Tributes pour in for acclaimed medical pioneer
Bongani Mayosi, a cardiologist whose pioneering research changed the way doctors treat tuberculous pericarditis, committed suicide in Cape Town on Friday. He was 51.
Born in Mthatha in the Eastern Cape, Mayosi was inspired to pursue a career in medicine by his father, who was a rural doctor. His career took him to the pinnacle of academic medicine, but his work as a clinician scientist had influence far beyond the laboratory bench.
“His love for clinical research and capacity development, coupled with an innate intellect, quickly propelled him into a leader in clinical medicine and cardiology,” says Medical Research Council president Glenda Gray. “He always inspired me. Over our coffee meetings in Cape Town, we would dream about a future for clinical research in SA and how we could conspire to make this realisable,” she says.
At the time of his death, Mayosi was dean of the faculty of health sciences at the University of Cape Town (UCT), a post he took up in 2016 after a decade-long stint as head of its department of medicine. There he was forced to grapple with the competing demands of research, clinical practice and administration in an institution still scarred by the aftermath of protests by the Fees Must Fall movement, which in 2015 launched a violent nationwide campaign to demand free higher education.
The student protests triggered an unprecedented exodus of academics from UCT, a sign of the stress that continues to this day. Mayosi’s office was occupied by protesting students in 2016 and he took several months off work in 2017 due to the strain of the job.
His family issued a statement shortly after his death on Friday, saying that Mayosi had been battling depression for the past two years.
There is a strikingly high prevalence of suicide among doctors worldwide and SA is no exception, notes Salim Abdool Karim, co-director of the Centre for the Aids Programme of Research in SA. Karim, who had known Mayosi for the better part of 20 years, recently attended a 35-year reunion for his graduating medical class. He was struck, he says, by the number of their peers who had committed suicide. “It was the leading cause of death,” he says.
Mayosi studied medicine at the University of KwaZulu-Natal and went on to win a prestigious fellowship to the University of Oxford, where he studied the genetics underpinning cardiovascular risk factors. He returned to SA in 2001 to take up a post at UCT and Groote Schuur, and in 2009 was awarded the presidential order of Mapungubwe for his contribution to medicine.
Energetic, warm and charismatic, Mayosi researched heart conditions that are rare in developed countries but common in developing nations — rheumatic heart disease, tuberculous pericarditis and idiopathic cardiomyopathy.
His most influential work was a groundbreaking study on tuberculous pericarditis, published in the New England Journal of Medicine in 2014, which showed that treatment with inflammation-fighting corticosteroids tripled the risk of cancer in patients who also had HIV.
Tuberculous pericarditis occurs in about 10% of TB patients, many of whom also have HIV. It causes a build-up of fluid and compression of the heart and kills a quarter of the patients who get it. The Investigation of the Management of Pericarditis trial, which included patients in eight African countries, changed the way the condition is treated and had an immediate impact in countries with a high HIV rate.
Mayosi also helped identify a new gene responsible for sudden-death syndrome, which causes otherwise healthy athletes and young people to go into cardiac arrest, and led research that highlighted the neglect of rheumatic heart disease in many of the worst affected countries. Rheumatic heart diseases is triggered by untreated rheumatic fever, which is caused by streptococcus A infection. A simple course of antibiotics can stop it in its tracks.
He was deeply committed to growing the next generation of clinician scientists, and lent his support to the health department’s drive to create 1,000 new PhDs within 10 years. He was held in high regard by the health minister, who appointed him head of a task team to probe problems at the Health Professionals Council of SA in 2015.
The tributes that have poured in from the government, academics and the medical profession over the past few days highlight his multiple contributions to SA, says South African Medical Association deputy chairman Mark Sonderup, a hepatologist at UCT.
Mayosi is survived by his wife, UCT dermatology professor Nonhlanhla Khumalo, and their two daughters.