This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. OBITUARY

Professor Bongani Mayosi: A legend in our time

was considered the doyen of heart muscle disease on the African continent and has clarified the clinical profile, epidemiology and genetic basis of cardiomyopathies in Africans. Through this process he was involved in the discovery of many novel genes that cause sudden cardiac death and heart failure in Africans. In cardiovascular genetics, Prof. Mayosi’s discoveries included genes causing dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmo­ genic cardiomyopathy, coronary artery disease and hypertension. He established an internationally renowned laboratory at UCT, which at the time of his death was leading unique studies of the genetics of rheumatic heart disease and congenital heart disease in Africa. Among his contributions to knowledge in single-gene disorders, his discovery in 2017 of a new gene for Bongani Mawethu Mayosi was born on tenure, during which he transformed the arrhythmogenic cardiomyopathy was 28 January 1967 in Mthatha, Eastern Cape, Department of Medicine, growing it to be recognised as one of the most important the second son of Dr George Sikhumbuzo the largest and leading medicine department medical advances made by a South African Mayosi and Mrs Nontle Mayosi. He on the African continent, in 2016 he was scientific team since the first human attended primary school in Upper Ngculu appointed as the Dean of the Faculty of heart transplant. He has also provided village, Ngqamakhwe, Eastern Cape. He Health Sciences at UCT and occupied this the most complete investigation of the completed his secondary schooling at the position until his untimely death on Friday contemporaneous causes, clinical profile age of fifteen, matriculating from St John’s 27 July 2018. and optimal approaches to management College, Mthatha, and passing six subjects His enduring legacy will be one of research of heart failure among Africans. He has with distinction. His first two degrees excellence, academic development and the advanced our understanding of the biology were a BMedSci completed in 1986 and transforming effect he had on individual of rheumatic heart disease, the role of concurrently an MB ChB completed in 1989 lives, institutions and countries, particularly screening and the employment of a strategy at the University of KwaZulu-Natal, both on the African continent. of syndromic treatment of pharyngitis to obtained cum laude and at the top of his His research focused on non- prevent this disease in children. His research class. communicable diseases. He believed in a has influenced policy and guidelines on the He worked as an intern at Livingstone diversified portfolio of research, and proj­ management of this disease globally, and Hospital in Port Elizabeth, then moved ects of varying risk. For him, that portfolio these have been adopted by the African to Cape Town the following year to work included research on the epidemiology Union, the World Heart Federation, the as a senior house offer and later join the and genetics of heart muscle disease; heart World Health Organization and the medical registrar rotation at Groote Schuur failure; pathophysiology, clinical outcomes World Health Assembly. More recently, he Hospital (GSH) and the University of and genetics of rheumatic heart disease; advocated for the widespread availability of Cape Town (UCT). Within three years he tuberculous infections of the heart; HIV penicillin for the eradication of rheumatic had been admitted to the Fellowship of infection as it involves the heart; rare heart disease in the global south. Through the College of Physicians of South Africa. genetic disorders among Africans; and his investigation of tuberculosis in the Immediately after this, he was awarded strengthening of health systems in South heart, he clarified the appropriate diagnostic the prestigious Oxford Nuffield Medical Africa and on the African continent. When strategy and role of adjunctive steroids in Scholarship, allowing him to read for a DPhil criticised by many that his research focus tuberculous pericarditis. He showed that in Cardiovascular Medicine on a project on was too divergent, he always emphasised unstimulated interferon gamma is the most cardiovascular genetics at the University the important thematic linkage: he studied sensitive and specific screening test for of Oxford, under the supervision of Prof. cardiovascular diseases of the poor – as he tuberculous pericarditis. In addition, his Hugh Watkins. He returned from Oxford to called them, ‘the afflictions of the wretched IMPI trial showed that adjunctive steroids complete his clinical training in cardiology of the earth’. It was his firm belief that by cause cancer in HIV-infected individuals at GSH and UCT. Thereafter, he worked as studying these diseases of pestilence, he but reduce constrictive pericarditis and a consultant in the Cardiac Clinic. He was could make his greatest contribution to the hospitalisations in all patients. This has led appointed as the seventh Chair and Head world. to the recommendation for the selective of the Department of Medicine at UCT During his career, he made seminal use of adjunctive steroids in HIV-negative and GSH in 2006. Following an illustrious contributions to all these seven areas. He individuals alone. These findings resulted

695 September 2018, Vol. 108, No. 9 OBITUARY

in the revision of clinical practice guidelines of the mechanisms of physical signs, and immense dignity and an infectious optimism. for tuberculous pericarditis. He reviewed an encyclopaedic knowledge of clinical A visionary who imagined an Africa capable the state of healthcare in South Africa medicine. As a researcher, he was a global of driving its own agenda and using science and on the continent and made important leader in his field. He published over 350 to improve the health of its nations. He recommendations on how health systems peer-reviewed articles and book chapters. will be remembered for his absolute love of could be strengthened to improve the health He had an h-index of 67 and over 40 000 the UCT students. His fundamental drive of all Africans, in particular those in rural citations. He is one of only a handful of was the transformation of society through and under-served areas. A-rated scientists in South Africa. As a investment in future generations of scientists, While the contributions he has made will teacher, he was legendary. His knowledge of physicians and future leaders. He will be influence the outcomes of future generations, the cardiovascular system was outstanding. remembered for his absolute love of the I believe that his academic career will be But he was revered by undergraduate hospital, the Department of Medicine, the remembered most for the relationships students for his approach to his teaching of Faculty and the University. Both those who he built. He made friends everywhere he neurology. He graduated over 30 master’s knew him well and those who hardly knew went. He recognised potential and invested and doctoral students for whom he had him spoke of their absolute love of the man, substantially in the development of human provided supervision. All of them will and their sense of his apparent and evident capacity as part of the academic project. remember him as a caring supervisor who affection for them. He will be remembered Prof. Mayosi used research to advance invested substantially in them and created for his unwaver­ing belief in the potential of his dream of ‘1 000 PhDs’. He wanted to opportunities that have defined their others and for his excellence in research, and undertake research that would answer careers. Many of his students have gone translation of that research into work with a the prevailing fundamental questions on on to be leaders in academia, industry and meaningful impact. His ultimate belief was African cardiovascular health, and to answer government in this country, on the continent that science should be a vehicle for social and these questions definitively. He embarked and throughout the world. As a leader, he political change, and ultimately a vehicle for on building research capacity on the African was awesome. His brand of leadership was economic upliftment. As he often reminded continent and went into countries with no honest, full of integrity and characterised by us, ‘health comes before wealth’. But, above all, existing research management infrastructure creativity and innovation. His commitment he will be remembered for his absolute love or ethics committees and helped to set these and passion were evident at all times. He of his family. He was a devoted husband and up ab initio. is one of the most inspiring people I will father and never missed an opportunity to His professional achievements and ever know. He believed that there was no share how much his family meant to him. He accolades are too many to list, but include problem that could not be solved, and his spoke often of his gratitude for the support the Order of Mapungubwe (Silver) in work ethic was unquestionable. He played of his wife, and the love he received from his 2009 and an A-rating by the National the long game, and always reminded me: daughters, who he constantly referred to as Research Foundation. He was a member ‘A journey of a thousand miles begins with a his ‘pride and joy’. of the Academy of Science of South Africa few steps.’ As an advocate, he made seminal He is survived by his wife, Nonhlanhla, and a former President of the College of contributions to health policy and practice and three daughters, Nosipho, Sivuyile and Physicians of South Africa. In 2017 he in several important areas. Following Camagu (and many other ‘daughters’ raised was elected to the US National Academy appointment by the Academy of Science in his home). He also leaves behind his of Medicine (arguably one of the highest of South Africa to chair a Consensus Panel mother, Nontle, eldest brother, Sipho, and honours in the fields of health and medicine, on the Revitalisation of Clinical Research two sisters, Khuthala and Ncumisa. He will which recognises individuals who have and Related Training in South Africa, be dearly missed by his family, friends and demonstrated outstanding professional he published a report in 2009 that has colleagues. May his soul rest in peace. Lala achievement and commitment to service). significantly shaped the policy framework ngoxolo Rhadebe. Phumla ngoxolo qhawe He was instrumental in securing dedicated on the revitalisation of health research in lamaqhawe. Oko ubuthunywe nguThixo funding for clinicians from organisations South Africa. This formed the blueprint of ukugqibile. Umzamo omhle uwenzile. Ugqatso such as Netcare, for the Hamilton Naki the approach adopted by the government. ulifezile! Scholarship and the Discovery Academic How will I remember Prof. Mayosi? I will Fellowships. This culminated in the ‘1 000 remember him as a dear friend, mentor and Rhadebe! Bhungane! Mashwabada! PhDs in 10 years project’ (also known as the confidant. I will remember him for tireless Mthimkhulu! Ndleb’entle zombini! National Health Scholars Programme), in dedication to advance a great cause. I salute collaboration with the Department of Health, him for a life of integrity, his humility, his Ntobeko Ntusi the National Health Research Committee, outstanding intelligence and his absolute Department of Medicine, Groote Schuur the Public Health Enhancement Fund and pursuit of knowledge and truth. Hospital and Faculty of Health Sciences, the South African Medical Research Council. How will the Faculty of Health Sciences at University of Cape Town, South Africa As a clinician, he was second to none. He UCT and GSH remember him? He will be [email protected] was loved by his patients, who remembered remembered as the consummate professional his gentle and impeccable bedside manner. and the epitome of hard work. A leader who S Afr Med J 2018;108(9):695-696. DOI:10.7196/ He had a fascination for the understanding was exemplary in every fashion. A man with SAMJ.2018.v108i9.13584

696 September 2018, Vol. 108, No. 9