SPEAKER_03 0:00

Welcome back, everyone. Our guest today is Professor Glenda Gray, a pediatrician who has dedicated her life to the care of children and HIV medicine. Prov. Her groundbreaking work in preventing mother-to-child HIV transmission and pediatric HIV research has saved countless young lives, not just in South Africa, but around the world. For her contributions to science and medicine, she was awarded the Order of Mapungubwe in gold, which is the highest honor South Africa can bestow on a citizen. She's also been recognized globally elected to the US National Academy of Medicine and named on one of Time magazine's top 100 most influential people in the world. So today we're exploring her journey from pediatrician to one of the world's leading medical researchers and scientific voices. Prof.

SPEAKER_00 1:01

Well, I was the president of the CEO of the MRC.

SPEAKER_03 1:04

So that's the one thing my AI got wrong.

SPEAKER_00 1:06

And I I got it I got uh Mapungwe and Silva.

SPEAKER_03 1:09

Silver, okay, you see.

SPEAKER_00 1:10

Okay.

SPEAKER_03 1:11

So yeah. Well that's a lesson to people. Don't don't do better research. You know what I'm saying? Yeah, exactly. But prof, that's the last thing I'm gonna read. It's the first time I've ever read out an intro. I didn't want to get it wrong. Ironically, I got some of it wrong.

SPEAKER_01 1:25

Yeah.

SPEAKER_03 1:25

Um, you know, I was telling you off camera, this show is not about the black and white about uh doctor, it's about why did I become it's your journey, you don't need to prepare. And hopefully today we won't just be doing black and white, but be getting 50 shades of gray. So yeah. Prof, I mean, how did you when you grew up, when you were growing up, did you ever think one day I'm gonna be, you know, Times top 100 influential people, I'm gonna be a doctor. What did you want to be?

SPEAKER_00 1:49

I always wanted to be a doctor. So um from a little girl, and um there was no real specific reason because no one in my family were doctors, but I just kind of had this innate feeling that I was gonna be a doctor.

SPEAKER_03 2:03

What did your parents do?

SPEAKER_00 2:04

And um my father was an engineer and my mother was uh she was a bookkeeper, and um th my f my sisters became teachers because in those days uh that they paid uh if you became a teacher, if you wanted to go to university and there was no money, you'd get a bursary, become a teacher, and then uh go do something else after that or after teaching for a while. So when I said I wanted to become a doctor, it is sometimes a joke at school because at my school no one became doctors. Um if you were clever, you became a teacher because uh we came from a poor community. And so I think um everyone, you know, d kind of indulged indulged me. And um I applied to for medicine only at Witz University, and it was the year that um they were doing an experiment. So they wanted to diversify um the people that they were um bringing in. Normally they bring in um private school straight A students, and to um get in you had to go and have an interview with um a group of people, write a an essay, um, and you know, and and ask answer specific questions. So I went there um and um I guess they were looking for diversity. Um it was the first time there were a lot of women, um, a lot of people of colour at the um um in the here and um people coming from um quite uh diverse backgrounds. And so um the experiment worked out well for me because um I became a doctor. In the beginning it was big it was difficult because I can't I you know I was a sch I was at Boxburgh High. We never had maths and science teachers, and so the first two years um I struggled and then um suddenly everything clicked and um I started to really enjoy and thrive at medical school.

SPEAKER_02 3:55

Yeah, it's quite it's quite interesting for us hearing a white person say um, you know, they were looking for diversity, and that was, you know, the premise of how you got in. And I'm sure, you know, you don't mean agree uh sort of per uh uh persona when you meant looking for people of color. Can you take us back then as to what era was it, what sort of year was it, and the diversity that they were looking for that sort of included you was I mean, I'm assuming it was from a socioeconomic status. Um and prior to that, it was probably, as you said, like you know, private school with people with straight A's. Yeah. So when was that? And and even before that. Take us back. So you grew up in Boxburgh.

SPEAKER_00 4:44

Yes.

SPEAKER_02 4:45

So I down the road.

SPEAKER_00 4:46

I grew up on the wrong side of the railway line in Boxburgh. So um Boxburg North area. So we we were kind of working class, poor families, poor big families um, and and not rich. Um and uh so I grew up on the other side of the railway track and um and um a lot of the people that I went to school with um grew up in Park Dean, Liberdeen, um all those places. So um so we so um coming from a poor white background, um no one really is successful. So I when I used to catch the bus to school and at the end of the year when they would um tell who was gonna get prizes, you know, my bus was always proud of me because like I was, you know, I was their kind of um uh I c I demonstrated that that even though you were poor, you could thrive and you know I was beating the the rich kids, which was which was um you know, it was important for for you know for aspiration. So in n say 1981, so I went to medical school in 1981. So when I s when I say diverse, um up until then, um Witz medical school had been largely white. And um very few black um or any other um, you know, any other any other grouping, you know, black uh maybe I should say black as in um black, yeah, meaning black African, um um Indian coloured, so you know, had very few um people uh people of colour in in in that spectrum. And I guess um, you know, very little um government and also very f you know, it was never fifty percent woman.

SPEAKER_01 6:28

Yeah.

SPEAKER_00 6:29

So this this was an attempt to to bring more women in, um, bring people from different cultural backgrounds and people diverse colour. And you know, so I guess I got in on the diversity ticket, uh, so to speak. Um so you know, so so so which was which was so we were a an eclectic group of of of medical students. We were odd. Uh and everyone knew that we were this odd group, um, you know, in in the um uh the experiment class. So it was quite an interesting um, you know, ex you know, experience to be this group that was so different um to everything else they'd seen before.

SPEAKER_03 7:08

Yeah, I mean so so basic essentially you also benefited from a diversity and inclusion kind of program.

SPEAKER_00 7:13

Yeah, I benefited from social engineering. Yes, yes. Um, you know, so that's why I also believe in social engineering because um, you know, um there there are benefits of of of um transformation and um looking at um at who should be what with a different lens.

SPEAKER_03 7:32

Yeah. Okay, but not being exposed to doctors in the family and things like that, I mean what what made you think m medicine? You know, did you was somebody in your inspiration or did you watch something or read something?

SPEAKER_00 7:43

I just I mean so I liked animals. Um so um one day I was watching a a vet. Um there was a breach car delivery and he had to take a rope and in real life in real life and pull a calf out of the out of you know out of the the um you know out of the youth the the reproductive uh tract of the anyway, so I was swinging on a gate watching him, and then he looked looked up and said, So Glenda, um are you gonna become a vet one day? Yeah and I looked at him and I said, No, I'm gonna become a doctor. I want to save real people. So anyway, so it was so anyway, so so anyway, so then um, you know, and that kind of you know stuck in um So the animals around where you were growing up and still so at at one stage of of my life when I was little, we lived just outside Heidelberg near Mapleton in a in a small holding. It was my father's dream to be a farmer, and he failed miserably like that. My mother was the person who had to ride the tractor, he he was working um as an engineer, and um she would um try and run the farm. So she was a um a labourer. So you know, I learned hard work from my mother because she would plow, she rode the tractor. Um, we used to go and sell tomatoes um at the at the train stations. Can you imagine these poor white kids running around? We used to go knock on doors, sell milk, get chased away. Anyway, so it was a so I had I had an exper you know, I had a very good grinding experience about about poverty, uh being poor, um diversity because already at that stage we were selling um uh um uh you know uh vest to produce at at um train stations uh you know in where the non-Europe so-called non-Europeans, you know, so in those days they were the you know non-European part of the railway line and European and you know, so very, very quickly um, you know, we were exposed to to to poverty and and diversity. And so, you know, we got to see um as a as a white person, I gotta see a a different lens of South Africa just based on m our circumstances.

SPEAKER_03 9:57

That's amazing. So were you a bookworm in school, were you?

SPEAKER_00 9:59

I was. Um I used to during so I you know, we so I used to catch the so then we eventually we the farm, we eventually had to sell it and blah blah blah. So we went landed up in Broxburg. And um I used to catch the the bus to uh the library during school holidays and and just and get um piles of books and read a read a book a day. So if we would wake up, we wouldn't get out of bed in our pajamas and we would just read. Yeah. Eat post toasties and read books. So basically the you know, the so I would um I would we would devour books. I read a lot of books.

SPEAKER_03 10:36

But was that the norm in the time or were other kids out playing and I slept?

SPEAKER_00 10:39

You know, well we used to play cricket in the back garden, but I we loved I mean I loved uh reading. So it was most you know, mostly I used to go and catch the the the bus. But you know by yourself, because in those days you know you run you like you run wild. No one looks after you. Parents go to work and you know, latch door kids. So you basically, you know, you bring yourself up. So um, you know, you would just you know go and get get the books and catch the you know, and come back and read.

SPEAKER_03 11:06

That's cool, eh? I mean it has its benefits, the so-called latch door kid life, you know. Yeah. You know, you do your own thing, you learn some independence, you figure stuff out. Okay, so you're doing well in school then, clearly.

SPEAKER_00 11:18

So I was doing well at school.

SPEAKER_03 11:19

Beating all the kids, the the rich kids and all that stuff.

SPEAKER_00 11:21

Oh, with all the rich kids, I think.

SPEAKER_02 11:23

But w was that the same school to the rich kids and the poor kids?

SPEAKER_00 11:27

Yeah, so it was a government school at Boxburg High, and basically um so it is it was near Park Dean I don't know if you know the East Rand, it was just near Park Dean. And so we would catch the bus from Boxburg North to um to to the school. When when our when we were when I was younger, we lived in Brackpan. And um so after we we after the farm, we we moved to a place in Scarp near Scarpins Russe, Witburkey, and we used to catch the train to Boxburgh to go to school. So, you know, my um we would get on the Hoppossix um train, get off at the station at seven, and then um and then walk to school. And that was at Martin's school, so we're from Boxburgh East Station to to Martin's school, so which is probably about three or four kilometres every day. Yeah. Um we would save our bus fares so we could buy ice creams in the afternoon. So, you know, so um so very so very from a very young age we we were these um, you know, kind of independent, you know, managing, navigating a life by ourselves.

SPEAKER_02 12:33

Yeah. But academically, what do you think what's was going on? Did you have any aspirations at that stage, knowing that you were you know you were good at school and uh good at academics that you would want to end up um in academia?

SPEAKER_00 12:49

Yeah, so I I didn't think I was gonna end up in academia. So my idea was to um run a um a ward at Barragwanath Hospital and teach look after kids and teach uh yeah. Yeah, I wanted so it's it's just um um that so that's that was my aspiration. I wanted to basically have a ward where, you know, so we so in at Barragwanath Hospital there are all these pediatric wards, and I wanted to be one of the consultants who ran a ward and then, you know, basically look after the kids, do ward rounds, teach students, you know. So that that was gonna be my those are my aspirations, just to, you know, basically run a ward at Barraguanath Hospital.

SPEAKER_03 13:26

Is this you figured this out when you were a student? No, no, not then.

SPEAKER_00 13:29

So I mean, so as I was doing um clinical practice, you you start to see what you liked, and I I dug the kids. But I mean, so in terms of school, maybe maybe what what um what's important about teachers. So around uh around about grade uh what we would call grade uh eight works, grade eight. Grade ten, grade ten. Um I uh we we were doing physics and I I wrote a physics test and I I think I got 70% for it. And for me, you know, I kind of thought that was quite good. And the teacher at the time uh uh th uh threw the um the the the test results um in the test on my desk and he said not good enough. Not good enough. And then I thought you know, so he made me kind of double think 'cause maybe a as girl children, um you know, at 70 we settled for 70 for physics. And like he just said like that's not good enough. And I and that made me think, you know, he saw something in me that um, you know, and so the next test, you know, I got 80, and then the next test I got get ninety and then the next test ninety-eight. You know, so he made me work he made me start to enjoy physics and then chemistry. So um and so that what so that was what was lucky because basically um I, you know, I was a uh I did I did well in chemistry and and physics, and it was because he believed in me. So it's just the power of of teachers. And so if I hadn't done well in physics and chemistry, probably I wouldn't have got good marks to you know, good enough marks to get to to medical school.

SPEAKER_02 15:11

What's your opinion on that? Because I mean that's a significant enough story for you to remember and tell us. And it's a it's a common theme or uh thread here withn in this podcast. I mean, Yesh has mentioned it before when he was unshaven at university and he got kicked out and I I don't know what happened, but a few of our other guests have mentioned it. And people always say that it's not the quality of the person in acad academia or how good they are academics, but how good are they in order to be able to reproduce that in a learnable way for you to actually how they inspire a learner?

SPEAKER_00 15:50

Yeah. You have to see the light, you know. So and I see this a lot because I I you know, in my my work as a as a a researcher, as a scientist or as in clinical research, you you you see sometimes you see a light in someone and you and you s you see magic. And um and and the the most important thing that that when I see this magic or this light on some in someone, I do my best to open up opportunities because I know they're gonna thrive. Yes and they're gonna fly. And I guess what this teacher did is he saw some light in me. Yes. And and and a lot of people ignore that light and like kind of think you just gotta s you know, you ever each man for himself. And um so teachers, uh people who are involved in running teams or nurturing, it's important when you see light to to give them opportunity.

SPEAKER_03 16:43

But isn't it also like amazing, prof? It it's one moment in grade ten, standard eight, where a teacher's looked at you, threw a paper down, and said, not good enough that you remember to this day, like decades later, right? And if that guy didn't do that, who knows where you would have gone and where you would have been, right?

SPEAKER_02 17:00

But also in the way that he did it. Because as you know, some people see light in people and they want to cultivate it. They want to say, you know, oh you I see something in you and I want to inspire you and I want to do better. He did it in a roundabout way where he showed you, no, you you were good, but you were not good enough.

SPEAKER_01 17:17

Yeah.

SPEAKER_02 17:17

That's what he said. He almost used, you know, like a reverse psychology in order to motivate you.

SPEAKER_00 17:23

And also because uh because because uh girls' students would settle at 70.

SPEAKER_03 17:28

Is that how it was, Dose?

SPEAKER_00 17:29

Tell us about that that kind of because I mean, you know, so um because because what happens as you as you know in high school is that you know girls in uh in the first two or three years in in high school are are doing better than the boys, and then they kind of plateau and maybe they settle. Okay.

SPEAKER_03 17:46

Um and I don't know, because I went to all boys school. Yeah, this is a coet.

SPEAKER_00 17:51

And then so what you you normally see in seven and eight is that the boys start to take off. So the guys that you were thrashing, you know, start to basically take you on. And um, and I guess um uh a lot of a lot of you know uh girl children may may settle, you know, think okay, 70 is not is not too shabby. Yeah, those days, those days, yeah. And 70 well in those days, 70 was not shabby.

SPEAKER_01 18:15

Right.

SPEAKER_00 18:16

Um, you know, because and but um and then just him saying um, you know, um because then he he saw something in me that I wasn't seeing.

SPEAKER_03 18:24

What was his name, bruh?

SPEAKER_00 18:25

It was Mr. Marks, his name was Mr. Marks. I don't even know what happened to him.

SPEAKER_03 18:28

Yeah.

SPEAKER_00 18:29

But he was this um, you know, he he was there for two years and then you know he went on somewhere else. Um and he might never know that he he inspired. You never know these things. You know, so I was um i often when I'm I'm going around, some some young person will come up to me and say, You don't remember me, but um I worked at you and I worked at PHRU and if it wasn't for you, I wouldn't be this. Of course. And if it wasn't for you in that, you know, so so sometimes you don't even know who you touch. Sometimes you touch people very directly where you open up spaces and you, you know, you you move them along. And others um uh you may not even realise. And but it's always such a treat when they come up to you and say, Um, it's because of you I started a business. What a cool feeling, yeah. It's it's it's a lovely feeling, you know, and um it's a it's a nice it's a nice feeling uh to to and that's what nice I guess about academia um is because you always are working in a team and you always are working with a whole str uh strata of people who um are are anything from doctors to uh uh um uh people who are the you know, who make the tea.

SPEAKER_01 19:45

Yeah, yeah.

SPEAKER_00 19:46

And you know, and tea tea people who make the tea become counsellors and become s study coordinators. And you know, and so you know, so that it, you know, um I guess it's like success. Yeah. You see something in them and you and you um, we've literally got success behind the camera. So you know, so you know, success is that you see you saw something that um that um that made you believe that you know you you know you could do more.

SPEAKER_03 20:15

So prof tell us about getting into med school.

SPEAKER_00 20:17

So you only applied to well, you know, we were poor, so I couldn't afford if we had to go somewhere else, and it means I had to get on an aeroplane, you know, find uh student. I mean, I caught the train, you know, so I I stayed f you know for the first year at at um the JCE um Res. And then um second year I commuted from from Boxburg.

SPEAKER_03 20:37

So um But how was the interview and stuff to get in? Did they ask you grueling questions?

SPEAKER_00 20:41

I mean they are you know they did ask, they you know, asked your view on so far. They asked what books you were reading. So I guess to gauge, you know, um was it a big panel or something? Ann Rand. James Joyce or Inner Blatter. Um it was yeah, it there was I remember there was a sociologist sociolog sociologist on it called um Beryl Unterhalter. So there was a bunch of, you know, I wonder if she's related to the lawyer. Yeah. I think they're our family. Okay. Um and um, you know, they asked they asked you what books you were reading, you know, then they uh you had to write an essay. Um and and then they asked you like, so what do you believe do you believe in abortion? Um capital punishment? What's your view on capital punishment? Wow. So they wanted to know, I mean, they were looking for, I guess, people that that had a perspective of the world, you know, um, and you know, read newspaper, you know, so they were looking for for kids, 18-year-olds who were reading the newspaper thought about capital punishment and abortion, um and things like that. So yeah, so um, you know, and and also, you know, were you did you were you just uh uh besides school being excelling at school, you know, was you know, are you a ra a well rounded person? And so some people, you know, are just um do well at school. But they don't know about the news and about the politics of the day, you know, in 76, you know, because, you know, we were we were um at school in in 1976 um with the student uprisings in Toeto, you know, and so we got to hear um about these st about all of this stuff. And I guess I also was lucky because at that stage I had a brother who was at Witz University and he was part of New SAS. And and he um which is the the student, as is like the SRC of today. Okay. Um and he was a a political activist. Um and he would also bring bring me home um fem feminist books. So you know, he he gave me at Incend 8 um feminist literature to read about you know about you know um feminism and that so I was you know so I was you know I was lucky to have him who he politicized me and and then also um being able to read these books that um that maybe not not many sixteen year olds were reading at that stage from Boxbook no.

SPEAKER_03 23:05

Exactly, yeah.

SPEAKER_00 23:06

So you know what Boxbook Girl is reading a um you know. So did you impress the panel?

SPEAKER_03 23:10

Did you impress the panels? Did you know that you impressed them?

SPEAKER_00 23:12

I don't know. I mean I may I must I must have because they gave me a play. No, but they didn't give you an indication in there. They got I got it accepted before my marks came out.

SPEAKER_03 23:21

Okay. But but when you came out of that interview, was it like oh goodness?

SPEAKER_00 23:24

I don't I didn't I didn't have a perspective, so you don't have a perspective on these things.

SPEAKER_03 23:29

It's funny because I interviewed uh an orthodontist called uh Mark Wertheimer. He's a big orthodontist in Santon and he said he went for one of these interviews also. And the first question the guy asked him was, Have you ever opened a watch or and and put it back together? Or and do you know what a spring con is? And how many teeth does a spring con have? So it's uh it wasn't like that kind of interview where it was just weird. Abstract. Yeah, yeah. It wasn't like that.

SPEAKER_00 23:53

Yeah. Well, if it he'd asked my son, you know, my son um used to take everything apart and then put it together again. You'd come home and there was just a screw, then you think, uh, this is never ever gonna come together again. But if you put it back, I would do that, but it would never go back.

SPEAKER_03 24:10

Boys boys like to like dismantle.

SPEAKER_00 24:14

You know, he'd come home, um, even like now he has a motorbike, and uh in the garage the the the motorbike is just in pieces, and I think, okay, I'm never gonna be able to put my car in the garage again.

SPEAKER_02 24:27

But as a mum, that's probably a better way for it to be rather than riding around to the mother.

SPEAKER_00 24:31

Yeah, and then you know, then suddenly the he's he's you know the bikes together and he's riding it.

SPEAKER_02 24:36

And then there's a nut lying on the garage floor. So how was med school? Yeah, tell us about med school and especially from your perspective of being the only well not only, but quite a new age student now as opposed to what it was. It must have been very like alienating.

SPEAKER_00 24:54

So it was. So yeah. So first of all, you know, I you know, so so first of all, um that's when you when you understand uh socioeconomic socioeconomic differences in class. So um um so I'll be going to med school and um you know there's the people are riding Alfa Romeos and have their own cars. Um, you know, you don't have a car. Even the clothes that you wear are, you know, um you you know that your clothes are uh bought at um what do you mean at OK Bazaar and you know and they they're buying uh you know their clothes. You know, even then you can see the clothing difference. So you're very acutely aware. So that's also why, you know, I understand how how how students from poor backgrounds must feel, particularly in this kind of in in medical school where there are lots of rich people, you know, and you know, you might be hungry, um different stresses that nobody thinks of the and the clothes you wear are not um designer clothes. And so you immediately know that that you're odd and um you're different and you're not privileged. So, you know, suddenly you because in my in Boxburgh, you know, even though rich kids weren't that rich, um, suddenly you you're in a an environment where people are really rich and um you feel your poorness um, you know, quite quite substantially. And then also because you haven't been to a a private school, you're a completely disadvantaged. And so I understand bridging, you know, um, because I the first two years, I like I was just um, you know, kind of whiplashed, you know, um barely barely passing. And then um and then suddenly, you know, you catch up and and then you thrive and you do better. You know, so when you look back, I probably am the most successful um student from my from my my class, you know, that no one no one became an A-rated scientist and you know, you know, this and you know, so so um and so if you predicted someone's success in first year, you know, you can be so completely wrong. And so I was probably a dull student in first and second year, and then suddenly the lights went on.

SPEAKER_03 27:09

How did they go on?

SPEAKER_00 27:10

Um I just things just started to, you know, you st you start to catch up, things start to make sense, you you start to figure out how to how to learn.

SPEAKER_01 27:19

Did you make friends?

SPEAKER_00 27:20

I ha yeah, I was I did make friends, you know. So I had, you know, we had you know, we had lots of I had, you know, friends and then you know, also so lots of things are happening, you know, so as you go into medical school, um uh, you know, so you eventually catch up, you make friends. You also then also become politicized because you're at university, you know, and so you you know, and this is the eighties and you gotta take a stand. And so, you know, you also become, you know, I also became uh uh politicized as well. And then, you know, um and um being cute acutely aware of what I mean the eighties was a terrible time in South Africa, you know, um uh in the most violent time, you know, and so you you know, and so being at Vitz University, um, you you quickly get exposed to to um activism. So that also was was good for me as a doctor, is to, you know, you can't come into medicine in a bubble. In fact, a doctor I always feel that doctors are most um they're the maybe doctors and dentists and nurses. They they the uh if you come from a white background, um they're the only people that that ever get to to engage closely and intimately with people of all races, um, um and staff of all races. So very quickly, um um doctors are immersed in um a diverse situation and that exposure is critical because it kind of shapes your empathy, um your your um your view of the world, your your your political stance.

SPEAKER_02 28:57

You could see that disparity first hands.

SPEAKER_00 28:59

And and so so that's why so so I think so that's uh it was a gift to be able to be a doctor because basically it it showed me, you know, you we would go to Baragwana Hospital and then you would go to the Joba Gen, and um, you know, your your black um uh uh students in your class can't go there, but you can go there. So then eventually and You're not allowed to go there. Because in those days, you know, um uh there's all you know in particular gynecology, you know imagine like gynecology.

SPEAKER_01 29:32

Yeah.

SPEAKER_00 29:32

And th they, you know, so like the last vestige of like whiteness is a woman's body and her vagina. Yeah so um you know, so there's only so so uh so black students couldn't rotate through particularly gynecology and obstetrics um in those days. And so when so suddenly you get split. Um and then um so some of some of us then refused, some white students then said, um, if black students can't go to um gynecology and obstetrics at the Jobic gen, then then I'm not going. And so there were students white students also took a stance that um not to also go to those go go to those wards. And then they had to obviously redo the you had to go to the head of department and explain why you didn't want to go to uh the Jobja Jobic Gen, and then you get sent to Natal Sprite and and other places. So um so very very quickly you you you get so get aware of the the kind of uh prejudice and and um and kind of petty petty racism, petty apartheid. Um that's happened. That is so petty. But it was a whole process. So when so when the so we when this the when the hospitals opened up, um there had to be a whole kind of engagement um about you know who you who you bring in first and you also that there had to be a you had to assert. So, you know, the moment um black gynacologist arrived at uh the gen at the gen at that stage, th there there had to be a team with him and said, it's not negotiable, he will touch you. Sure. You know, if you don't like it, then go to another hospital. And so you had to have that that kind of stance. And when we desegregated wards, um in at that stage I was working as a pediatric registrar. We would bring um black families and and patients, kids to the ward, and if the the white families objected, we'd say, leave the hospital. We're not separating you in these wards. You're not having a black ward and a white ward. You know, we you you all have to be in this.

SPEAKER_02 31:45

Was that going against the green or what was legislated up to the other?

SPEAKER_00 31:48

So that's so we had to so this was when we so so because of m um my involvement in student activism, I then got involved in um something called the Health Workers Association, which was a a um there were different associations, uh pol uh liberal there were different progressive associations in those days. There was Namda that organized doctors and nurses, and there was Health Workers Association that organized people irrespective of your whether you're a porter, radiologist, or a doctor. So I joined that um that group. I didn't want to hang out with a bunch of dentists and doctors. They wouldn't even let nurses come in, you know. Elites and Progressives. There were there were only two two whites who joined um HWA and you know, most other progressive whites who joined Namda.

SPEAKER_03 32:38

So do other white colleagues not like to look at these people, what are they doing there? Did you get any flack from them with them?

SPEAKER_00 32:43

I think that, you know, so um Nobody talks about that. People were uncomfortable, you know. So um when I was um uh you know, there was a period of time when we were organizing strikes in hospitals, and um I uh we the the head of Nihawoo, there was a court order, he wasn't allowed to come in within a hundred metres of Barragon at the hospital. And so we put a a white coat in a telescope what he so he walked there, so he walked he walked into the hospital and then we we jumped over the um turnstiles and we took the lift to where the superintendent was was was staying, and then we took over the office. Um and then they came and arrested us.

SPEAKER_02 33:25

But you know, so I was about to say, you could have been arrested for that.

SPEAKER_00 33:28

I w We were, and and then and then it is strange because um the one of the heads of department at Barrow was an Afrikaans, all Afrikaans doctor, pediatrician, and she phoned the police in us. Obviously these guys have got connections. So she phoned um the the police station and say, you you must release these people. She's got she's and I was I was on call that night. Maybe they were more worried than I was than we had. Yeah, so you know, and she she has to be on call tonight, you know. So anyway, they they released it. So so they were a little bit uncomfortable, you know, they were a little bit uncomfortable, but they also were, you know, they weren't gonna criticize me, but they um, you know, they were wary, shall we say the old God were wary of people like people like how.

SPEAKER_03 34:13

So how was jail?

SPEAKER_00 34:14

No, wait, were your family and friends part of you or they Um So um so my so my um so my family were they kind of just let me they they they didn't ever criticize or not support me. They just stayed out of out, you know. So besides my brother, um the rest of the family were kind of um I would call liberal, but they were never ever going to stick their necks out um, you know, in in any way. But you know, so but they were never ever um uh judgmental or criticized me, you know. So they they accepted that I was quirky.

SPEAKER_03 34:52

Well that's good enough support at the time for that time. That was good enough. And they've always been like that.

SPEAKER_00 34:56

Yeah. And so they they, you know, so you know, um, and maybe because I as I say, because being a doctor, you're in this this fortunate role in society where you can actually make a difference. So if you're um, you know, uh a banker, you know, you're not exactly I don't know, you know, you you you're not put into a a a situation where um you can act and say this is not fair and this is not happening. Yeah. So so you get lawyers and doctors can change the world, I feel they've got the ball. So you have the privilege of, you know, so as as as lawyers you can you you can um defend someone who's who's up for treason, you you know, there's a there was a little bit. Well you can't, you know, you could run a free clinic.

SPEAKER_03 35:40

It depends. I heard a lovely.

SPEAKER_00 35:42

But I heard a lovely story on on 702, there was a quiz, and um this little boy had to answer five questions and he was he they were di difficult and he was a right boy. And if he answered all five questions, he would um uh win ten thousand rand. And they said to him on the radio, if you won ten thousand rand, what would you do with it? He said, I'd give it to my mother so I could go to the orthodontist. So anyway, he got he he got a bit unraveled. Then he uh got all four questions right, and then the fifth question, he just he got unraveled, I guess this the the pressure, and he he he didn't make the last question, so he only got a thousand. But what was beautiful about um that an orthodontist, uh a dentist phoned in and said, Um, send me the details of this child, I will do their teeth for free. So you see, so dentists can do things.

SPEAKER_02 36:35

That is a very small world because I think the person you're talking about is me.

SPEAKER_00 36:39

Well, is it you? Okay. But not an orthodontist. But no, it was a dentist who said, yeah, so yeah. So you see, um so so if it even dentists can make a lot of people.

SPEAKER_03 36:48

Yeah, wow, that they they can change a life.

SPEAKER_00 36:50

Yeah.

SPEAKER_03 36:51

But I feel like doctors and lawyers can change the world.

SPEAKER_00 36:53

Well, in the doctors, so it's depending on what you do.

SPEAKER_03 36:56

And and pol politicians. Yeah. But anyway, that's it.

SPEAKER_00 36:58

Yeah, depending on what I mean, so doctors at an individual level can save individual lives. But then I guess the the the beauty of being a doctor is that is that you can go from being a a a practitioner, clinician, or you could go and do other things. And and that's that's where I w I was lucky. So I was this this pediatrician. Um I I worked as a pediatrician before AIDS even happened. So I lived I b I b I belonged to the world where we didn't have HIV. Imagine that.

SPEAKER_01 37:30

Yeah.

SPEAKER_00 37:31

And then as a young doctor, HIV starts to explode in your ward, and pretty soon every third child is dying. So my dream of running a well baby clinic and looking at a little ward um was uh was changed because suddenly I as a pediatrician I needed to do something. You couldn't just have these kids dying like this like flies, you know, in your ward. And um and so I didn't even m I didn't ever ever see myself as a scientist because scientists were f for clever people. You know, I thought you only become a scientist if you're clever. I only realize afterwards you you become a scientist because you're curious, and you come up you become a scientist because you don't know the answer. And actually, science isn't about clever people, it's about it's about uh people trying to un unravel an answer for a question. So there I was, and I wanted to stop uh tr transmission from mother to child, and the only way we could do it was to look at because we had no drugs then, this is you know, early, this is 96. I've jumped up and down with my timeline. That's fine, no problem. But um and so suddenly you um you you write you write a st you know, I write a protocol and I designed a study, and suddenly you're um, you know, you're enrolling you're enrolling women into a study, you're following them up, you're looking at the impact of breastfeeding on transmission, you know, you're running a cohort of of um of women and children, you you're getting results, and suddenly these results are strong, you know, are strong and they change policy. So quickly I realize, gee, um, you know, um research provides evidence and evidence can be used uh for to advance policy or as activism. So at that stage it there was age denialism in the country. The government government was refusing to provide antiretroviral therapy uh to women, you know, um for to prevent their babies getting HIV. Um and uh the treatment action campaign took the court, uh took the government to court and we as as clinician scientists could provide the evidence that made them win. Did you have to go to court case? So we we I went we went to court and we were the we were giving we were providing the medical advice to the advocates to for their argument. And um and then you realize just how powerful s evidence is, how powerful science is. And then, you know, um and then by doing these these research this research, um you sh you know, you basically provide an avenue for people to people to get treated in South Africa. So we used to be running um these clinics for for for women living with HIV and their children, and we used to bring in people um to talk to them, you know, and um uh they would, you know, we would have um you know, at that stage there would there were two there were two epidemics, you know, one one amongst mostly black women, heterosexual, and then um a you know a um a an epidemic in men who have sex with men. And we we would work, we would bring men who have sex with men into the clinic and they would talk. And these guys were on treatment trials in the in the suburbs, and these women said to us, uh you know, how can if you if you if you're white and you live in the suburbs, you can get on a treatment trial and you know, how come we can't? And it was a good question. So we we then started um trying to get um drug companies to to um include uh government sites. And at first that's you know, you know, these people, you know, you need nutrition, you need watches, um, you know, and and eventually um someone cut us some slack and gave us a trial. Um, pharmacy up john at that stage gave us a a trial where we could enroll women into the trial. And at first we it was a struggle even to get the the um the trial approved by our ethics committee because they said oh there's only two years um post-trial access and it's unethical. And then when we told the women this is what the ethics said, they said, Who are these people? We want to go and talk to them. So I put them in my car, the woman and the children, and we went to the ethics committee, and there's a bunch of white men uh sitting there and there's women with babies crawling around, and they like try and explain to these women why they're not gonna approve the study. And these women are saying, if I have two more years, you know, so I don't care that I only have two more two years post-trial access. You know, my baby, look at my baby's two, and if I get two more years, it's you know, I get to see four and maybe even more. And like you're saying that uh it's unethical, you know, and so basically these women changed the view of an ethics committee. And so that's also what I, you know, so I learned very quickly that, you know, working with the community, you know, working with activists, um, um, and then also generating evidence uh helps. And if we hadn't done these trials in the 90s, um, we wouldn't have had doctors who were experienced enough to to initiate people on treatment. And so the first places when we were able to get ARVs in South Africa came to the researchers that had been doing all these trials because we knew how to initiate treatment. And we were at that stage, um, um, we put we were putting we were we put about a thousand people on treatment in about six months. We were putting we were putting a hundred people a day on treatment. And, you know, and that was okay, so that there were there there's been some important times of my in my life that have been really pivotal. You know, though that one was um basically uh initiating treatment. And you know, our our clinic went from a from a place where there were drips and wheelchairs and oxygen, you know, to a a clinic where there was there were no no one was sick. And it was amazing.

SPEAKER_02 43:37

And prof sorry, was the objective then to prevent uh just mother to child transmission or the overall treatment of AIDS?

SPEAKER_00 43:46

So that the so the there we had two objectives. One one was to prevent mother to child transmission and there were different trials for that. But the other trials was post pregnancy, you know, um these women need to be on treatment. Okay. And so that's how we were able to get those.

SPEAKER_02 44:00

So it was from a pediatric approach.

SPEAKER_00 44:03

Yeah. It was, you know, because we we listen to, you know, you're in a in a clinic with women, you're running support groups and um you're listening, you know, so the the the good thing about you know um being a doctor or being involved in these kind of um areas is that you get to hear, you know, that's what's good about being a doctor or Daz, you get to be in the face of the the problem, you know, of humanity, you know, their suffering, you know, with their their sickness. And sometimes you don't even want to know. So you just want to treat some at times as a doctor. Like I don't even want to know if you've got a mental health problem. You know, I'm gonna prescribe your antibiotics and you know and then but yeah but it's but it's also important I mean so but if you don't ask those questions like are you sleeping at night? And sometimes you think I don't want to open that door you know I don't want to know that um you know you're out of work and you you're on the bones of your ass and you know so but but that's also important because you know as a doctor you you get to to you get face to face with humanity and it and it can be ugly and painful.

SPEAKER_03 45:11

Prof, you you said something huge just now and you probably don't even realize it because you've lived through it and it but you said you come from a time when there was no HIV to a time when there was an when you know HIV was huge. What was it like that transition? I'll tell you why I thought about this is because one of our guests we interviewed Norman Kai told us how he used to see patients with no gloves as a dentist.

SPEAKER_01 45:36

Yeah.

SPEAKER_03 45:36

And and to us that seems mind blowing right but then everything changed. So what was it like? Was it scary? Was it like oh gosh are we going to get infected here?

SPEAKER_00 45:45

Take us through that was so in while I was a medical student we start started to hear about the slim disease in Uganda and and and about the um epidemic in in the US and um so we started to hear about about HIV and at that stage um uh in the the the government which is which was the apartheid government um had very strict obviously border controls and they were testing um mine workers and they would repatriate all mine workers, Malawians or people from Lizard who had HIV so we just basically had a very um um um vociferous stance against um against HIV. So so so so as a s as a a medical student we we got lectures on on this new um slim disease slims because people are so thin. So we we got lectures so we were getting lectures there's this new disease it's in east it's in West Central Africa you know we didn't even know what you know you know that you know um it was you know that they had this this virus had jumped the species barrier and you know no one really knew how it emerged and everything.

SPEAKER_02 47:02

So almost like COVID.

SPEAKER_00 47:04

Yeah COVID and then so we you know so it's theoretical you're writing notes everything in your but not like COVID 'cause much slower, right? Much slower.

SPEAKER_03 47:12

Yeah.

SPEAKER_00 47:12

So so then when there were um so if there was a so on the odd occasion there would be a child who would land up and eventually you test and the kid comes back um diagnosed with HIV and then there would be a grand ward round because this was an exotic exotic disease of childhood, you know so everyone would come around and then and the the physician you know there's the stigma explained to you the stigmata of of you know this is this, this one's got PCP pneumonia and look at the X-rays. You know, so it was like um an it was an exotic disease at that stage. And then suddenly and it felt literally overnight but um in a space of two or three years suddenly we went from um you know one woman in a hundred being HIV who was pregnant um being diagnosed with HIV to one woman in ten. You know, that's how it it changed and it was you know literally as as we were as we were doing our clinical years the the as a student the the epidemic was changing and you were starting to see HIV and then fast forward um you land up in at Barrow and uh thirty percent of all pregnant women have got HIV and in the wards one in three kids are infected and you know basically and these kids are you know there's nothing there's no treatment the only thing you can give them is back drum for PCP pneumonia and you know you just basically are choreographing death at that stage and that and that's devastating because the women were young first baby you know they'd come with the Road to health card um with you know Christmas you know how you you wrap your your your when you go to school you you have to go and wrap your your your textbook and your and your books and you put Christmas cards you know and these this is what you know these women come with their Christmas cards and the name of their child in Kokie Pen and you know like you know excited about this this journey but then I need to know that first of all, you know, so that the child was the canary in the coal mine. I need to I need to realize my baby's gonna be dead within a year and I'm gonna die as well. Shh. And they were 20, 22, 23.

SPEAKER_03 49:28

And and in those early days of of the so-called slims and stuff, was it seen as, you know, just a a a disease of men who have sex with men and some something in Africa or what was it like?

SPEAKER_00 49:38

So there it was so it was seen as two then there were the the two epidemics um you know and the one was um you know amongst amongst um blood transfusion, hemophiliacs and men who have sex with men. And at that stage we no one knew that it it could be transmitted through breast milk or through in you know so we didn't even know that was a route of transmission until we started to see babies and that was in the US that were actually you know um were infected either you know um you know through hemorrh you know their husbands had had hemophilia the the mother was infected um and the child then was infected like Elizabeth Glacer uh and you know those those kind of cases and um and and yeah so so there was and then we saw this this epidemic coming down from Central Congo. So I guess much like COVID, you know, so we have these these these pla these origins that are happening all over and it's not just one epidemic or two you know it's um it's you know it's through sexual acquisition no matter what sex you have and through blood and and um and through breast milk. So you know that's you know as long as there's bodily fluids and there's you know there will be virus and you'll be try you know it can be transmitted.

SPEAKER_03 50:56

Okay so we as you said we did skip a lot in the chronology there because we went straight to the research and stuff.

SPEAKER_00 51:01

I mean we didn't even talk about what what made you think of doing PEDs was there a moment there was it just a natural progression from med school so I liked so when we when you go from you know discipline to discipline I I always like the kids um first of all because um they were easy to manage they're not big adults you know it's hard to turn an adult around. That's the opposite exactly I was about to say the opposite try injecting in the mouth yeah yeah you can't yeah you know you can strap them in a blanket so they can't move yeah pizza I I used to be really afraid of kids so when they were sick they were sick but when they were well they were well and you know when they were well they would you know and then there's no bullshit with children you know you know they're not typochondrics when they're sick they're sick when they're well they're well you know and that's you know when they uh even when trying to get a sick even when they're sick they're well they want to dress up when they're sick yeah so yeah so I you know I just liked um I I liked you know the it you know they're vulnerable and you know you know I like their honesty they were always a pleasure to work with. And also you know and you you know so I had this kind of affinity. So they just that was you know I really enjoyed working them so I wanted to become a pediatrician.

SPEAKER_03 52:11

So when do you so you finish med school you have to do internship?

SPEAKER_00 52:13

Yeah so we did int I did internship at um what was called Cor Cor Cor Coronation Hospital which is now Remote was a a general hospital. It wasn't just a mother and child hospital. So I did my house job there then I did um uh six months in in as a senior house officer in pediatrics and then I went to Barrow to main ICU so and that's so and in main ICU so main I went so I loved um intensivist I loved um you know emergency medicine I loved ICU um and when I was there you know going and learning how to you know you know work in an ICU there was this cardiothoracic surgeon who was the head of ICU and I kind of thought like what is this cardiothoracic surgeon doing um running an ICU he should you know he apparently you know he apparently was one of the top cardiothoracic surgeons in the country and he was you know had golden hands and lucky I was this guy who was not in theatre and you know and so this was this was 1988 and um he you know um you know in in the ward rounds and you know um in it after you know you know in the evenings you kind of sit around between ward rounds and you know he he um um told me he was HIV he was he was living with HIV and um and basically the moment he found out that he was like a dentist who didn't have gloves um the moment he found out that he um was HIV you know HIV infected um they took him off the the circuit because obviously they were worried about him transmitting um you know you know a blood blood leakage and that nineteen eighty eight nineteen eighty eight and he died a year later of T B. Um you know it was just like you know so that that was my first exposure of of a a a not a patient but a a my boss, my doctor boss a colleague, you know, who who died um before treatment was available. So now if if treatment was available he would be allowed today he'd be operating. Yeah. You know um as so many are right yeah you know so it was it was just um so that's you know so then you know so you see it doesn't only affect um um you know the people that you work your your patients but also your colleagues and we did see in those days um we did you know we had nurses that that died, social workers that died, doctors that died, statisticians that died of HIV.

SPEAKER_03 54:48

But doesn't that hit you and think it is horrible carry on now?

SPEAKER_00 54:51

No, I mean that it it was it was devastating um to see that. And you never think maybe I should, you know, do something else or no because you you kind of you so that's you know with with being that's kind of becomes your core. It's our job to to to do something.

SPEAKER_03 55:13

Figure it out.

SPEAKER_00 55:14

To figure it out, find ways and so so so so going back to that was you know I was gonna be a doctor and I landed up becoming a scientist because of a epidemic.

SPEAKER_03 55:27

Yeah. Okay so Barra, then what happens after Barra?

SPEAKER_00 55:30

So Barra so um so after Barra, so um I then obviously you you know you go into your your red circuit um so you apply and you get in yeah so you do your you do your your your s your your your circuit yeah and then um got my exams and then landed a job um at the ICU at the near natal ICU at Barra because I I liked little babies ventilating them pricking them. No as a joke as a hero that's concerning. Yeah so and then and then that's when I started my research because I'm I'm you know I'm looking after babies and who teaches you how to do research? I mean is it part of the program I mean so in those days in the olden days um there was a research methods course Peter Cleeton Jones who is a dentist and I think do you know him? No he was a dentist um he ran this research methods course it was a two week course yeah and at the end of the two weeks you present your protocol and like oh you now you're a scientist. Anyway so it sounds like a dentist sounds like a dentist I wrote my first protocol and got ethics approved and applied for funding got 4000 Rand from the medical research council. It's big isn't it and then like basically that started my career then I had money to you know pay for the blood tests and and um and we're just coming out of apartheid. So this is so so at this so remember this is a stage there was still academic boycott. So um South African scientists doctors who are involved are not are not going to conferences, are not mixing with everybody because of the academic boycott. So um you know so the academic boycott um lifts and suddenly they're these South Africans. So first of all when we went to conferences and we presented our data they they didn't understand our English. But you know they had not so they could we always they couldn't they you know I so you know they basically is um Irish but I c I have a a mixture. So Portu so from my mother's side Afrikaans uh Portuguese and Irish and from my father's side Dutch and um um in Dutch and and unknown because um his ma his father was uh illegitimate so we don't know much about what what his dad's dad came from. But essentially you know the the typical uh melting pot of um whole lot of um people but but I do you know so my mother was Pretanella Hendrina Villomina so she is she was Afrikaans but um after the Second World War a lot of Afrikaans families what called the Ferengost Englicized yeah they so they went they these Afrikaans people send their kids to English schools and so that's so I guess it's a I'm a hybrid.

SPEAKER_03 58:35

Yeah but you do have a white South African accent so it's Africa No it's like an I can understand you.

SPEAKER_00 58:42

Yeah but imagine like these South people hadn't heard any South African African accent you know um and they you know we say aluminium and they say aluminum and laboratory and they say you know and you know they say you know so they like you know definitely you know th they were you know mandatory you know uh mandatory you know you know so they like they like Yeah you know so they and we say it's a pleasure like or or shame. Yeah that's shame for what? Yeah you look how cute that you know that you see a baby say shame and they're like no this is a perfect what shame about my baby. So anyway so so suddenly um there are these South Africans that are that start to um go to World Health organization, start meeting and um I'm part of that and this is I'm in my early thirties and suddenly you get exposed to um in a global area particularly around HIV and um and because we had such huge problems and you know I guess also when you're young you're you're pushy you're ambitious and so basically you you know you make sure that you that you are um heard heard yeah um in those areas and so they you know and we must have just sounded like these upstarts from South Africa.

SPEAKER_03 1:00:04

You think so?

SPEAKER_00 1:00:04

Yeah I do think so you know um so when I my so my research um in breast milk transmission so this is before ARVs so when I was trying to design my study you know um um you know so women women without ARVs have got two choices if they breastfeed their babies either your di baby's gonna die from diarrhea diseases and um malnutrition because you can't afford the formula or you're going to infect your baby and the baby's gonna die from HIV. So women have it's like um it's like Sophie's choice um you know like what do I you know what do I do in a you know in like in a sense like you know how do I kill my baby? You know and you know that kind of that kind of dilemma. Sectic you know um and so I would when I would present that so I would present the the information to the the woman and then I'd say you've got to make a choice. You know you've got to look at your circumstance and you're gonna choose um the the best the least risk for you and and then what my job was to follow up the the the babies and and then look at the the the difference in transmission but also the outcomes of of not breastfeeding you know diarrheal diseases so you know so yes you were HIV free but were you free from malnutrition and all of that or yes you you you you got HIV but you know are you know how is your health so when I presented my my data for the first time at a conference um there was this young yeah was it in Vancouver in 1996 oh you know like so first I went completely naive so I don't understand the breast milk politics the Nestle you know so you know we like um isolated in South Africa and I was of I was of the generation so I wasn't from Jerry Cavadia's generation who saw what Nestle had done in South Africa and malnutrition and pushing formula so I that that had escaped the older the next the next generation of pediatricians so I was less uh you know I and I thought women could even poor women could feed responsibly if they were using you know if they were supported they could safely formula feed.

SPEAKER_01 1:02:15

Okay.

SPEAKER_00 1:02:16

And you know and so when I first presented my data, you know, I you know this is like 33 year old I don't even know how old I was 33, 36, and so you know and then suddenly there's this queue of people lining up to ask me questions and like who found who funded your study? Like like what do you mean? The MRC funded my study you know are you on Nestlé's payroll? So like so there was this whole backlash.

SPEAKER_03 1:02:40

Well give us a nut what's what's the nutshell of what your data said.

SPEAKER_00 1:02:43

So the the basically my data showed the the the transmission rates were higher in the in the woman that um breastfed as compared to formula and the kids that were getting formula didn't die and they they didn't they they weren't malnourished so they weren't that but and this was Soweta and I did make the point. But they kind of thought that you know Nestle was paying it. Well this explains the line of cynics the line of cynics saying like yeah who's funding you're not sure yeah in a white and I'm white white from South Africa. So you know like how you get big pharma this is big formula funding but why Nestle specifically because Nestle was that you know the evil because at those that stage Nestle was one of the biggest companies had had dumped formula in in in the so-called third world in those days and kids had died because you know there was no safe water uh you know it cost money so that was diluted so kids were malnourished and so Nestle did a terrible thing you know um to sell formula. Yeah this is when in the n ninety six oh this is yeah this is in the sixties and the seventies it's important to mention the time so by the time you know by the time I did my study you know we were in a different situation. So even though we were in Soweto and there was access to water, you know a socioeconomic status of a a woman in Soweta as compared to a woman in rur rural Malawi are completely different. And so that so the point that I was trying to make also was that there are situations in Africa where women can breastfeed. Okay and you know and if if you know at that stage HRV positive positive there is a time at that stage before we knew ARVs you know before we even we this is ten years before we knew if you give a woman ARVs from the time she's diagnosed triple therapy you can breastfeed your baby. So we didn't know all of that at that stage because at that stage there were no ARVs so so avoiding um breast milk um would you know help with preventing transmission. And so so it was that dilemma and um and and what my point was that in s even if you are in a poor setting um um women should be able to make a choice. They shouldn't be told by a doctor breastfeed your baby That's what doctors were saying at the time or bottle feed your baby. And they should say this is the dilemma and um how can we help you?

SPEAKER_03 1:05:12

Okay. So that was your first experience in Canada first time we got leaving the country they putting your your words in subtitles that nobody can understand.

SPEAKER_00 1:05:20

Because then they you know we had to go BBC uh was it BBC ABC was interviewing me and then I saw like how like they don't understand my you know just embarrassed me I was like mortified that they couldn't understand my English.

SPEAKER_03 1:05:32

Yeah. And then it then your research career takes off from there.

SPEAKER_00 1:05:35

So then so then you know we're involved in a lot of mother to child transmission studies and so I was you know becoming good at clinicians as a clinician scientist. Because of our HIV um epidemic, Eskim Department of Science and Innovation and Department of Health realized that they they need to start making an HIV Vaccine. So they they put money together and they give it to the Medical Research Council.

SPEAKER_03 1:06:05

Why did they do this? Is it because it's affecting their workforce?

SPEAKER_00 1:06:14

It's all about the money, right? It's all about the money. So they start, yeah. They start the something called Savi, the South African AIDS Vaccine Initiative. And money is given for scientists in South Africa to start uh designing a vaccine. So at that stage, uh I didn't know much about HIV vaccines, but the director of Savi approached me and said, Look, Lindy, you know how to do clinical trials. I want you to join the team. And I'm saying, no, I'm doing mother-to-child transmission. This is my career. And he said, No, um, you know, um, the country needs you to work with them on an HIV vaccine. That's cool. And so that was cool because, you know, so anyway, so I joined the team. There were virologists, immunologists, uh, me, the clinician, people doing animal experiments, ethics, community engagement, and we had this whole mul you know, multidisciplinary team. Um, and um, you know, the s the virologists designed um a vaccine. We we we got it manufactured in um overseas because at that stage, well still not even at that stage, even now we can't make our own vaccines for you know for HV amongst, you know, that's another story we can go down. But um and we tested this vaccine in both in the US and in South Africa, but it um but it it didn't, you know, so other you know, other events took over, and then um this this this vaccine regimen wasn't chosen to go forward, and then we got involved in in other other research. So um so then I sp I've spent since then working in mostly in HIV vaccines and HIV prevention, um, and then getting involved again in clinical development, clinical design, doing, you know, so so most of my time, besides when I was in doing COVID vaccines, has been in HIV vaccines.

SPEAKER_02 1:08:05

Okay. That's fascinating. And that must have been very interesting because you moved now away from clinical settings. You were not seeing the babies that you usually see.

SPEAKER_00 1:08:13

So I moved away, um, still seeing um people, but adults.

SPEAKER_01 1:08:19

Yeah.

SPEAKER_00 1:08:19

And you know, but I was always interested in an HIV vaccine um because I think the best place for children. So the best the the best place if you ever had to have an HIV vaccine, the best place to implement it it would be with the EPI program. And then um you could prevent breast milk transmission and then boost them when they become adolescents and protect them when they're older. So the reason why I became involved in HIV vaccine research because I always wanted to bring it back to infants. And in and in all my years doing HIV vaccines, I've always pushed, when are we gonna start to do the trials in infants? Which man which basically we've now we're starting to do trials in infants. So we're starting to do um discovery medicine trials in infants, because what we've discovered is that the infant's immune system is very plastic. It's um naive, you know, um and and um immunization in children, um who if you immunize in children, and the earlier you immunize, you have much more durable immune responses. So that if you immunize um for any any you know, so if you compare an adult or a five-year-old to immunizing um babies, um you have you induce much uh more potent immune responses and they're more durable. So basically, um, you know, we've managed uh I've managed to to push um uh people to start to do um some studies in in infants.

SPEAKER_02 1:09:55

Okay. There's there's two questions I want to answer now. They're loaded questions, but before I forget, we're not gonna go down that road. But maybe in summary, if you know why, if you have an understanding, why is it that we are not producing vaccines in South Africa? Well, I I guess Or the research to produce. Yeah.

SPEAKER_00 1:10:15

So I think that's so that's an important question. So um post during apartheid, South Africa was quite s was quite s um uh self-sufficient in making certain vaccines. And um um post apartheid there there was a a kind of look and I think there were some decisions made that actually, you know, that shouldn't be our business. You know, we we all closed down the oral polio polio program, and so we basically um, you know, got involved in global procurement and didn't really um see the need for um research and development in vaccines. So that was a a a bad policy decision. But I guess it was pragmatic and um with the people at the time were probably getting advice from WHO and you know, that they're like, you know, don't waste your time. But but it became evident that um, you know, that that was not a a good strategy. And um so there hence Biovac was formed. Biovac is a public-private partnership, I think government owns 39% of it, um, to try and um uh uh start a vaccine manufacturing capability. And so Biovac um mostly did first of all, they you know they did reverse tech transfer. So they they would get the the the the vials and then you do labeling and then you get fill and you do fill and finish. So you basically um you you get the the reagents and then you you bottle and then you so basically they've been moving down to to so you want to have end-to-end capability. And um, you know, we we haven't we haven't had end-to-end capability um in South Africa for human vaccines um uh since uh 96. And I'd so but now um uh Biovac has got um had got a tech transfer for oral cholera vaccine, and this will be the first end-to-end vaccine made on the African continent in 50 years. Yeah.

SPEAKER_02 1:12:20

So when you say end-to-end, you mean from the image.

SPEAKER_00 1:12:24

Yeah, from the yeah, from right from the beginning. Yeah, from the seed, you know.

SPEAKER_02 1:12:28

Very cool.

SPEAKER_00 1:12:28

Oh, yeah. Yeah, not like made overseas and then brought your and second phase and third phase. So this is so it's exciting. That is exciting. And um, so I've been lucky because I've also been able to be involved in that program as well. So we're doing a clinical trial now. We hope to, you know, um have the results at the end of the year and then register it, and it'll be the first African vaccine that'll be used for global procurement and and there's a shortage of orocholera vaccines at a global level. So so this is an exciting area. So so so there has not so why hasn't South Africa got a vaccine manufacturing capability? There's just not enough investment from from the government. So you need to uh invest more than just fill and finish. So pharmaceutical companies just want to make profit. And so they they will just give us the the the give us the um the the the volume and we'll put it into um vaxx we'll we'll fill it like Aspen does. We'll put it into we'll violate and label it. But the research and development, the upfront, the discovery work is expensive. And normally at a global level, the discovery work is paid by the public purse or philanthropy. And um and um no farmer is going to to to invest in our uh in in the kind of blue sky research because it's at risk, it's huge risk, and that's why you need government to put it up.

SPEAKER_03 1:13:56

What does discovery work mean?

SPEAKER_00 1:13:57

It means so you start from the beginning, you say, okay, I want to find a an HIV vaccine and I don't know where to start, and I'm gonna start um with various strategies, and most of them will fail. And up to date, most of them have failed. And so you spend uh billions of rand or dollars getting to a phase one trial and you have to abandon it. So so big pharma is not interested. So you need other people to find this. And it it it's at it's and it's uh you know, it's funding people at universities, finding people who, you know, who um the the vaccine may never see even um an animal experiment. A lot of risk. Yeah. But you have to do that, because if we don't do that, then we don't, you know, we don't find mRNA and we don't find um cancer vaccines or COVID vaccines. So you have to invest in that beginning part. And um and and then you also have to invest as a a government in um also um so there's research and development, so big R, small D, and then there's research and development. So you have to also invest in development um of a vaccine candidate. And um that also requires um, you know, public public money because um uh b besides fit and finish, all of that costs a lot of money, lots of plants, all of that kind of thing. So you do need a government that understands um the value of vaccines and understands that it that you're creating a a workforce for um um good manufacturing processes, a whole industry. And so you have to have someone who understands that and drives R D in the pharmaceutical arena that from discovery to to production. And and and you need big money. Um and we we have you know, we've never invested that much in in in that. Even with our animal vaccinations, you know, we used to make animal vaccinations in honesty put. Now with this foot and mouth disease, we don't we we haven't to import vaccines from Botswana because we we don't, you know, we it you know, um honest to put has has um is you know has collapsed, you know, it's not working properly, and so it's just a a tragedy in our in our in that area.

SPEAKER_03 1:16:15

Aaron Ross Powell So it seems like you scientists have a tough job having you know trying to influence and convince and s you know tell people the story. Like the policy makers is the story. Yeah.

SPEAKER_02 1:16:25

It's almost like you need a PR campaign to tell a story of a world. You know Dr.

SPEAKER_03 1:16:29

Neeraj Mystery. I was gonna say uh you don't know Neeraj Mystery. Yeah, he was one of the guests, you'll enjoy his episode.

SPEAKER_00 1:16:35

I'll look at Craig.

SPEAKER_03 1:16:36

Because he went to the US and became big in that sort of You do need okay.

SPEAKER_00 1:16:40

So first of all, most people think science is a luxury.

SPEAKER_03 1:16:42

Yeah.

SPEAKER_00 1:16:43

You know, and um and actually science is not a luxury because science dri drives um GDP. So if you look at at countries like Singapore, Malaysia, South Korea, so um they were desperately poor countries. And these guys knew if we don't invest in STEM, China, you know, we don't invest in STEM, we don't invest in um innovation, you know, um we're we're not gonna be anywhere. And um and so the you know, there's a there's a lot of indicators to look at what drives GDP. And over over and above democracy and and everything, the the thing that drives GDP is is publications. So publications is a proxy for for science. Okay. You know, uh discovery. So so so um the biggest driver of of of economic growth is um is science. And so if people people most people think, oh, you know, it's that's a luxury art a luxury function of of a poor country. And actually it's it's not it's the most important thing to do in a poor country. Without science, countries will remain poor. And you know, that's why China has also understood that they've got more engineers per capita than anywhere anywhere else in the world. And so um you if you don't drive um investment in STEM, then basically even TikTok has a STEM.

SPEAKER_03 1:18:10

You know what STEM is, yeah? Science, technology, education, education, something.

SPEAKER_00 1:18:15

Mathematics, yeah.

SPEAKER_03 1:18:16

Yes. You had another loaded question, or should we are we moving on?

SPEAKER_02 1:18:19

Yeah, well, uh we might be jumping ahead, yeah. But um, prof, you've lived through two like health scares in the world, epidemic and a pandemic. Firstly, what's the difference between the two?

SPEAKER_00 1:18:32

Aaron Powell Well I think it's uh I guess the spreader um it's that's debatable. And the epidemic is largely in in different pockets of the world, and it's um you know it's it's a l uh it's you know, you have endemic, epidemic, and and pandemic. So endemic is just, you know, some malaria would be endemic, um, TB. You know, but some people fight and say, no, that's also an epidemic. So depending on the the the burden of disease and the distribution. Um and so HIV is probably a pandemic. And it was a pandemic but before ARVs But it was labeled as an epidemic. It was labeled as an epidemic. Pandemic was, I guess, and pandemic was because it was just um I guess the infectious nature and the f the flurry of its spread and the the the the the um the extent that at a global level, um, you know, you were exposed, were you in a village um in Malawi or you were in the It didn't matter where.

SPEAKER_02 1:19:27

Yeah. And my question is, I'm reading about something called Nipah virus now that's coming around. And do you think that we are gonna be living through are you are we in our June lifetime gonna see another epidemic or pandemic?

SPEAKER_00 1:19:44

It's likely given the the combination of um climate climate change, um natural disasters and mobility of people and the proximity of humans to to um species and to animals, um and you know, and the exposure. So so it it is likely that we will face um either outbreaks of um uh you know, re what we call re-emerging diseases like Ebola, so outbreaks of um of known um known viruses, or um, you know, outbreaks of of new of viruses that have evolved, like like influenza, an avian bird flu, you know, or you know, a um a a species jump that you know, because of the exposure um to to um animals. So so one of it's very likely, and I guess the drivers of this now is probably climate change.

SPEAKER_02 1:20:48

Okay. So uh just on that, like if you can when these sort of things happen and you watching it on the in the news or because I mean you're exposed to this all the time. You just you don't just see this sort of or get the sort of information from the news, it's from your colleagues. Because you've been in the industry, you're a pivotal part of HIV and even coronavirus. But what makes you worry? Should we be worried right now?

SPEAKER_00 1:21:17

I think we should be worried because um uh whether it's an outbreak or a or an epidemic, we should be worried because these things are inevitable and we should be prepared. And so that's why surveillance is important. Um the reason why we were so lucky with COVID was because of the global investment in in HIV vaccine research. So basically, um the um we just pivoted, so all the infrastructure we had built at a global level um in in HIV, basically all those scientists just pivoted to um to to COVID. So the clin the clinical scientists were ready, the labs went from neutralizing antibodies for HIV to test, you know, to developing assays for for for for COVID. The the molecular biologists, you know, rapidly who were working on HIV, rapidly sequenced um the the you know the the SARS-CoV-2, um, um the platforms we were using, later, you know, you basically just basically um switched to that immunogen. So the the whole the whole global infrastructure allowed us to pivot. And so if we don't so that's why research is important and and um and we should be worried if we're not investing in this kind of infrastructure to respond. So you don't have to, you know, you can't have something that's that's latent and everyone's just sitting, you know, in a room uh waiting for and you know, you you need to be you need to be ready, you need to be in the field. Uh you need to be doing these things in the lab, and maybe not you know on in HIV and TB. So you need to be practicing. Um so when something does happen, you just basically shift your your response to that and you're ready. Um the regulators are ready, the the clinicians, the the lab people are ready.

SPEAKER_03 1:23:09

Aaron Powell So the mention of COVID is probably a good segue to this next point that I wanted to make is w is that I think I suspect that your name became somewhat of a household name during the COVID time. I mean I think that's the first time I heard your name. That's when I discussed it. How did you get involved? What was that about and what was it like becoming quite well known and prominent?

SPEAKER_00 1:23:28

Aaron Powell So at that stage I was the president of the South African Medical Research Council. And in and our job is to fund and conduct research in South Africa. So um on the 5th of March, I think it was, um, the DG of science and technology for Majah, he phoned me, I was I was I was I was I was in Durban and I was about to catch a plane to Cape Town. 2020. 2020. And he phoned me and said, Glenda, what's our research strategy for COVID? I said, Look, DJ, I'm I'm on this plane. When I land, I'll we'll send you something. And I sat on on the plane and I thought, okay, like what what is our problem? Okay, first of all, um we we there we have a shortage of diagnostics. So, you know, the the the PCR, there was a short global shortage of PCR. So we have a shortage of diagnostics and and point of care diagnostics. We don't know what's gonna happen. We have a country full of HIV and people living with um TB. Um I don't we don't know what the natural history is. We don't know what natural history is in in black people, you know. We you know, we don't know about the comorbidities, we know we don't know what's gonna happen. Are we gonna breeze through it or are we gonna be devastated? So we so I knew that so we we didn't know much about that. We didn't know um at that stage the tri, you know, like we you know, we thought it was those um droplet spread, but actually it was uh you know aerosol. So we didn't even know the mode of transmission and we didn't know what if there was gonna be th therapeutics or a vaccine. So so I I knew that for vac vaccines are expensive. So the only way um we can work is to collaborate collaborate internationally with vaccines and therapeutics. So I said we we have to we have to have we have to be able to co-fund research that happens on vaccines and therapeutics, but we can't lead it because we don't it's we're talking billions of of dollars. Um but what we can immediately do is um invest in um natural history, um uh start working on rapid diagnostics and um and and and try and figure out how to do to to do PCR and how we can you know how we can be able to diagnose this. And then also the molecular epidemiology, like how so we set up so basically um so I you know, I I put that list together and I sent it to so Lynn Morris was the the director of NICD. I said, does this look like a fair approach? And that was our Bible. That's we stuck so what we made on the 5th of March was what we s what we stuck to in our funding model. And so we would so immediately we were able to set up a uh genomic surveillance, so that's how we could diagnose um um Omicron. Um you know, so we had the so the the guys were testing, and so we w we paid and we supported that. We set up wastewater surveillance, so basically we could check, um, you know, we could predict an outbreak ten days before it happened by just looking at at sewerage. And and so we set up wastewater surveillance. Um, and then we we we had a healthcare worker cohort and some and some community-based cohorts, and we also invested in um uh diagnostics. I gave uh Bavesh Khanor, he's a TB um uh uh uh lab scientist, gave him 650,000 Rand and he cultured uh COVID for us before we were culturing it, and he made a a rapid diag uh a diagnostic, um not a diagnostic, a a control to test um um uh uh to test new tests coming in to see if they were valid. And we could deploy that test. We deployed it to about 50 countries. Um, you know, and so so basically all the stuff that we did um enabled us to respond um, you know, um as scientists.

SPEAKER_03 1:27:21

So you were you on this ministerial advisory committee? So I was there.

SPEAKER_00 1:27:24

So I was on the ministerial advisory committee, and then we I had a f we had we had a couple of fights with the minister, and then it got thrown off of Shabir and I. Who was the minister at the time? I was waley and McKinsey. Oh, yes, yes, yeah. Yeah. So so so I I guess we I was fortunate enough because I was the president of the MRC um and we could direct the funding and we and and everyone and and and we kept to this the you know my hymn my my my the Bible of what we were gonna do. And that really um gave us an advantage um in at a global level. And so, you know, we had a lot. of information that so every Sunday I would I would meet with Tony Fauci and the HH sec secretary and we would we we could show him with um with the datcov um database we could show them um because we were two weeks always two weeks two or three weeks also ahead of them how come you you meet with Fauci how how does that happen well because we had we had date data as king you know and we could say okay Omicron's happened um and um this is what it looks like in children these are what's our getting admitted so we could show them so we were also really yeah we were helping them and maybe did they have subtitles on your on your Zoom calls I think by that stage they could understand me. But Discovery also was so we also so Discovery we used their databases because we had to we didn't know whether these vaccines were working. Because when Omicron came we thought we know what's going to happen. And so the data that so by having a public-private partnership um we were able to generate real world effectiveness on on both the Pfizer and the J and J vaccine um at a time when no one knew this.

SPEAKER_03 1:29:06

And we could then say to um uh you know uh policymakers across the world um the vaccines are working on the South Africans yeah we know we did we did very well in in well done too yeah well but but also in that time surely you have there's lots of other stuff you deal with because when you become a a well known person, a household name there's going to be the haters and the trolls anti-vaxxers and all that stuff to get to deal with all that death threats from the anti-vaxxers.

SPEAKER_00 1:29:32

Yeah yeah so I got we know at at one stage we I had a bodyguard. Really? 'Cause they said we know where you live, we know your route. What? And um So is that serious? Yeah. So anyway, so so we basically for a period of time we I had a bodyguard who I had guards at home and a bodyguard that drove me to And you live alone or who do you No with my kids.

SPEAKER_03 1:29:53

Sh that's not cool. So you've got and your kids are probably Well they were like yeah That's cool.

SPEAKER_00 1:29:58

We've got a bodyguard. No they don't well they like the they like the guard at home.

SPEAKER_03 1:30:02

Hectic man okay and then uh tell us about the time top hundred most influential where where did that come up?

SPEAKER_00 1:30:09

From from HIV vaccines. So um we were running a trial um a a an efficacy study in in Africa and um we had just about to start it. So I had a lot of promise. So um I was uh I guess I got it because of my my work in HIV vaccines and that I was leading this big vaccine trial.

SPEAKER_03 1:30:31

Awesome is that do you have like do you frame the what do they give you a m what do they give like little like you know like this thing?

SPEAKER_00 1:30:36

Yeah. What are those things called it's a little pin or pear badge and um that's underwhelming. What I think they give us um I think we we got a a picture of ourselves in the Time magazine. So all a hundred of you cool and we got uh we got to go and um uh get the award I d there what what did I no we just got that little thing.

SPEAKER_03 1:30:54

And where do you get the award?

SPEAKER_00 1:30:56

At in um it was in New York at the Times you know yeah it was it was fun.

SPEAKER_03 1:31:00

Yeah.

SPEAKER_00 1:31:00

Um you know I McTrevanowa there. Wow and um and um I hope you took pictures and stuff we did yeah I did yeah that was fun so um it was a it was a a lovely experience.

SPEAKER_02 1:31:12

Okay and so what's next prof? W well before that what are you doing now? Yeah you advanced two things.

SPEAKER_00 1:31:18

Good question Okay So I'm the director of the Infectious Disease and Oncology Research Institute. So in South Africa we have two um we have a a a an increase in cancer and a rising increase and um we also know that people with HIV um are likely to get um both infectious disease related cancers and non-infectious diseases related cancers early and so um there is an interface between HIV and cancer around inflammation that we don't truly understand the mechanism what happens what triggers um this pathway you know what's happening at a um at a at a gene level you know at a um inflamm inflammation level you know are you know what's happening so so we have a lot of things to discover around why people living with HIV get cancer. So there's that issue. There's also the issue of a lot of cancers in Africa are um are infectious disease based and we some and we don't really know the mechanism and there are a lot of cancers we don't know what the mechanisms are but they could be infectious disease related. So my part of my job is to basically open up a an area of of new research around infections and cancer and so that's part of my that's one part of my job. But the other part of my job is HIV vaccines and so um we you know I'm involved in in um in first in human first in Africa studies that are discovery medicine so there's a lot of technology now available so the time is now not it's not the time to stop working in on HIV. We can see it we can we've got crystal structures we we've got new um technology we can do single cell assays we can do we can understand um how the immune system evolves based on the pressure of an immunogen that you give someone so we're on the frontiers of of an amaz amazing HIV vaccine science which I'm I'm involved in and I'm very excited. So I see my yeah I see these two things. But uh I have a job to to drive a a um a new area of research um interest in South Africa and that's with Wits University.

SPEAKER_03 1:33:42

Our listeners won't know this because they they won't be watching you because but I just wanted to say that your face was lighting up as you talk about your job would seem very excited. Which is really cool to see.

SPEAKER_02 1:33:52

But Prof this is going to sound like an anti-Vax uh question and I really don't mean it but I just from my clinical experience if I have a headache I take a Pinado, my headache's gone, but then I can't sleep for two days. But are there studies being done, as you said, you know the correlation between the prevalence of people living with HIV getting cancers are or is there a study being done to to maybe correlate that it might be itrogenic because of the ARVs that they're taking, could that be causing some form of a cancer prevalence?

SPEAKER_00 1:34:28

Well the ARVs itself can cause metabolic syndrome so they they they can affect your gluconeogenesis. So th there there it's probably an interplay. So it's all it's based on inflammation and what are the drivers of inflammation in people living with HIV? HIV itself per se would be in inflammatory but if you suppressed um so your your immune system is not seeing HIV but yet how much in how much HIV in your reservoirs um that that that um may play a role. But then the drugs itself you know so um so so you know the the drugs themselves can affect um gluconeogenesis uh lipid uh um you know um lipogenesis um so the drugs themselves can have an effect on this this this the what we call a metabolic syndrome and then um you have the genes you know so we have our genet our genetic predisposition so you put HIV your drugs and your genetic predisposition all in one and then we have lifestyle you know food and so basically you know ticking time bombs but also an important um you know so if we can unravel the some of these things we can create interventions you know for people you know should people living with HIV on ARVs be on statins from the time they're on it? You know, we see a lot of hypertension um a lot of um diabetes you know um does HIV itself accelerate this? How do which the drugs that they're on, how does this play a role? You know what does it do to liver function? You know so I think all of these things um are are interrelated and so I think it's important that that we try and understand the mechanisms.

SPEAKER_02 1:36:15

No of course and it it's so interesting what you do because you got to study those variables and even those variables have variables. So how can you even pinpoint it to one specific thing and then you know people will come out there and you know hate based hate the research and say that this is uh this is all very biased towards something but inevitably what you're trying to do is understand what's something that is not understandable to even probably likes of yourself. And social media also a thing that's like causing what's the thing.

SPEAKER_00 1:36:45

Yeah well people get on yeah so people get yeah they they there's an there's an association and it may not be a direct attribution attribution so you know people you know you know you might you know you could say oh HIV causes hypertension but it it doesn't you know um so I think it's all those associations. I mean the most important thing about um vaccine safety is is to m have um you know is to have what we call pharmacovigilance. So all drugs, even vaccines, everyone, you know we should have be able to track the safety of these of these um of these um uh med medicines and um and see what the side effects are. So you know and there are rare side effects which give vaccines a bad name or drugs a bad name. Some some drugs can get give you Steven Johnson syndrome uh some vaccines you know you might you might have an anaphylactic shock or it could cause a a stroke. But those are rare, you know they're rare and so then you have to say okay do do we have a you know what's the risk benefit? Am I am I willing to live with so during COVID maybe you were will willing to live with a a one in million um you know you give a million vaccines and one person has a bad side effect so you maybe you're willing to live with that risk um in during COVID. But in peacetime then maybe you're not willing to live with those risks. And you know and that's those the kind of and we should one should be flexible and you know and uh about those things. You know, plastic about your policy depending on whether you're in peace or in pandemic.

SPEAKER_03 1:38:24

Yeah exactly. So Prophet I ask this question because you're because of the fact that your li your face was lighting up as you were talking about your work, do you think you'll be doing this till till the day you die or hopefully. Yeah is that what you want to do? Or till the day we die.

SPEAKER_00 1:38:37

I mean I think so the that's also the beauty of science is that um uh um there's no retirement age. Yeah yeah and um I think as long as you you know you you feel you're making a difference um but at the same time you also have to make sure that you you you empower the next generation okay that's a good point you keep working and so you also need to know your place in the team as you get older because you can't have these people that rule from the grave open up chances for for new ideas, new thoughts.

SPEAKER_03 1:39:09

What's made you think of that?

SPEAKER_00 1:39:10

Well I just think that it's important um you know we need intergenerational um uh teams and young people think differently if I think of you know I think of myself when I was young I probably made more impact in my from 30 to 45 than you know so I think I think young people are seeing things in different ways. Um you know the issues of AI and machine learning and you understand you know big data better than us. And so you m you might have ways of of solving um things that we can't do.

SPEAKER_01 1:39:45

Okay.

SPEAKER_00 1:39:46

And so that's why I think it's important. So I I'm a big fan of interdisciplinary team. I'm also a big fan of um um not always being the leader of the team.

SPEAKER_03 1:39:55

Okay. And div a diverse team and diversity.

SPEAKER_00 1:39:57

People coming from different avenues. You know we we were I was at a meeting the other the other day, yesterday, and w the um we're working in um climate and I mean heat and health because heat can have an effect on uh prematurity. So women who who are in exposed to high temperatures their babies are born early and um this has obviously impact on on infant mortality and that and um some someone made a a 3D uh one of the scientists in this team made this rudimentary 3D watch like a watch but basically this picks up it can measure it has to measure temperature ambient temperature and your your own temperature and um it has to like kind of record things but it's very rudimentary it can't transmit to uh you know you have to then SMS you know you know like so you know so so that so we were I said well why don't we bring together biomedical why don't we bring the biomedical engineering team together together with AI and um the teams and let's pose this you know he has this watch but this this watch needs to transmit this watch needs to do this this watch needs to be better um like make help us create this device that we can then um you know follow people with you know and not have to wa get SMSs but basically you know we basically just transmitting it into the cloud. So those so I mean so that's why we need young people. Yeah. Because like we we can you know we we can we can we we got paper and we SMSing results and no you know you don't do it like that anymore.

SPEAKER_03 1:41:39

Yeah young and diverse also diversity of thought we were at a meeting yesterday where um the guy was presenting to us about mouth guards in dentistry and mouth guards with elite athletes right I didn't know this they've got these special mouth guards that have a chip in them and it picks up when they get high impacts you know and it it it feeds to a doctor in the sidelines.

SPEAKER_00 1:41:58

Yeah and they call them awful concussion I've seen that's really cool I saw that during the you know the the spin box that they get a big controversy in one of the matches there.

SPEAKER_02 1:42:08

And well while while we're talking about that this thing was a line just what's that instance this is a 3D printed model of Mount Everest. But I belong to this forum you can have a look at it it's pretty cool I belong to this forum where they were discussing newer routes. There's only two routes on Everest North and south but in this forum someone printed an STL or sent an STL file for us to have a look at it. But you can only see it in two dimensions. So you sent this file and I 3D printed it and I was having a look at it yesterday.

SPEAKER_03 1:42:36

And that's like the type of you can figure out like a we could walk this way yeah so so prof the future's long and bright I mean just t take good care of your health and keep alive as long as you can what do you do for what else makes you light up besides the work you do?

SPEAKER_00 1:42:50

Wine.

SPEAKER_03 1:42:50

Okay yeah wine yeah red wine.

SPEAKER_00 1:42:53

Is that why you're in the Cape now?

SPEAKER_03 1:42:55

No lots of You live in the Cape now right? No don't give away a location.

SPEAKER_00 1:42:58

Cape and Job both Okay so so um um exercise so walking I love walking um when I'm in Cape Town um if the waves are good I bodyboard so I like bodyboarding and I like cold water swimming. So the cold I like going into 10 degrees you know if you want you want um you know um endorphin you know if you want it's you know it's good for first of all it's good for um metabolic and anti-inflammatory aging. So you know so so I like so I like cold water swimming. Um into that longevity type of stuff Peter Tia and all this kind of thing so um so so not in those kind of I like the philosophy of what what are the what should you do to retain your health as long as possible. You know and and there's you know it's exercise it's diet it's it's do you fast? I I try and do intermittent fasting and you know and so it's it's it's it's impact and it's it's community. Yes community of a blue zone country and then and then basically it's then and then and then you know enjoy joy in your life and what is joy you know red wine music. Who's your community?

SPEAKER_03 1:44:12

Who do you see as your community?

SPEAKER_00 1:44:13

I th it you know it's a it's a it's a it's a group of um it it's it's a there are a lot of different kinds of community but say in Cape Town it's a bunch of girls that we hang out go to go to nice restaurants and bodyboard and you know um hike. In in Johannesburg it's another group you know where we go on you know what go listen to jazz or movies, dinner, um walking and then you know and then in you know in um uh in Sweeto it's a different group so so it's you know there's a lot of I so I have a lot of diversity and variety you know in um you know in in my community but you know but it's the important thing is is to feel like I'm in a community you know I I don't exist by myself and you know that these are these are the people that um um you know I'll you know I will take a bullet for and they'll take a bullet for me. And so I and that's what's now you know so the joy the joy and the feel and the feeling of connected connectedness is important.

SPEAKER_03 1:45:16

Well prof no I thank you so much for sharing your story with us. I really learnt a lot and I enjoyed it. I had goosebumps many times in the in this c conversation just hearing your story and inspiring stuff you do. So thank you so much. Yeah I don't know if you got anything I just want to say thank you for even accepting our invitation even after hearing the story that you know you had to have a bodyguard and you took a chance on us and drove all the way to I mean my colleague I mean my colleague from the UK he said to me how how did two naughty young boys from KZN get the Minister of Health and stuff on so uh similarly we we say to you thank you for just trusting us and coming on the show.

SPEAKER_00 1:45:54

I mean yeah is there anything that you'd like to say I had fun you know um and um I look forward to seeing uh how you're going to navigate uh Everest again yeah me too don't tell that his mama would be happy to hear that thanks prof thank you prof okay bye all right cool