Obituary

Bongani Mayosi: a tragic end to a brilliant career

World-leading cardiologist never recovered after being denounced as a 'coconut' and a 'sellout'

05 August 2018 - 00:00 By Chris Barron

Professor Bongani Mayosi, who committed suicide at the age of 51, was dean of the faculty of health sciences at the University of Cape Town (UCT). First and foremost, however, he was a researcher, clinician and medical cardiologist of world standing who specialised in heart diseases related to poverty, a field that had received little attention previously.
He improved the understanding and control of cardiomyopathy, tuberculous pericarditis and rheumatic fever using a broad range of investigative approaches from molecular to clinical to population-based methods.
He led a multinational team of medical researchers which identified a "sudden death" gene found to be responsible for an inherited genetic disorder called arrhythmogenic right ventricle cardiomyopathy that causes supposedly fit and healthy young people, mostly under 35, including athletes, to have sudden and fatal heart attacks.
It was estimated that more than five South Africans died from this every day and countless thousands around the world.
The discovery, published in 2017 in the prestigious journal Circulation: Cardiovascular Genetics, opened the way to its diagnosis and treatment.
The South African Medical Research Council (SAMRC) hailed it as "probably the biggest breakthrough in South African cardiology since Dr Chris Barnard's first heart transplant".
His most influential work was a ground-breaking study on tuberculous pericarditis published in the New England Journal of Medicine in 2014, which showed that treating it with inflammation-fighting corticosteroids, as was then the norm, tripled the risk of cancer in patients with HIV.Tuberculous pericarditis occurs in about 10% of TB patients, many of whom are also HIV-positive, and kills a quarter of those who have it.
His trial included patients in eight African countries. It changed the way tuberculous pericarditis is treated and had an immediate impact in countries like South Africa with high HIV rates.
Mayosi was born in Mthatha in the Eastern Cape on January 28 1967. He always wanted to go into health care like his father, George, who was a gynaecologist, and his mother, Thelma, who still works as a nurse.
After matriculating at St John's College in Mthatha he enrolled in medicine at the University of KwaZulu-Natal.
After his third year he took a year off to work on a private research project. His consequent thesis earned him a bachelor of medical sciences degree with distinction in 1986.
He published a paper on his research in the South African Journal of Science.
"When I saw that I could make an original scientific observation and publish it and the world accepts it, it put a switch on," he said in an interview.
"That's how my hunger for discovering new knowledge in the medical field was switched on."
In 1989 he achieved his MBChB, also with distinction.He gained clinical experience as an intern and medical officer at Livingstone Hospital in Port Elizabeth before being appointed senior house officer and registrar in medicine and cardiology at UCT-affiliated Groote Schuur Hospital in Cape Town.
In 1998 he went to Oxford on a prestigious Oxford Nuffield Medical Fellowship, where he studied cardiovascular genetics under one of the world's most renowned clinical cardiologist and laboratory scientists, Professor Hugh Watkins.
He was awarded his DPhil (the Oxford equivalent of a PhD) in 2003, with a doctoral thesis on the "genetic determination of cardiovascular risk factors in families".
He returned to UCT and Groote Schuur as a researcher, lecturer and clinician in internal medicine and cardiology.
His research focused on heart diseases affecting the poor, an area he felt had received far too little attention given the scale of poverty in South Africa.
In 2006 he was made head of medicine at UCT.
Mayosi was obsessed by the need to succeed. But his conception of success changed radically. He began measuring his own success by the difference his research made to people's lives.In 2009 he received the Order of Mapungubwe (Silver), in 2011 he received a National Research Foundation (NRF) award for transforming the science cohort in SA and in 2017 he received the NRF A rating, a supreme accolade for those deemed leading international scholars in their field based on research output.
He published more than 250 papers in peer-reviewed journals.
But all this meant little to him unless his work improved lives, he said.
"There is no point publishing papers if they can't be translated into better treatments, better outcomes, better survival, better quality of life and longer life for the people of SA."
At the same time he believed research and the production of knowledge that benefits society should not be self-funded, as so much of his own research had been.
He warned the department of health that because of inadequate support, clinical research in the country was dying.He used his position as head of medicine to push for a programme that would give suitably qualified South Africans "who look like me" the opportunity to further their studies, do research and build academic excellence in various fields of medicine that could be applied to local problems.
"We need to invest in our best and brightest people so that we are world leaders on our problems," he said.
Largely through his efforts the "1,000 PhDs" programme was born, funded by the national department of health and the SAMRC.
In light of this it was tragically ironic that #FeesMustFall protesters occupied his office for two weeks after he was appointed dean of the faculty in 2016, and hurled insults at him, calling him a "coconut" and "sellout".
The ordeal left him shattered. He had a nervous breakdown and had to take time off to recover, but never quite did.
He tendered his resignation as dean eight months ago but it was declined.
Mayosi, who was unfailingly warm, friendly, cheerful and helpful to students, research graduates, colleagues, doctors and nurses alike, is survived by his wife, Nonhlanhla Khumalo, a professor of dermatology at UCT, and three daughters.
1967-2018

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