When Dr Sumy Thomas returns from a secondment to Harvard Medical School, her research which focuses on work on the endocrine system of patients affected by HIV and AIDS, will be invaluable to the 7.7 million South Africans on antiretroviral treatment.

Thomas is a recipient of the Discovery Foundation MGH Fellowship Award for 2020/21 and will use her fellowship to focus on internal medicine. Since 2013, a South African doctor working in the public sector is chosen for a year-long fellowship at Massachusetts General Hospital, the largest teaching hospital of Harvard Medical School based in Boston in the United States.

It is an opportunity of a lifetime for a doctor to learn from the world’s top medical specialists and an opportunity to conduct cutting-edge clinical research. However, while the Discovery Foundation MGH Fellowship Award is aimed at helping to develop the next generation of leaders in academic and clinical medicine, the broader aim is for better healthcare for South Africans and citizens globally.

“The metabolic unit at MGH undertakes groundbreaking studies aimed at improving the lives of people living with HIV, and I will have the incredible opportunity of being involved in novel trials conducted there. By being attuned to the needs of our population, I hope to generate relevant research and be involved in the training of specialists in years to come,” says Dr Thomas.

The Discovery Foundation MGH Fellowship Award was first introduced in 2013, and the specialist doctors are required to come back to South Africa to implement the knowledge they have gained.

A decade of partnerships to strengthen medical resources

In the past 10 years, the Discovery Foundation, an independent trust tasked with the objective of investing in human resources in South Africa’s public health sector, has invested over R261 million in grants to support academic medicine through research, development and the training of nearly 500, predominantly black, medical specialists in South Africa for the public sector. 

These grants include scholarships, bursaries, research fellowships, and support for teaching and research institutions to strengthen the country’s healthcare workforce.

In 2020, the Discovery Foundation awarded R24.5 million in grants to boost academic, specialist and rural medicine in areas of critical need. These grants were based on data that, by 2040, key healthcare areas such as cardiothoracic surgery, forensic pathology, neurosurgery, otorhinolaryngology, radiology, public health, and surgery will be in urgent need of specialists. Feminisation in the specialist field is also a key area of interest. Soon, we will announce the 2021 recipients, which no doubt will be another special cohort of doctors wanting to make an impact.

I consider the many impacts of the COVID-19 pandemic, and one of the most significant insights from this unexpected event was exposing and shining a light on healthcare systems globally. For South Africa, it was an indicator of our healthcare capabilities and an unveiling of what works and what needs to work better.

There are parallels between the rollout of the country’s vaccination programme and universal healthcare. I certainly see this rollout, which is on a progressive path, as a microcosm of how universal healthcare will work in South Africa, because it has to.

The vaccination programme is reliant on partnerships between the public, private and non-governmental sectors. Similar relationships are critical to achieving universal access to quality healthcare – a basic human right we must achieve.

Where we are right now

Minister of Home Affairs, Dr Aaron Motsoaledi, published a 2021 Critical Skills List detailing more than 100 skilled occupations that South Africa urgently needs to fill. The list includes a critical shortage of health sector professionals, including general medical practitioners and registered nurse specialists.

Research shows that an estimated 97 000 more health workers will be needed by 2025, and billions of rands in additional investment will be required to reach an equilibrium where there is a sufficient amount of doctors to treat a growing number of patients. 

Research by the Discovery Foundation in 2019 tells us that currently in South Africa there are 7 specialists per 100 000 population in the public sector and 69 per 100 000 population in the private sector, with an average national level of 16.5 per 100 000. This is low, relative to other upper-middle-income countries. By comparison, Turkey has more than double the number of specialists, and Cuba has eight times more specialists per 100 000 than South Africa, according to OECD data. The United Kingdom’s figures are three times higher.

In addition, our projections show that while the number of specialists is expected to more than double by 2040, this still falls way short of South Africa’s needs.

Nurturing future medical professionals

What is needed is a collective effort by the public, private and non-governmental sectors. My appeal is for corporate South Africa to prioritise improving access to education to strengthen our healthcare system for the collective good. 

In my tenure at Discovery, I’ve learnt that this is not a simple exercise, and we have had numerous learnings over the last two decades. But the data shows that change is definitely possible.

Data presentation: MediaHack Collective