Four researchers from the Desmond Tutu TB Centre (DTTC) at Stellenbosch University have recently graduated with PhDs after conducting research which holds valuable lessons for the way TB and HIV is managed in South Africa.
Sue-Ann Meehan’s research followed her extensive experience in setting up mobile HIV testing clinics, where encouragingly a large number of men were tested for HIV. Meehan showed that men made up more than half of the over 180,000 people who visited the DTTC’s mobile testing centres.
Specially made tents and caravans were set up at taxi ranks and other easily accessible public places in and around Cape Town. Waiting times were significantly shorter at the mobile units than at clinics and many people who tested HIV-positive linked to clinics to start treatment.
“Not everyone accesses clinics and so community-based HIV testing services have a vital role to play in finding and diagnosing those living with HIV,” said Meehan.
In his PhD research, Peter Bock, who co-leads a global study on HIV prevention, found that providing antiretroviral treatment (ART) to people with high CD4 counts resulted in a 63% reduction in the incidence of TB. However, he also found that a high proportion of people who received ART when their CD4 counts were high, did not continue taking ART.
“I hope to continue with meaningful HIV work. If my research can contribute to both local and global efforts against HIV, I would really value that. I’m very grateful for the opportunity to work in the HIV treatment field, which can lead to positive and groundbreaking health effects for people in communities,” said Bock.
Rory Dunbar developed an operational model to explain why GeneXpert - a new molecular diagnostic test for TB - led to a 157% increase in cost, yet did not lead to an increase in the number of tuberculosis cases that were diagnosed. His research recommended that improving the systems at clinics as well as reducing the test costs would ensure that the test could be more affordable and lead to more TB cases being diagnosed.
Dunbar said it had been a tough but rewarding few years. “It’s been long hours grafting away to get a PhD, but I always remember the bigger picture - that I’m working to improve people’s health and living conditions. I hope that my research will help policy makers as well as the Health department to better strategise and implement diagnostics for TB in future.”
Florian Marx’s mathematical modeling work focused on detecting and preventing the transmission of TB among former TB patients. His research showed that focused interventions to detect and prevent tuberculosis among former TB patients could substantially reduce the transmission of TB in the entire local population.
Mariana Kruger, executive head of the Department of Paediatrics and Child Health in Stellenbosch University’s Faculty of Medicine and Health Sciences, said the four researchers had done incredible work. “The knowledge these four researchers have generated will tremendously benefit public health policy and programmes.”
Kruger said it was very significant that four researchers from the same research centre graduated with PhD degrees at the same time. This was a real boost for the Desmond Tutu TB Centre as well as the faculty. She also credited former director of the DTTC, Nulda Beyers, who was the supervisor for all four graduates.
“Nulda put tremendous effort into this. It’s a mammoth task to supervise four PhDs at the same time and to have them all finish at the same time too.”
Beyers said it had been a privilege working with each one of them. “It is fantastic to see how they have developed as young scientists, the way they can reason through science, and also very importantly, how they have developed as people. A PhD is not a doctorate in science. It’s a doctorate in philosophy. So it’s really about life.”
Beyers said she hoped the benefits and challenges outlined in the research would be a priority for programme implementers in the Department of Health.
“This research could help advise how to manage TB and HIV. We have very good policies in South Africa, but this research will help to show how these policies can be implemented to benefit the diagnosis and treatment of TB and HIV.”
Professors Kruger and Beyers applauded Stellenbosch University for providing financial support for Dunbar, a quadriplegic, to be able to travel to national and international meetings with an assistant. The university has also made the DTTC offices wheelchair-friendly and created a garden for Dunbar’s worker dog, Vaughn.
“I am profoundly proud to be associated with a university that not only talks equality, but acts equality for disabled colleagues,” Beyers said at the graduation ceremony in March.
The four graduates said they were looking forward to some free nights and weekends now that they have wrapped up their PhD studies, but would continue to reflect on the past few years.
“Working at the DTTC has been a wonderfully supportive environment in which to do a PhD. The journey has been a mix of more highs than lows, a huge amount of hard work and determination…and a lot of chocolate,” said Meehan.