impact of dementia will increase accordingly within this period. 21 September marks World Alzheimer’s Day, and this year the focus is on the global economic impact of dementia. Currently, the world wide cost of dementia exceeds 1% of the total global GDP. If the global cost associated with dementia care was a company, it would be larger than Exxon-Mobil or Wal-Mart.

The researchers also say that of great concern is the fact that South Africa’s public healthcare system is essentially geared toward addressing primary healthcare needs, such as HIV/Aids and tuberculosis. The adult prevalence rate of HIV was 18,1% in 2007. According to UNAIDS figures more than 5,7 million people in South Africa are living with HIV/Aids, with an estimated annual mortality of 300 000. In many instances the deceased are young parents, with the result that the burden of childcare falls back on the elderly, and in many cases elderly grandparents suffering from dementia are left without children to take care of them. “These are but a few reasons that highlight the need for advocacy and awareness regarding dementia and care giving in a growing and increasingly urbanized population,” they say.

Low and middle income countries often lack epidemiological data to provide representative estimates of the regional prevalence of dementia. In general, epidemiological studies are challenging and expensive, especially in multi-cultural environments where the application of research protocols relies heavily on accurate language translations and successfully negotiated community access. Despite these challenges, the local researchers are keen to support advocacy and have joined the international effort to establish the prevalence of dementia through the 10/66 DRG.

The 10/66 DRG is a collective of researchers carrying out population-based research into dementia, non-communicable diseases and ageing in low and middle income countries. 10/66 refers to the two-thirds (66%) of people with dementia living in low and middle income countries, and the 10% or less of population-based research that has been carried out in those regions.

Since its inception in 1998, the 10/66 DRG has conducted population based surveys in 14 catchment areas in ten low and middle income countries, with a specific focus on the prevalence and impact of dementia. South Africa is one of seven LAMICs (low and medium income countries) where new studies have been conducted recently, the others being Puerto Rico, Peru, Mexico, Argentina, China and India.

Mr Van der Poel says participating researchers endeavour to conduct cross-sectional, comprehensive, one-phase surveys of all residents aged 65 and older within a geographically defined area. All centres share the same core minimum dataset with cross-culturally validated assessments (dementia diagnosis and subtypes, mental disorders, physical health, anthropometry, demographics, extensive non-communicable risk factor questionnaires, disability/functioning, health service utilization and caregiver strain).

The local pilot study, funded by Alzheimer’s South Africa, was rolled out through an existing community partnership, the Mangaung University of the Free State Community Partnership Programme (MUCPP).

According to Mr Van der Poel and Prof. Heyns, valuable insights have been gained into the myriad factors at play in establishing an epidemiological research project. The local community has responded positively and the pilot phase in and of itself has managed to promote awareness of the condition. The study has also managed to identify traditional and culture-specific views of dementia and dementia care. In addition, existing community-based networks are being strengthened, since part of the protocol will include the training and development of family caregivers within the local community in Mangaung.

“Like most developing economies, the South African population will experience continued urbanization during the next two decades, along with increased life expectancy. Community-based and residential care facilities for dementia are few and far between and government spending will in all probability continue to address the high demands associated with primary healthcare needs. These are only some of the reasons why epidemiological and related research is an important tool for assisting lobbyists, advocates and policymakers in promoting better care for those affected by dementia.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
21 September 2010

 

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