Professor Ntobeko Ntusi, who takes over the hot seat at the South African Medical Research Council in July, may be soft-spoken but he is unafraid to stand by his strongly-held views, writes Biénne Huisman in Spotlight.
Inside his office at Groote Schuur Hospital’s Old Main Building, department head of medicine at the hospital Ntusi speaks quietly, his words a few decibels above a whisper, yet his observations are thoughtful and sharp, crafted with precision.
Born in Mthatha to academic parents, at 13 he was named South African Junior Ballroom Dance Champion at an event in Sasolburg. Some three decades later, the cardiologist with qualifications from around the world does not sidestep public healthcare debate in favour of keeping the peace.
Catastrophic budget cuts
Earlier this year, Ntusi publicly criticised healthcare budget cuts: R200m was shaved off Groote Schuur’s coffers just last year as the Western Cape Department of Health & Wellness announced an R807.8m shortfall for the coming year.
He told Spotlight that communication on the matter by provincial government officials (with healthcare professionals) was “appalling”.
In February, Ntusi was one of a group of executives at the hospital – affiliated to the University of Cape Town (UCT) – who spearheaded a petition to national and provincial Treasury, decrying “crippling austerity” and “catastrophic budget cuts”; saying how clinicians with multiplying work hours are watching patients deteriorate, as waiting lists for lifesaving elective surgery lengthen.
At a boardroom table in his office, he says: “How we ration limited resources is causing real moral injury to our front-facing clinicians. We’re having to deal with complaints from patients who no longer have access to services to which they have grown accustomed.
“This is causing a lot of distress, especially among young doctors, and medical registrars – the engine of our operation – who are increasingly anxious and taking time out for mental health reasons.”
In his present position, Ntusi’s voice has clout. He oversees 13 divisions, from cardiology to pulmonology, and infectious diseases and HIV medicine, and corresponding research units like the Desmond Tutu HIV Centre, directed by Professor Linda-Gail Bekker.
‘Hope cannot be a strategy’
On how Groote Schuur’s management is responding to these challenges, Ntusi says the hospital’s CEO (since February) Shaheem de Vries, while new, in time ought to bring concrete priorities to the table. “It’s important to have hope, but hope cannot be a strategy,” he says.
This insight may well inform how he approaches his own new job as CEO and President of the South African Medical Research Council (SAMRC), taking over from Professor Glenda Gray.
From July, Ntusi will give up his Groote Schuur office and hang up his clinician’s stethoscope to take up the hot seat at the country’s primary health research funder at its headquarters in Parow.
The SAMRC employs 718 employees: Ntusi will answer to the National Department of Health, the SAMRC board, and the Parliamentary Portfolio Committee on Health.
Across medical bureaucracies, budget remains an issue. The national government allocated R1.35bn to the SAMRC for 2023/24. In the council’s latest annual report, diminishing funding from government is listed as a threat; while the ability to attract external funding is listed as a strength.
“A key role of the president of the SAMRC is to engage with organisations like the Wellcome Trust (in the United Kingdom) and the NIH (the National Institutes of Health in the United States) and high worth individuals to attract funding,” Ntusi says.
He points out that the SAMRC has had clean audits for several years running – a remarkable achievement for a South African parastatal. The council’s annual performance plan for 2024/2025 states: “Despite interruptions of Covid-19, SAMRC’s exemplary performance and good governance led to the organisation achieving four consecutive clean audits… It is the organisation’s intention to continue on the same path.”
On the SAMRC’s functions, Ntusi explains: “For government, the SAMRC plays a critical role in bridging the gap between strategy and policy, and implementation. In science, it plays a critical role in providing priorities for the funding of research, and capacity building…”
In the SAMRC’s last financial year, R61.6m was allocated to funding 171 “research capacity development” grants, including 120 to women. The annual report describes this as funding “the next generation of health researchers… with most of these awards aimed at individuals from historically disadvantaged backgrounds”.
For Ntusi, points of focus to be expanded on at the SAMRC include health issues relating to climate or planetary change, epidemic preparedness, “restoring trust in science in an age of misinformation”, digital health and artificial intelligence; and projects linking South African scholars with research entities across Africa.
“In many of these countries, they don’t have the research infrastructure and budgets we have in South Africa – it is important to assist them with projects.”
To the US and back home
When he was 14, Ntusi’s family – he is one of three boys – moved to the United States where his mother pursued a PhD in social work. In Philadelphia, he continued competitive ballroom dancing while attending Lower Merion High School, where a video on childbirth showed in a biology class stirred his medical passions.
At liberal arts college Haverford, in Pennsylvania, he completed a BSc Honours in cellular and molecular biology, before returning “home” to South Africa in 1999, to enrol in medical school at UCT.
Here his initial interest in obstetrics was disappointed – “it was loud and messy, an anti-climax” – seeing him drawn to internal medicine and cardiology instead. In following years, he would study cardiovascular medicine under mentorship of the late Professor Bongani Mayosi.
Like Mayosi, Ntusi was awarded the Oxford Nuffield Medical Scholarship, which funded his DPhil at the University of Oxford in the United Kingdom. His doctoral research looked at cardiovascular magnetic resonance (CMR – non-invasive tests that produce images of a beating heart) to study inflammatory heart disease.
In 2016, Ntusi took over from Mayosi as head of Groote Schuur’s department of medicine, as Mayosi became dean of the university’s faculty of health sciences. At the time, Ntusi continued treating cardiology patients, with ongoing research projects including on HIV-related heart disease.
Seven years later, against pale yellow walls (the same walls decorated by Mayosi back when it was his office) several art works and certificates attest to Ntusi’s time here. He points out one painting of student protestors made by a friend – based on the #FeesMustFall protests at the university in 2016 – “a difficult time”, he says.
In 2018, Mayosi’s suicide was partially attributed by some to pressures relating to the violent protests; while also putting a spotlight on pressure on prominent black academics at UCT, and other tertiary institutions in South Africa.
An inquiry found that the “sometimes disrespectful manner” in which protest was conducted, and “instigation of student action by some of his colleagues”, caused Mayosi “a lot of distress”.
On a shelf, beside a 2021 SAMRC gold trophy for “scientific achievement”, a burgundy-bound book recounts Mayosi’s legacy. Ntusi penned the introduction, where he writes: “Bongani Mayosi – as a leader, he was awesome. He is one of the most inspiring people I will ever know. He always reminded me: ‘a journey of a thousand miles begins with a few steps’.”
Asked about following in the footsteps of Mayosi, Ntusi replies: “I am his protégé. There was always room for me to build my own scientific investigations.”
Precarious times
As Ntusi is poised to leave Groote Schuur, present dean of UCT health sciences Associate Professor Lionel Green-Thompson points out how the cardiologist cared for critically ill patients in Covid-19 high-care wards, particularly during the fear and uncertainty of hard lockdown.
“Sometimes we would work up to 16 hour shifts in these wards; when we would finally leave, I’d go outside to find anti-vaccine protesters in front of the hospital. … they were just annoying,” Ntusi recalls.
Foremost, Ntusi describes himself as a “humanist”. Apart from science, medicine and health equity, his interests include art, wine and dogs. A keen runner, he is a member of the Gugulethu Athletics Club.
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