When Wendy Stevens' mother succumbed to breast cancer in 2020, she left a series of letters to her four children that she had penned during her illness.
"One of these letters," says Stevens, "explained to me how - as we grew up - I would always go in a different direction [than] the other kids. My sisters and brother would go right. And I would go left. My mother wrote: 'You'd go left, and I'd have to spend an extraordinary amount of time telling you why I had wanted you to go right.' Well, my mother said in the letter that in time she realised how there was a reason and a place for me."
Indeed, this trait of swimming upstream has come to mark Stevens' career in public health, where she is not afraid to inhabit what she describes as the naughty corner.
A global leader in HIV and tuberculosis (TB) laboratory medicine, Stevens is known to fight for the integrity of science in a health system riddled with political interference - most recently during the early stages of the COVID-19 pandemic. In 2020, Stevens' friend and colleague at the University of the Witwatersrand (Wits), Professor Glenda Gray, president of the South African Medical Research Council (MRC), made headlines when former health minister Zweli Mkhize publicly rejected her criticism of government's COVID-19 strategy. At the peak of the dispute, then-acting Director General for Health Dr Anban Pillay wrote to the chair of the MRC asking them to investigate Gray's conduct.
I believe completely in the honesty of science - Prof Wendy Stevens
When science and politics collide
Commenting on collisions between science and politics in South Africa, Stevens says, "Well, with me, they collide all day, every day. It's been like that the whole of my career and it's not always the easiest. But you know, you have to roll your sleeves up. I believe completely in the honesty of science. So I'm on the naughty list here. I'm in the naughty corner - the same as Glenda. It has been a really difficult navigation. Have I been beaten and bruised badly in the last three years? Yes. But if you're not at the table, how do you bring change? You've got to be somewhere in the game to change it. It's about being brave enough to put your hand up and saying when something is not right.
Later in the interview, she adds, "I mean, just the rollout of TB diagnostics aged me ten years!" Part of what she is referring to is the rollout of transformative new molecular TB tests in South Africa over the last decade. Currently, millions of these TB tests are done every year.
🗣️📢Introducing @WitsUniversity's newest research entity, the Wits Diagnostic Innovation Hub (#WITSDIH).
Led by Prof. Wendy Stevens & her team of renowned scientists, WITS DIH aims to spearhead research that is responsive to global needs.@Wits_News @nhls_sa @ShabirMadh pic.twitter.com/I7UYtHFZZl
-- Wits Faculty of Health Sciences (@WitsHealthFac) October 4, 2022
A lesson in self-sufficiency
This is the woman who dashed into a Builders Warehouse in Johannesburg to buy safety equipment for her laboratory staff as they worked on replicating the COVID-19 virus in April 2020 and who spent hours on the phone negotiating with foreign companies for laboratory supplies as flights grounded to a halt during South Africa's hard lockdown.
The thing that upsets me the most was the way people on this continent were treated during COVID
"We got people to make the bug for us," she recalls. "So we had really fabulous scientists growing the bug to be able to try the new tests. At the time, even keeping yourself safe in the lab was a whole thing. I mean, I ran into Builders Warehouse and said to the man - do you think we can buy all the visors you have on your shelves?
"The thing that upsets me the most was the way people on this continent were treated during COVID," says Stevens. "Even for me to get supplies - you know, I was up all night phoning every contact I had at every supplier the world over, just to bring in supplies for tests and so on. Remember, the planes weren't flying. I mean, I had a team assisting me who had to deal with the legal issues. We had to work with SAHPRA (the South African Health Products Regulatory Authority) to try and bring in things that weren't rubbish."
Speaking over Zoom, Stevens wipes strands of hair from her forehead, frowning in concentration as she searches for just the right words.
She says, "We literally would be phoning, I would be talking to one of the big diagnostic suppliers saying you were happy to sell to me in the past, now you don't want to give me this? I think it taught us a lesson, which is self-sufficiency. There is a lot of innovation here in South Africa and we've got to stop being so reliant on supplies from elsewhere."
"A lighthouse for innovations across the pathology value chain, creating space for innovators to experiment, manufacturers to refine new solutions, & for gov and scientists to work together to enable scalable implementation."
Launching Today! #WITSDIH #Wits100@WitsUniversity pic.twitter.com/ODzvl8GXNN
-- Wits Faculty of Health Sciences (@WitsHealthFac) October 4, 2022
'Necessity is the mother of invention'
In 2003, at just 33 years old, Stevens became a full professor at Wits and head of the university's Molecular Medicine and Haematology Department. She recalls the wisdom of her predecessor and mentor, renowned haematologist Professor Barry Mendelow. "He used to say necessity is the mother of invention. And it's one of those things that has stuck with me my whole life," she says.
Initially, Stevens specialised in haematology, working in cancer diagnostics before switching to infectious diseases as the HIV epidemic peaked.
Stevens holds a joint position with the NHLS (National Health Laboratory Service) - South Africa's largest pathology service provider - where, amongst other pioneering projects, she established the first HIV PCR [polymerase chain reaction] public testing service for early HIV infant diagnosis, for CD4 counting, and for HIV viral load testing.
"I remember landing up at a children's home, where the guy said look at these babies and tell me which ones are HIV positive and which ones are negative. And I said to him I don't know! How must I know who's positive and who's negative?" This motivated her to create a team that established the first HIV PCR laboratory in the NHLS to provide public service testing for early HIV infant diagnosis.
There is a lot of innovation here in South Africa and we've got to stop being so reliant on supplies from elsewhere
'keepers of truth'
Over 15 years, the NHLS has developed a network of 265 laboratories around the country, with every public sector test being recorded in a single database. Stevens is one of the people who made this possible.
Professor Lesley Scott, who has reported to Stevens at Wits for twenty years, describes Stevens as "a lighthouse for laboratory innovation".
Scott tells Spotlight, "People often don't realise that behind the diagnosis and treatment of every single patient are laboratory test results, much of which were established in South Africa by Wendy."
Last year in a TEDxJohannesburgSalon talk entitled "A blueprint for the future of testing labs in Africa", Stevens referred to laboratories as "keepers of truth".
To Spotlight, she explains, "It's not as subjective as social information and it remains on record. We can tell using the indirect aggregated data what exactly happened, and it doesn't involve subjective interpretation."
This system played a key role in bioinformatics scientist Professor Tulio de Oliveira's discovery of Omicron last year.
"So the network of laboratories was set up for different reasons - a lot for HIV, a lot for TB - and we used these networks in the collection of information as well as running tests for COVID. We looked at the COVID data and because we could do it nationally, we could actually predict that there was a change or a new variant coming almost three weeks before the surveillance. So, it's been truly remarkable how having full access to the national data was able to even assist Tulio [de Oliveira] in saying you better look because we think this epidemic is changing."
Stevens highlights two professional values she holds dear. "I need to make a difference. And the thing I think I'm very good at is finding talent - those people that think differently." A multidisciplinary approach is integral in laboratory work today, she says, with several new recruits in her laboratories being scientists trained in engineering and economics.
And the thing I think I'm very good at is finding talent - those people that think differently
'a bit of street fighter'
Looking back at her career in infectious diseases, Stevens refers to leapfrogging. She points out how it took decades to roll out HIV diagnostics and treatment, years with TB, and mere weeks with COVID. In South Africa, each pandemic paved the way for a more efficient response to the next. She, however, warns about the declined capacity for HIV and TB testing in South Africa due to COVID, along with other diagnostics like cancer.
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Born to a chemical engineer father and a mother who worked as a nurse, Stevens matriculated at Alberton High School on Johannesburg's East Rand, before qualifying as a medical doctor at Wits in 1989.
"Coming to Parktown, to medical school, it was all quite foreign," says Stevens. "I mean, I hadn't been to the fancy Joburg schools in that area. But having attended the school that I did - which wasn't fancy - I think it gave me that desire to get out. It made me hungry; it puts a bit of street fighter in you.
"My dad, Trevor, is a chemical engineer now, but all I remember from childhood is him studying. Working during the day and studying at night and he did very well for himself. He will be 80 next year and he is still working. He also runs laboratories. He was probably responsible for most of South Africa's concrete design in the early days.
"My mom, Sue, was a nurse. In fact, it's quite ironic. She was the head nursing sister of Joburg Hospital's [Charlotte Maxeke Johannesburg Academic Hospital's] respiratory ICU unit for about 25 years. She taught many of the current pulmonologists. And then we lost her to breast cancer about a month before COVID started. Well, it's just sad, you know, because we kept thinking of her legacy. During COVID, my mom would have been able to ventilate and provide information on a person's respiratory function from a distance. She probably would've been one of the most knowledgeable people around."
I think it gave me that desire to get out. It made me hungry; it puts a bit of street fighter in you
Stevens has one daughter who studied both biomedical engineering and electrical engineering at Wits and who worked in COVID modelling during the epidemic.
Wrapping up, she says, "I've worked with the most amazing people in over forty African countries, Indonesia, China... "
In 2016, the Chinese Centre for Disease Control invited Stevens to present on lessons learned during the implementation of molecular TB diagnostics in South Africa. At the time, Stevens and Scott also climbed a part of the Great Wall of China together.
"It's been a wild ride," she says. "I'd love to write a book one day."
