ISC Presents: Science in Times of Crisis is a 5 part podcast series exploring what living in a world of crisis and geopolitical instability means for science and scientists around the world.
In Episode 2 we were joined by Salim Abdool Karim, a world leading clinical infectious diseases epidemiologist, widely recognized for his scientific and leadership contributions in the HIV/AIDS and COVID-19 pandemics and Mercedes Bustamante, Professor at the University of Brasilia, Brazil, and member of the Brazilian Academy of Sciences, who has contributed to vital multilateral conversations on ecosystems, land use and climate change.
In this episode we explore two examples, one thematic and one country-level, which highlight the way in which perceived national interests can impact on the capabilities of collaborative science, the scientific community and society. We explore two major issues – firstly, the COVID-19 pandemic and AIDS crisis and secondly, Brazil’s tumultuous science-policy nexus on issues such as climate change and the Amazon rainforest.
Holly Sommers: We exist at a time in which war, civil strife, disasters and climate change impact almost every corner of the globe. And crisis is, in many ways, an inevitability. Paired with this are the sensitive geopolitics that shape the way in which policymakers and governments prepare for and react to those crises.
I’m Holly Sommers and in this 5-part podcast series from the International Science Council we will explore the implications for science and scientists of a world characterized by crises and geopolitical instability.
As crises from health to the environment and conflict evolve all around the world, intergovernmental bodies such as the UN continue to emphasize the critical role that collaborative science plays in solving these global challenges. However, fractious geopolitics and sensitive national interests can directly impact societal outcomes.
In this episode we will explore two examples, one thematic and one country-level, which highlight how perceived national interests can impact on the capabilities of collaborative science, the scientific community and society. We’ll explore two major issues – firstly, the COVID-19 pandemic and AIDS crisis and secondly, Brazil’s tumultuous science-policy nexus on issues such as climate change and the Amazon rainforest.
Our first guest today is Professor Salim Abdool Karim, a world leading clinical infectious diseases epidemiologist, widely recognized for his scientific and leadership contributions in the HIV/AIDS and COVID-19 pandemics. He previously served as President of the South African Medical Research Council and as Chair of the South African Ministerial Advisory Committee on COVID-19. Salim was recently awarded the prestigious 2020 John Dirks Canada Gairdner Global Health Award for outstanding achievements in global health research along with his wife Quarraisha Abdool Karim, both of whom work for CAPRISA – the Centre For the Aids Programme of Research In South Africa. Professor Salim also happens to be Vice-President of the International Science Council.
We’ve had the most recent international health crisis with the pandemic caused by the SARS CoV 2 virus, but long before this novel Coronavirus, you were working on another global health crisis, HIV, and the inequalities that arose, particularly for those in lower and middle income countries with limited access to life-saving antiretroviral medication. Could you tell us a bit about your work in discovering how this medication prevented the spread of HIV?
Salim Abdool Karim: So let’s just go back to the year 1989. My wife and I, Quarraisha, had just got back from Columbia University, arrived in South Africa, and we knew that we were sitting on a huge potential problem in HIV. So one of the first things we did is, Quarraisha led a study that assessed the prevalence of HIV in a community in South Africa. And when we saw those results, at the end of 1989, we were stunned. Here was a situation where the prevalence of HIV was the highest in young teenage girls. So now it became clear to us that actually what we were dealing with is age disparate sex, that these teenage girls were getting HIV from men who are eight to ten years older than themselves. We started back in 1993, by working with a company in the US to make a little foam with a spermicide called Nonoxynol-9, and it took us 18 years of failure. In fact, at one stage, we were called the experts in failure. And it wasn’t until 2010 that we announced to the world that we had discovered that Tenofovir, an antiretroviral drug, made in a gel formulation was effective in preventing HIV, the first ever evidence of the ability to prevent HIV in young women. But essentially, we have spent about 33 years together, just trying to solve that one problem, how do we slow the HIV infection spread in young women?
Holly Sommers: And in what way did national and private interests play out over the years in terms of equitable access to those antiretroviral medications?
Salim Abdool Karim: When Quarraisha and I went to the conference in Vancouver, back in 1996, it was called Bridging the Gap. In fact, when we left that conference, the gap was even wider than when we arrived there. We heard terrific presentations about triple antiretroviral therapy, they had shown that the inclusion of a protease inhibitor in a three-drug combination was highly effective, and so came the name, highly active antiretroviral therapy, and it was saving lives. Problem was, it was too expensive. So it was only saving the lives of people in rich countries. And so when we went to the Geneva conference in 1998, things were even worse. Now, the gap was even bigger. The difference between survival in the developed world and developing world from HIV was getting worse, the differences were marked. So come 2000 and we are hosting the International AIDS Conference in South Africa. When President Nelson Mandela closed the conference, he received 17 standing ovations. And he, at the end, summarized it well when he said that this cannot continue, this reality that where you are born, determines whether you will live or die with HIV. And so it came to pass that all the key players, the drug companies, the academics, the service providers, the policy makers, the community organizations, the activists, we developed common purpose, we had to find a way to make drugs available. And within a matter of two years, the Global Fund was created for rich countries to put money into enabling poor countries to buy the drugs. But most importantly a mechanism was found, voluntary licensing. The big pharmaceutical companies were giving voluntary licenses to companies in India and China, and they were able to make the same drugs at a fraction of the price. And essentially, by 2002, it was my good friend Yusuf Hamied from the drug company Cipla that announced that he could make antiretroviral treatment, that three drugs available for $1 a day. That was it. I mean, that set the stage, we could save a life for $1 a day.
Holly Sommers: The COVID-19 pandemic provided a pertinent example of what happens when scientific advice and guidance on a health crisis comes up against different priorities at a national level. When you first heard about the virus, did you have any idea of the scale that it would reach? You’re an epidemiologist and a virologist, you saw the figures, and I imagine followed the early stages very closely. Did you worry then that countries wouldn’t take the threat seriously enough, and perhaps wouldn’t implement the necessary precautions and measures?
Salim Abdool Karim: I didn’t actually take it very seriously when I first heard about it. It wasn’t until I got back to the office on the 11th of January that my colleague comes up to see me, and he says to me, have you seen this on Twitter? The sequence of the virus is on Twitter. And we realized that we’re not dealing with SARS, that we’re dealing here with a different virus, it was sufficiently different in its sequence. And that’s when it became clear to me we were dealing with something quite serious. I was still very optimistic, but when I saw two things, the first was the announcement by my colleague George Gao, the head of the China CDC in late January, saying there is now unequivocal evidence of human to human spread. And I saw the first data come out on the mortality rates, that changed everything. And what became clear to me is that in a pandemic situation like this with so many countries affected, if you leave the distribution of essential goods, like vaccines, treatments and diagnostics, if you leave it to market forces, and you leave it to company executives to make the decisions about who gets these essential products, it’s very simple, they protect their markets. They are interested in making a profit, the worse the pandemic the more products they sell. So what we ended up with is a situation of gross inequity. But it was when we saw the vaccine situation that became most clear. Here was a situation where the US was now vaccinating low risk individuals, they’d vaccinated the elderly, they’d vaccinated the high risk individuals, vaccinated the healthcare workers, they were vaccinating low risk individuals. And we hadn’t received a single dose of vaccine yet in Africa, sorry within South Africa. And here was a situation where Canada had bought nine doses of vaccine for each of its citizens, and was already receiving supply, and we hadn’t had access to these vaccines. And so this gross inequity became for me, a moral dilemma and one that just highlighted that we cannot let private interests influence this because then all you have is they play countries off by other countries.
Holly Sommers: Professor, you were one of the leading members of the ISC’s COVID-19 Group, which produced the pandemic report unprecedented and unfinished, released in May 2022, which stressed the need for multilateral collaborative approaches to global threats such as COVID-19. Could you tell us more perhaps about the way in which a country’s national interests impacted their responses to COVID-19, perhaps beginning with the ignored and repeated warnings from scientists and researchers that this scale of a pandemic was extremely likely in our near future.
Salim Abdool Karim: Put very simply, you cannot deal with a pandemic as individual country epidemics, because there is no scenario that sees you beating the virus, if the spread is being highly contained in one part of the world and is spreading rampantly in another part of this world. And I think it couldn’t become clearer than Omicron. What we saw on the 24th of November, when we announced to the world that we had discovered this Omicron here in South Africa, that very evening the US imposed a travel ban on eight countries in Africa, six of which didn’t even have Omicron! And within a matter of days, several countries, the US, Canada, most of Europe, were all imposing travel bans on Africa. So the thing that got me was that actually a case of Omicron was present in Hong Kong even before we had announced it in South Africa, retrospectively when you look at it, there was a case already in Hong Kong, nobody imposed a travel ban on Hong Kong. And, you know, within days of our announcement, you had the UK announcing it had a case of Omicron, nobody instituted a travel ban against the UK. So it was clear to me that this is not just a travel ban, but there’s a racial element to it as well. And that was quite disappointing, that the world, in taking on a pandemic, decides that the way to deal with it is to punish the country that made the first announcement, not necessarily the country that was the source. I think that that highlighted how wrong we got at a global level in our response to this pandemic.
Holly Sommers: As you know, the International Science Council is calling for a new science advisory mechanism at the United Nations, at the multilateral level, to ensure that science is more present in these global policy processes. How do you think that the scientific community can best ensure global cooperation when, as we saw during the pandemic, these multilateral systems fall short?
Salim Abdool Karim: I think science can only go so far in that, you know, we can generate the knowledge we can generate the information. We can generate the new technologies, but fundamentally, it is our ability to talk to and talk with policymakers that translate our ideas into practice, into actual implementation on the ground. And that comes because we work at that interface, we work at the interface between science and policy. And it’s our job as scientists to make the evidence available in a way that is readily interpretable and is readily transformable into policy and practice. I think at the level of the multilateral system, that’s one level, but it’s got to happen at all levels, it’s got to happen at the country level, it’s got to happen at the local level. And if it doesn’t, then what happens is that we get top down, rather than top down and bottom up, that there is a meeting of the minds, the scientific evidence is being used to drive a common understanding and a common goal. And so I think that’s the challenge we face as scientists, is to find a way in which we talk not just in the language that we understand the scientists, we talk in a language that’s understood in the world of policy and practice.
Holly Sommers: After hearing about the way in which private, national and scientific interests have clashed at a global and international level. We turn now to Brazil, to explore the complicated science-policy nexus impacting critical issues such as climate change, indigenous rights and the Amazon rainforest.
Our second guest today is Professor Mercedes Bustamante. Mercedes is a Professor at the University of Brasilia, Brazil, and a member of the Brazilian Academy of Sciences. She was a co-coordinator of a chapter in the 5th Report of the Intergovernmental Panel on Climate Change (the IPCC) and is currently a member of the Science Steering Committee of the Science Panel for the Amazon, as well as lead author of the 6th Assessment Report of the IPCC. Mercedes has contributed to vital multilateral conversations on ecosystems, land use and climate change.
In 2019, Brazil’s National Institute for Space Research published data which clearly showed that levels of deforestation in the Amazon were rising, but President at the time, Bolsonaro, disputed the trend and attacked the credibility of the Institute, accusing them of falsifying the deforestation data. Bolsonaro then fired the physicist Ricardo Galvão, head of the Institute at the time. Mercedes, what has been the impact of the political climate in the past few years on Brazilian science? What was the direct impact of the disregard for scientific expertise, particularly on the Amazon, the land and its indigenous inhabitants?
Mercedes Bustamante: I think we can divide the impact on science into two processes. The first process is related to resource cuts. This period of government has been marked by a dramatic reduction in financial resources for science, both in universities as well as in research institutes. As a result, many projects had to reduce their work, and many others have completely stalled. The second process directly involves the example you just explained, the discrediting of scientific information. This example of the deforestation data was particularly emblematic because Brazil is a pioneer in monitoring the deforestation of tropical forests. The development of this monitoring has always been a reason for pride for Brazilian science. So, when Brazil’s president publicly discredits this kind of public information, this was a very heavy blow to Brazilian science.
Holly Sommers: And what do you think were the less visual impacts of this political climate? How has it affected Brazilian trust in science and in scientists?
Mercedes Bustamante: This process of discrediting science started at a moment in time where Brazil faced two crises in which science was essential: the environmental challenge and the health challenge. It was not just about discrediting what was happening within the Amazon region and the monitoring of other biomes’, but also about discrediting vaccine campaigns and necessary public health measures, like social distancing in order to face the Covid-19 pandemic. So, we had the convergence of two crises: the sanitary crisis and the environmental crisis. And exactly at this moment, where science was most needed, it was most attacked. I believe that the Brazilian population still believes in science, but I’m aware that nowadays we have some “cracks” in its credibility due to this campaign of denial.
Holly Sommers: Mercedes, what do you think will be the long-term consequences of the political climate of the last few years on Brazilian science more generally ?
Mercedes Bustamante: I believe the most enduring effect that will emerge from this crisis will be in human resources development. Financial limitations impacted most master’s and doctoral scholarships, as well as research grants for young Brazilian researchers. Hence, these young Brazilian researchers now feel little motivation to pursue an academic career. At the same time Brazil is facing what we call a “brain drain”. A lot of young, talented researchers are leaving Brazil in order to continue their work at international institutions. So, this will create a very important gap, because when one generation leaves, a new one is needed to replace them. So, I believe this will have a very significant long-term impact.
Holly Sommers: Policies implemented during the Bolsonaro administration incited violence and socio-environmental conflicts on indigenous territories in the Brazilian Amazon. I wonder, Mercedes, how do you think that Brazilian science can help to ensure that indigenous land, people, and their knowledge are protected at the national level?
Mercedes Bustamante: This is a very critical case, our indigenous people suffered many attacks, a lot of harm, and part of their rights were suppressed during the last few years. Important points where I believe science can contribute are: first, the recognition of the important role of science in relation to the conservation of nature in indigenous territories. Indigenous territories in Brazil are those with the lowest deforestation indexes in the country, and the highest protection of fauna, flora, and whole ecosystems. Another important contribution is the approximation of traditional science with indigenous knowledge. For example, the Brazilian Academy of Science recently elected Davi Kopenawa, from the Yanomami tribe, as one of its members, in order to approximate their knowledge with that of traditional science. This dialogue among different knowledge systems is also a form of valuing and recognizing the contribution of these people. So I think these are important points, and also scientific knowledge has contributed to legal processes running in court in favor of indigenous people.
Holly Sommers: And Mercedes, how do you think that Brazil can best build its scientific community back to strength, as well as repair the relationship between Brazilian science and Brazilian citizens?
Mercedes Bustamante: Brazilian science is very resilient. I tell you, I’ve had almost thirty years of being a part of a Brazilian university, and we’ve already been through various crises. But this one has been a very acute crisis because it combined a financial crisis with the need to defend science’s reputation. But during all those crises we were capable of rebuilding, because, as I believe, we have a community which sees science as a tool to leverage the country’s development. So, I believe we will have to restart in many places, but I feel there is motivation and hope that this can be done over the next few years. It won’t be easy, and it will take time, but I believe it is possible. Another important aspect of this crisis, for me, is that I see more researchers motivated to amplify their communication activities to reach public opinion in general. So, what I perceive is that when we were attacked, it was important to have bridges connecting us with civil society. I think this is a trend that will continue to strengthen and will be irreversible. Currently, scientists understand that they need to communicate better with civil society, which pays for the research done inside our laboratories.
Holly Sommers: Mercedes, how do you think that the international scientific community can best support Brazilian science?
Mercedes Bustamante: International support has been essential during these past few years, and I think it will also be essential during this reconstruction process. It has always been very important in Brazil when important journals like Nature, Science and other major scientific journals publish editorials about Brazil, supporting the fight against deforestation and protecting indigenous people. This also reverberated within the national press. Hence, this support is coming not only from prominent scientific journals but also from international scientific associations, and this has been essential in keeping the flame lit and warranting the resiliency of the Brazilian scientific community. And again, I believe Brazil went through many years where international cooperation was an important component of the growth of the Brazilian scientific community. I hope this can be resumed, not only in the sense of contributing with new ideas, but we also have to think about the fact that Brazil shares ecosystems with other South American countries. We have a part of the Amazon basin, but the Amazon spreads over other countries. We have a part of the Plata basin, but other countries share the Plata basin with us. So, this international cooperation, and, in particular, this South-South cooperation with countries who share similar problems to Brazil will be essential to recover not only lost time, but the period where we moved more slowly.
Holly Sommers: And how do you feel about the future of the science sector and scientists in Brazil? Do you feel hopeful for the future? And do you believe that science will be able to improve and be part of policy and decision making on the national level?
Mercedes Bustamante: I have hope; we already feel winds of change. We are breathing a slightly lighter air, tensions still exist, the country still needs to overcome its internal division, but speeches we’ve heard up to now from the newly elected government are very anchored in science’s value for Brazil. So I believe, as I already said, that this process won’t be quick, as Brazil will have to face some very critical issues in its national budget. Priorities exist because there are millions of people in a situation of food insecurity – I think this is Brazil’s first challenge – but at the same time we’ve already perceived the intention to have more support for young researchers, which I believe is the critical point for the recovery of our science-making capacity. I think signals received up to this moment have been very positive, and I also feel that attacks have diminished. So, both aspects give us hope for resumption, but always with a realistic perspective that it won’t be an immediate process. It’s much easier to destroy than to build. In particular for scientific activity, we need about ten years to fully train a young PhD fellow. Hence, a hiatus of four years is very significant.
Holly Sommers: We wrapped up our conversations with two questions aimed at the future, for Salim, the future role of scientific collaboration, and for Mercedes, the feeling amongst Brazilian scientists as a new political chapter begins.
Salim Abdool Karim: It doesn’t matter what our political persuasion is, doesn’t matter what our sexual orientation is, it doesn’t matter which country we come from doesn’t matter what gender we are. We are fundamentally joined, we are joined across political boundaries, geographical boundaries, we are joined, because we’re all trying to, to solve the individual bits and pieces in the puzzle, to try and fix a problem. And as each of us is doing this, we depend on each other. We share reagents, we depend on what new knowledge you generate, it helps me do what I’m doing. And so our ability to collaborate across these divides, is at a different level to politicians and others. So science, in that sense, is a healer. Science is the opportunity to come together. It’s the opportunity to bridge the divide, and work with each other to solve the problems of humanity. And I think that that’s the strength that we bring to the table.
Mercedes Bustamante: This new government brings, for many researchers, the memories of the previous periods where Lula was president. At that time, we had plenty of financial resources, many universities were created, and many training programs were expanded. So scientists remember this period as very favorable for Brazilian science. We know that we won’t be able to live those times with plenty of resources again, but Brazilian scientists are very resilient and efficient in utilizing resources, we can do a lot with very few. But the single fact that we won’t need to split our focus and energy between obtaining resources, managing labs, educating students and having to fight misinformation, denialism and the discrediting of science, I think is already a big relief. This will allow us to concentrate more energy on what is really essential. Another worry I think all Brazilian scientists share is, but especially those working in the environmental arena, is having a channel to bring scientific evidence back into the formation of public policy. Many of these channels to insert science into public policy have been closed during the last four years. So, we also are hoping that the participation of the scientific community in public policy is reopened, allowing us to bring our best to the whole of society.
Holly Sommers: Thank you so much for listening to this episode of Science in Times of Crisis. In the next episode of our series we’ll explore the impact of conflict on current and critical issues that science is at the heart of. We’ll be joined by Dr Melody Burkins, Director of the Institute of Arctic Studies at Dartmouth to discuss the scientific impact of current conflict on the Arctic. As well as the former general Secretary of the world’s largest astronomical organization, Piero Benvenuti, to discuss collaboration and conflict in outer space.
— The opinions, conclusions and recommendations in this podcast are those of the guests themselves and not necessarily those of the International Science Council —
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