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INAUGURAL LECTURE: Democratising healthcare across Sub-Saharan Africa, the focus of the Faculty of Health Sciences Prof’s Inaugural Lecture as she pays tribute to grand-dad

Edwin Naidu

“It really takes a village to produce a UP Professor,” said University of Pretoria Deputy Dean of Research and Postgraduate Studies, Faculty of Health Sciences, Prof Tivani Mashamba-Thompson, in her inaugural address last Wednesday.

In her address, the respected awarding-winning Prof paid tribute to her grandfather, who dared to dream that his grandchildren would one day be leaders in their fields.

She said that despite having no formal educational qualifications, working as a security officer in Johannesburg, leaving his family in rural Limpopo where access to quality education was limited, he made sacrifices and supplemented his salary through side hustles to send her mother to boarding school and teachers training college.

“Following that, he ensured that she had a better start in life by building her a comfortable starter home for her and her children. I dedicate this inaugural lecture to my late grandfather Father Frank Maluleke and to all the people who ensured that his dream came true.”

She was grateful too for the influence of her role model mom, Mihloti Mashamba, inspirational late grandmother Florah Maluleke, husband Rowan Thompson and children, Gabrielle Thompson, M’hloti Thompson and Frank Thompson.

She also thanked the university leadership and praised mentor Prof Thabane, colleagues, and FHS executives, with a special mention to Dean Prof de Jager, “who puts up with having his lunch break disturbed every time I want to share something that cannot wait for him to finish his lunch and a constant request for selfies”.

Democratising healthcare access in Sub-Saharan Africa through research conducted by teams in Ghana, Rwanda, South Africa and globally since 2015 was the focus of her lecture.

“The ultimate goal of our research is to democratise healthcare access through REASSURED diagnostics,” said Prof Mashamba-Thompson in her address on 11 July at the Tswelopele Building, Lecture Hall 1, attended by the university’s top brass.

REASSURED is an acronym that stands for Real-time connectivity, Ease of specimen collection, Affordable, Sensitive, Specific, User-friendly, Robust and Equipment accessible and Delivered to end users. The REASSURED criteria guide the research focus on POC diagnostics.

Prof Mashamba-Thompson, on 10 March, received a Bronze Scientific Achievement Award in recognition of her excellence in research from the South African Medical Research Council.

Dignitaries present at the inaugural lecture included Deputy Vice-Chancellor: Academics Prof Loretta Feris, FHS Dean, Prof Tiaan de Jager, FHS Deputy Dean Teaching & Learning Prof Vanessa Steenkamp, FHS Deputy Dean Research and Postgraduate Education Prof Flavia Senkubuge, as well as FHS School Chairs. Interim Vice-Chancellor and Principal, Professor Mosia and Deputy Vice-Chancellor: Research and Postgraduate Education, Prof Sunil Maharaj, attended virtually.

She said access to high-quality and timely diagnostic services is essential for strengthening health systems.

However, Prof Mashamba-Thompson, cautioned that diagnostics services have traditionally received limited attention in global health compared to drug discovery and vaccine development.

Inadequate diagnostic systems and inequitable access to reliable tests often contribute to poor health outcomes, especially in settings with limited access to laboratory infrastructure.

However, she noted that Point-of-care (POC) diagnostics have emerged as a promising healthcare innovation to address these challenges. POC diagnostics are near-patient diagnostic devices that provide rapid results to guide clinical decisions.

Prof Mashamba-Thompson said the World Health Organization had defined criteria which should be met by POC diagnostics used in resource-limited settings.

“We have identified that there is limited focus on sustainability of POC diagnostic tests that are deployed in resource-limited settings and limited focus on local infrastructure capability for sustainable delivering REASSURED POC diagnostic tests to end users.”

As part of the research, Prof Mashamba-Thompson recommended an increase in research resources investment on research focused on advancing local development and sustainable implementation of POC diagnostics that meet the WHO’s REASSURED criteria to ensure sustainable quality service delivery to improve health outcomes of underserved populations.

The research focus employs an implementation science approach to assess whether POC diagnostics, used in various SSA settings, meet the REASSURED criteria.

The Prof noted that tests must be connected to health data platforms in real-time to enable the reading of test results to provide required data to clinical decision-makers and for disease surveillance. Combining high-quality point-of-care (POC) diagnostics devices with mobile health technologies offers novel ways to diagnose, track and control infectious diseases and improve the health system’s efficiency.

“Our Nature Review examined the promise of these technologies and discusses the challenges in realizing their potential to increase patient’s access to testing, guide clinical decisions and improve the capability of public health authorities to monitor outbreaks, implement response strategies and assess the impact of interventions worldwide,” she added.

One of the key outcomes of the research relates to affordability. She added that tests should be affordable to end-users and the health system.

“The affordability of POC tests to end users and health systems is paramount. Globally, vulnerable populations face healthcare challenges such as limited access to diagnostics and poorer health outcomes,” she said.

Prof Mashamba-Thompson added that these challenges are more pronounced among vulnerable populations from low-and middle-income countries (LMICs), where the health system is fraught with inadequacies and lack of resources.

During the early stages of the COVID-19 pandemic, researchers observed the financial challenges faced by the public health sector under pressure to meet the increasing need for tests. Fortunately, the private health sector played a crucial role in expanding COVID-19 testing capacity.

Prof Mashamba-Thompson acknowledged that the presented research emanated from the work that was done by the team that she led in UKZN and UP in partnership with the University of Washington, University College London, McMaster, McGill University and Imperial College London.

“Our POC diagnostics research will also incorporate non-invasive sampling technologies, and we are collaborating with Prof Ashleigh Theberge’s lab at Washington University. We also plan to work on diagnostics for precision medicine, which will be enabled by our collaboration with the NuMeRi under Prof Sathekge’s leadership.

She said the team was also partnering with Edinburgh University to create a WHO collaborating platform for POC Diagnostics in SSA.

A partnership has also been reached with American multinational medical devices and health care company Abbott for a multi-country HCV POC diagnostics performance evaluation study, which started in West Africa, represented by Ghana.

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