FROM her school days as an academically gifted child in Chatsworth winning the Dux award in matric, medical scientist and the deputy director at the Centre for the AIDS Programme of Research in South Africa (CAPRISA), Professor Kogie Naidoo, has impressed those around her. She is now regarded as one of South Africa’s most accomplished medical TB expert in HIV/TB co-infection treatment and multi-drug resistant TB. KIRU NAIDOO tracked her down at the Palais des Congrès de Paris in Paris, France, where she received the ‘Outstanding Female Scientist Prize’, from the European Union’s (EU) European Developing Countries Clinical Trials Partnership (EDCTP). This prize recognises “world-leading female scientists in sub-Saharan Africa working on HIV/AIDS, tuberculosis, malaria and neglected infectious diseases”.
Q: You brought our country great pride.
A: I am pleased that South African scientists are being recognised for their incredible work. Personally, I am honoured to be recognised for my work that affects predominantly the poor and marginalised communities in South Africa and indeed in Africa. We have a global health emergency in TB and HIV/AIDS.
Q: Where did your journey begin?
A: My parents believed in the power of education - even though they had no money to complete their high school education. What they did not have for themselves, they wanted for their children. I grew up in a supportive and nurturing community in Bayview, Chatsworth, where I knew all the neighbours. There was a sense of community, which is dissipating today due to the demands of life. I went to public schools at Fairhaven Primary and Protea Secondary, which had the most extraordinary and dedicated teachers. There was hardship and a struggle to make ends meet in the communities where I grew up. This defined my path from an early age to contribute to community upliftment wherever I could.
Q: Did you think that medical school would give you that opportunity?
A: When I was growing up, good medical treatment was reserved for whites under the apartheid system. Most people could not afford doctors and resorted to home remedies. This has changed in our democracy but inequity in health care access and affordability still prevails. All I knew was that I really wanted to help the community uplift themselves. I wanted to be responsive to the suffering. I wanted to be in a profession that served.
Q: Was it easy getting into medical school?
A: My parents both came from humble beginnings and despite their hard work, they could not afford to send me to medical school. Together, they were a powerful influence on their children. I was fortunate that I won a bursary that covered my tuition costs due to my academic results. Throughout my undergraduate studies, I worked part-time to help fund my education.
Q: Did you have an inkling about a career in research?
A: In my senior medical school years, I secured a scholarship for underprivileged students from the Ford Foundation in the United States. I continued to work as a junior researcher collecting data for four years from the clinical notes of local doctors. From that information, I could see patterns in the relationship between medicine and science, and how one could build a story about the health priorities in a community. My passion for science and its value for society grew.
Q: What did you encounter as a doctor fresh out of medical school?
A: My work was in paediatrics in the early 1990s. I was struck by the fact that we were seeing an increasing number of pregnant women in the 15 to 39-year age bracket who were HIV positive. As a young doctor, all I saw was dying babies and sick mothers. During this placement, I discovered one in three women was HIV-positive. I changed focus and wanted to understand and do all I could in HIV.
Q: You were no doubt shaken by this?
A: I had a conversation with Professors Jack Moodley and (the late) Jerry Coovadia telling them that I wanted to be part of a solution to the unfolding medical catastrophe. The door was opened for me to get involved in some of the earliest clinical trials on HIV/AIDS infection, and in particular mother-to-child transmissions. For ten years I immersed myself in HIV and AIDS treatment and prevention. I discovered that many of these women were dying of tuberculosis, and knew that if we didn’t address TB, we could not stop the advancing HIV–AIDS pandemic - a disease caused by poverty and inequities in the health system.
Q: What were the interventions?
A: We set up clinics because the mothers had nowhere to go for treatment and the infections had to be managed. Those pioneering teams led by Professors Coovadia and Salim Abdool Karim, worked to galvanise government, civil society and scientists to provide lifesaving antiretrovirals (ARVs) to people infected with HIV. There were many barriers like AIDS denialism by the government at the time. I saw first-hand the impact of ARVs but people were still dying of TB. I knew that we had to understand the connection between HIV and TB through rigorous research.
Q: You are deputy director of CAPRISA, which is one of the world’s leading HIV/AIDS research centres. How did you make that transition from the hospital into the lab?
A: In 2002, Professor Salim Abdool Karim (Slim) was looking for a doctor with experience in managing HIV patients. He was talking to colleagues in a hotel in New York when Prof Jerry Friedland, a professor from Yale University who was one of my early mentors, mentioned me to him. Slim then contacted me, and I joined CAPRISA six months after it was established in 2002.
Q: CAPRISA’s work has been a game changer in global science.
A: In our study we found that the lives of half the people with co-infections of HIV and TB were saved by starting antiretroviral treatment (ART) at the same time as tuberculosis treatment. Our study showed a 56% lower mortality compared with waiting for tuberculosis treatment to finish before prescribing ARVs. These seminal findings in our study had a profound impact and changed local and international guidelines for treatment of HIV/TB co-infected patients. Our study led to the World Health Organization (WHO) publishing advice that co-treatment would now be standard-of-care for people living with both conditions. Our diverse medical research continues to save lives through these clear guidelines for doctors and patients.
Q: Is there much more work that needs to be done?
A: TB remains the number one medical cause of death in South Africa and the world. Studies aimed at finding better strategies for finding, preventing and treating TB are incredibly important. Several TB vaccine trials for preventing TB in people with HIV are under way. There is a need to understand the complexities of multi-drug resistant TB to establish robust diagnosis and treatment.
Q: Being feted by your peers in Paris brings you great joy but you also have the stellar accolade of being admitted as a Fellow of the Royal Society of South Africa.
A: Yes, I was admitted as Fellow of the Royal Society of South Africa a few weeks ago. I have not been asked to sign that book where Darwin, Einstein and others have their names. (She chuckles.)
Q: Is South African science under-rated?
A: We have brilliant scientists in South Africa across disciplines and in multi-disciplinary teams. We saw the incredible efforts of scientists across South Africa during the Covid-19 pandemic. To expand our science base there is a need for government and industry investment in expanding current research, investment in training the next generation of scientists and in providing the resources for young scientists to thrive and flourish. This is important to advance new knowledge, foster collaboration, and ensure ongoing innovation and responsiveness in science to make a difference to human lives – and this requires funding. We must appreciate that work in medicine and science is about making lives better.
Q: You remain energised. What’s on your agenda going forward, aside from research?
A: Global health equity and having a platform to make a difference to health outcomes are among my priorities. We must continue to innovate and impact public health policies, including strengthening health systems which is desperately needed. I will continue to invest my effort in research into saving lives of people with HIV and TB. My research focus on finding, preventing and optimising TB and HIV treatment including better diagnosis and treatment in multi-drug resistant TB will continue, as will my extensive collaborations with colleagues in Africa, Europe, USA, South East Asia and elsewhere. I am deeply committed to capacity building - training the next generation of scientists. With my professorial responsibilities at the University of KwaZulu-Natal, I have mentored a slew of PhD and post-doctoral students. Of these, 95% are black African women.