South Africa: Lighting a Candle for Mayosi's Legacy

"If we want to raise the bar for health in Africa, we must begin by supporting African scientists, working on African soil, addressing African problems."

This was the crux of Professor George Mensah's message during the inaugural memorial lecture held in honour of his "friend, professional colleague and ... wiser younger brother from another mother", Professor Bongani Mayosi - the late dean of the University of Cape Town's (UCT) Faculty of Health Sciences.

Professor Mensah currently serves as the director of the Center for Translation Research and Implementation Science at the National Heart, Lung, and Blood Institute, a part of the National Institutes of Health (NIH) in the United States (US).

Due to COVID-19 precautionary restrictions on gatherings, the inaugural public lecture was held virtually on Thursday, 28 January 2021 (which would have been Professor Mayosi's 54th birthday). Set to take place annually on this date, the Bongani Mayosi Memorial Lecture will be held in celebration of the legacy he left, especially in terms of African scholarship and research excellence.

Mensah was a close friend and respected colleague of Mayosi, and he expressed his continued grief at the tragic passing of his friend and colleague in 2018.

"The Bongani Mayosi Memorial Lecture is a fitting tribute to a man who dedicated his life to excellence in patient care, teaching and research."

"[However], today is not a day to look at the sadness and the darkness," Mensah noted. "As US president John Kennedy said: We are here not to curse the darkness; we are here to light a candle."

Following their first meeting in the late 1990s at a cardiology symposium in Cape Town, Mensah and Mayosi built a fast friendship and professional collaborative association based on the firm foundation of their shared determination to improve the health of the African continent through African-led scholarship.

Mayosi's own commitment to this ideal was perhaps most clearly expressed during his 2007 inaugural lecture, when he shared the vision of enrolling 1 000 clinical PhD scholars "who will change the fortunes of clinical medicine in Africa for the next 100 years". To realise this dream, he introduced an intercalated MBChB/PhD degree to "train and inspire a new generation of clinical researchers to replace the ageing pool of largely white male and white academics in health science faculties".

Mensah said that the Bongani Mayosi Memorial Lecture is a fitting tribute to a man who dedicated his life to excellence in patient care, teaching and research.

HIV research successes

During his lecture, Mensah highlighted the major national and global contributions South African researchers have made in the prevention and treatment of HIV/AIDS as an area of particular excellence that is deserving of genuine celebration.

"Along with international collaborators, the South has made pivotal contributions to biomedical prevention modalities that has contributed markedly to the survival of HIV-infected infants, children and adults," he said.

"A lot of this is based on the elegant work that has been done in South Africa."

"We have to ... work even harder to support African scientists working on African soil addressing these African challenges."

While these contributions to HIV/AIDS research are in and of themselves worthy achievements, this focus has also enabled South African researchers to turn their attention effectively to combatting COVID-19.

"The remarkable infrastructure that South Africa has built for HIV prevention and vaccine trials, as well as HIV surveillance, ha[s], collectively, poised South Africa to rapidly pivot to ... COVID-19 vaccine research," Mensah said.

In her closing address, Vice-Chancellor Professor Mamokgethi Phakeng underscored this by saying that UCT has already been awarded 41 contracts for COVID-19-related research, and opportunities continue to emerge.

Spotlight on cardiovascular disease

While many hurdles have been and continue to be overcome in terms of HIV/AIDS research and - more recently - COVID-19, Mensah suggested that a steady rise in non-communicable diseases is the next big challenge that African researchers face.

Citing a 2012 report published by the South African Medical Research Council and the Burden of Disease Research Unit, he said that South Africans are dying slowly of chronic diseases caused by hypertension, tobacco use, raised blood pressure, diabetes and psychosocial stress.

Mensah added that Mayosi had himself shown convincingly in a Lancet paper that over a seven-year period between 1999 and 2006, among both men and women, there had been a gradual and persistent rise of stroke and other ill-defined heart diseases, as well as heart attacks.

"Bongani talked about this 10 years ago," said Mensah. "These are challenges that have not gone away and, if we are here to celebrate his legacy, we have to keep that in mind and work even harder to support African scientists working on African soil addressing these African challenges."

Supporting African research excellence

This is something the NIH takes very seriously, Mensah said.

"As of the end of the fiscal year 2019, there are almost 1 700 active grants that the NIH has been supporting in sub-Saharan Africa," he elaborated.

There is also the African Postdoctoral Training Initiative, which funds 10 African postdoc fellows for two years with full support in NIH laboratories, after which they return to their African home institutions with an additional two years of support.

The initiative is supported by the NIH Director's Discretionary Fund, in partnership with the Bill & Melinda Gates Foundation and implemented by the African Academy of Sciences. The first cohort started their programme in January/February 2019.

"We are very proud of the diversity of the fellows," said Mensah. "They are from at least nine different institutions and six African countries and include three women scientists. Eventually, we aim to have at least half African women."

The Bongani Mayosi Foundation

Appropriately, the Bongani Mayosi Foundation - chaired by Sizwe Nxasana - is also committed to supporting and inspiring up-and-coming African researchers through a number of legacy projects.

These include the launch of the UCT Bongani Mayosi Legacy Project in January 2020. The project is set to continue with the repurposing and refurbishing of identified spaces "for undergrad as well as postgrad students to do their studies, their research, as well as interact with others," said Nxasana.

Furthermore, Siyafunda is a maths and science programme launched to support high school learners who are pursuing these subjects at schools in underserved communities.

"Prof Mayosi represented black excellence. [He was] living proof that black scholars can be the best in whatever they do. He was that message walking around us on campus."

Finally, the Bongani Mayosi Medical Students Academic Prize has been established to recognise final-year medical students who have demonstrated the all-round capacity for academic achievement, emotional intelligence and social accountability. To foster a culture of collaboration and mutual respect, the prize will be rolled out at medical schools across South Africa.

Reflecting on the memories shared by Mensah and a number of Mayosi's colleagues and mentees, Professor Phakeng concluded the proceedings by saying: "I've said before that Prof Mayosi represented black excellence. [He was] living proof that black scholars can be the best in whatever they do. He was that message walking around us on campus.

"While Prof Mayosi is no longer with us physically, his effect on us remains - challenging and inspiring us to be better and do better."

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