Pandemics, curiosity investments and all the facets of decision-making – interview with Prof. Quarraisha Abdool Karim

“When we come together with unity of purpose, we can achieve great things.”

The World Science Forum (WSF) had the opportunity to speak with Professor Quarraisha Abdool Karim, president of TWAS and Associate Scientific Director of CAPRISA, amongst the many sessions she had been moderating or speaking at during this year’s event. A wide range of topics came up in our conversation, including rethinking open science and science literacy, the need for investments in science, the safety of scientists and the effects of conflict, and helping women scientists thrive.

Professor Abdool Karim spoke about the sessions she took part in in this year’s Forum, several of which were on the theme of “Trust in Science”. The multiple sessions on the theme unpacked a granular understanding of science and its impact on society from different scientific perspectives by a range of stakeholders. “The session on Open Science and science literacy in this context was really important in terms of understanding attempts that have been made over several years on addressing the asymmetry in the knowledge generation process, notably between the Global North and Global South. While most discussions on Open Science focus on co-authorship, this session went beyond one output of knowledge generation, namely, peer review literature, to examining access to products emanating from collaborations and investments in skills development, knowledge transfer and infrastructure investments to bridge knowledge generation gaps between the global North and South.” 

Taking the topic further, Prof. Abdool Karim used the COVID-19 years to illustrate how, despite countries in the Global South having participated in the evaluation of several vaccines, access and distribution of vaccines was uneven for the Global South: epidemics and pandemics highlight our “shared vulnerability and our interconnectedness”. She said “When solutions are not shared fairly or equitably, the pathogen thrives, as we witnessed during COVID-19, and another example where sharing information openly as South African scientists did during the emergence of the Omicron variant resulted in a travel ban by several countries in the Global North for the entire southern African region.” These are concrete examples of where Open Science needs to be rethought in her view. 

She also spoke about the importance of funding ongoing investments in science, how sustained investment in research enables rapid pivoting when new threats emerge, as shown by the experience of scientists like Katalin Karikó, who had been working on the mRNA technology for decades that, enabling it to be used very rapidly for the development of COVID-19 vaccines.

She believes these kinds of discoveries do not automatically happen: “we have to balance mission-oriented investments with curiosity investments, because the discoveries from curiosity research enable the innovation for mission-driven science. Undertaking biomedical research is high-risk, and more often than not does not produce the desired outcomes. However, we learn and understand the phenomenon better and move forward incrementally. This persistence and perseverance is a hallmark of scientific endeavours together with vigorous debates and discussions of findings.”  

Turning to the topic of science literacy, Abdool Karim pointed out that, with COVID-19, debates in the public about the vaccine led the public to think that scientists cannot agree, making it all the more important that we in science should take the public with us in the scientific methodology and should demystify it for them, and not in a paternalistic or patronising way, but in a way which respects the existing knowledge and issues that underpin decision-making that can be context-specific.

She recalls the government-mandated interventions during the pandemic which did not take the low-middle-income strata into account: “so people who had to go to work, who were dependent on daily wages, whose whole life got turned upside down, because of schools closures and lockdowns … that did not take into account that not everybody had the luxury of connectivity, or data, or the internet and computers to continue their lives virtually, and those differences highlighted for me, particularly – and I think for many people – that this was not just a pathogen, but it was about lives and livelihoods.” This leads her to believe governments, and people, have to consider all the facets of decision-making, from the social, to the economic, as well as the political.

Prof. Abdool Karim continued by talking about her work at CAPRISA, which focuses on epidemics and pandemics: HIV, TB, sexually transmitted infections, and, more recently, COVID-19 and mpox. She and her husband Salim founded the organisation in 1990 as South Africa and sub-Saharan Africa were facing a disproportionate share of the global HIV burden, and life expectancy was dropping very rapidly, particularly amongst the most economically active segments of society. Most governments in Africa or people living with HIV in this region could not afford the high costs of triple anti-retroviral therapy. In South Africa alone, more than five million people were living with HIV around 2000, when “we were also seeing a resurgence in TB as a result of advancing HIV disease. This served as a reminder that when we have one pandemic, we cannot forget about other incomplete epidemics because that’s when you get outbreaks, epidemics and pandemics if you do not intervene appropriately, in the right places.” 

Around 2000, activism and advocacy had led to a moment of global solidarity, with the establishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), substantial reductions in the price of drugs to under one U.S. dollar a day, government investments, and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which to date have given about 30 million people living with HIV access to these life-saving medications.  “Today, most people have access to treatment. It is a wonderful example of global solidarity and also how, when we come together with unity of purpose, we can achieve great things.” She notes that profit from diagnostics, vaccines and therapeutics and the ethical values of respect, justice and beneficence are not mutually exclusive goals. 

Prof. Abdool Karim highlights that when proper scientific investment is available and made, organisations like CAPRISA and other African institutes can respond to various adversities much more effectively and quickly. CAPRISA already had the research infrastructure for diagnostics and to undertake clinical trials and the platform to train scientists, which was built for responding to HIV and TB, that enabled rapid pivoting to respond to COVID-19. “Our lab was able to set up the diagnostic assay within days of the gene sequences becoming available … We were able to use our gene sequencing infrastructure to monitor mutations of SARS-Cov-2 and alert the world to the emergence of variants of concern, including Omicron. … So even though we may not have had a cure or a vaccine for HIV, that infrastructure allowed us to pivot to respond to COVID-19.”

Reflecting on The World Academy of Sciences (TWAS), she talked about its background, being founded in 1983 by Professor Abdus Salam, who had won the Nobel Prize in 1979 after establishing ICTP in Trieste, Italy in 1964. “TWAS was set up by a man who envisioned that science and technology would lead to sustainable development and be the bridge for low-middle-income countries to uplift their communities from poverty, from hunger, from disenfranchisement, to really reach their full potential.” The professor said: “those are very much the same values, the same vision, that’s bringing us together with the SDG 2030 goals, the same vision that makes us think about sustainability for future generations.” 

Prof. Abdool Karim talked about TWAS’s efforts at building a critical mass of skilled scientists in the Global South to take on and address the multitude of challenges facing different communities and how, in more recent times, the substantial rise in wars and conflicts are disproportionally affecting the Global South and undermining these efforts. The increase in displaced and migrant populations and targeted efforts to destroy educational institutions and research infrastructure “is reversing our decades of investment in science capacity-building and training, disappearing within minutes, seconds, hours in front of our eyes.” 

As a consequence, the Global South not only faces safety issues for its scientists, but also the intergenerational impacts of disrupted primary and secondary schooling. Under these circumstances, it is all the more important to explore novel approaches to nurture the critical knowledge generated so that it does not leave these countries and to support those scientists who remain in their countries, which underscores the importance of peace for sustainable development for all. 

One of the topics discussed at the WSF was Education for Sustainable Development, where novel approaches included transformative pedagogy for primary, secondary and tertiary education as well as the training of educators and getting the public involved in science more: “we find repeatedly school kids are amazing. It’s that innate curiosity. And there’s a thing about when you learn about things that give you the power to think about solutions or amplify that, and so we are seeing lots of really great examples of school kids gathering data for scientists … you don’t need a big team, big budget, but by creative use of the resources we have, what you’re having is core knowledge generation, co-creation of that knowledge, co-design of that, which also means co-ownership, because you see yourself not being told ‘I need to contribute to carbon emission reduction’, for example, but ‘I can actually contribute to the knowledge that shows these are the success stories.’” 

Turning to the topic of women in science, Prof. Abdool Karim highlighted that there is still a long way to go for women, despite advancements. She says national and regional academies only have 10% to 16% of women in membership and even less in leadership positions. Increasing the number of role models inspires young women to dream and believe that they have a place in these institutions and academies. “And it’s not a token affirmative action process, but creating the space for women’s voices to be heard, women to contribute in the context of complex challenges that face us is no longer a luxury – we need all voices heard and opportunities created for all to contribute.”

She mentions 80% of CAPRISA being made up of women highlighted that “environments can be created where women feel they belong, and we can see from the 20 years of CAPRISA’s existence how creating a supportive space for women has enabled a lot of women to thrive, to make their contributions and be constantly making cutting-edge contributions. So this is a concrete example. It’s not just rhetoric; it's not idealism that we can make it happen, and we need to illustrate that more and more because that means inclusivity at all levels, which bodes well for human security and planetary health.”  

The professor believes a more holistic approach is needed as to the question of gender equity in science. She talked about how all the responsibility should not be borne by women only when it comes to parenting: “when we have parental leave, we encourage co-parenting, co-responsibility and parallel development of both parents’ professional careers. And I feel like these and other things in the workplace dissuade women from pursuing careers.” She talked about how medical schools start off 60% to 70% female, “but then when you go up on the leadership level we see a leaky pipeline – I believe in the 21st century, you should have the choice to make the decisions and the supportive environment to do that.”