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Trailblazers with Garry: a conversation with Ntobeko Ntusi
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“Trailblazers with Garry" is a series from Global Health Matters, where host Garry Aslanyan sits down with trailblazers — thinkers, leaders and influencers shaping the future of global health — for short face-to-face conversations, available in both audio and video formats. It’s a chance to get to know the people behind the work and hear their perspectives on the current global health landscape.
For this Trailblazer episode, Garry met up with Ntobeko Ntusi in Cape Town, South Africa. Ntobeko has been president and CEO of the South African Medical Research Council since 2024 after serving as Head of the Department of Medicine at the University of Cape Town. He is deeply passionate about seeing South Africa and the African continent more broadly emerge as a leader in research and innovation. In this conversation, they explore the mentors who have shaped his journey, his vision for the role of science in strengthening African health systems, and how global health can recalibrate power symmetries to advance greater equity.
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Welcome to Trailblazers with Gary, a serious but Global Health Matters podcast. I'm your host, Gary Aslan. In this series, I sit down with Trailblazers in Global Health for short face-to-face conversations which you can listen to in audio or watch the video. It's a chance to get to know the person behind the work, hear their stories, and gain their perspectives on current global health landscape. Join me as we explore the people, places, and ideas driving global health forward. Let's get started. For this Trailbaser episode, I met up with Ntombeka Ntusi in Cape Town, South Africa. Ntombeka became president and CEO of the South African Medical Research Council in 2024 after serving as head of Department of Medicine at the University of Cape Town. He's deeply passionate about seeing South Africa and the African continent more broadly, emerge as a leader in research and innovation. In our conversation, we explore the mentors who have shaped his journey, his vision for the role of science in strengthening African health systems, and how global health can recalibrate power symmetries to advance greater equity. Hi there, it's Gary Aslanian, and I am going to record another episode of Trailblazers with Jerry. I am today in Cape Town, South Africa. And I'm going to have a quick chat with the president and CEO of the South African Medical Research Council, Professor Ntombeko Ntusi.
SPEAKER_01Thank you, Gary. It's wonderful to meet you.
SPEAKER_00Great. Very happy to have this opportunity, and I'm sure our uh listeners and our viewers will enjoy hearing from you because you are in such a position that really is critical in this important time of global health. But before we do that, maybe you could share what early experiences in your life really influenced your interest in the medical field, in health, and in research.
SPEAKER_01There are three enduring influences that I think have significantly shaped my view of the world, but also my affinity for service and health. The first has been the impact of my parents on my worldview. My mother with a background in social work and my father, a teacher and a chemist, who emphasized the importance of service to my brothers and I as we grew up. And we've all gone on to take up professions that try to make a difference in the lives of others. The second important influencer have been my teachers. I had the fortune of having the most remarkable teachers, particularly in my schooling years, but also through university. Remarkable individuals who made a lasting impression on me and really enthused a desire to try and contribute as positively in the lives of others as they did to mine. And then lastly, as a young medical student and a young doctor in this country, I uh spent my formative years uh in my training um exposed daily to large numbers of um individuals uh living with HIV at a time when treatment was not available in this country. And daily we would be admitting uh large numbers of patients who would go on to die uh from the HIV. And that really um impacted uh the view I had of healthcare, a desire to have universal access and universal uh healthcare, but also a desire to ensure equity in all aspects of health and science.
SPEAKER_00Great. So you mentioned your mother, and actually, I do know your mother, Tembeka, and Tembeka actually was a guest on this podcast in season one. Yes, so our listeners go look for an episode focused on research management and leadership that we've recorded with her, and you may be the mother-son guest that we will ever have in on this podcast. Um Prof. Um, what about women that played a role? You did mention your mother, but I I think you had a lot of um strong support for strong women who helped you in your career and in your process and supported you. Do you want to uh give us a bit more about that?
SPEAKER_01Yeah, I've had uh the great fortune of having the most amazing uh female mentors. Um, in addition to my mother, one individual who stands out is uh Kay Soot, who my mom is actually visiting at the moment in Philadelphia. Right. And uh Kay was my high school English teacher, and um as my mom was finishing a PhD um in the US and moved back to South Africa, I was um studying uh in the US in college, and I adopted Kay as my second mother. And uh she has been um remarkably supportive uh throughout my life. And uh I've had a string of um wonderful mentors, uh, but two individuals uh are worth mentioning. Uh one is um uh Professor Janet Seghi, who is a physician uh and um taught training registers uh in the Department of Medicine at the University of Cape Town and um was a tremendous support um and somebody I came to trust and could bounce ideas against. She wrote my reference when I uh applied for the Nuffield Fellowship to go to Oxford. Oh, right. And she also wrote my uh reference when I applied uh to be chair of Medicine New CT. It's just been a constant and enduring uh source of support. And the last uh person who is one of my closest friends is uh Professor Valerie Mizrahi, who is the um previous uh professorial director of the IDM at UCT. At the time when I um was chair of medicine and head of medicine at uh UCT and Krodeskier Hospital, um she led the IDM and our two um organizations worked uh exceptionally close together, and I learned a lot about leadership from her. Um and uh she continues to be a wonderful mentor even in her retirement.
SPEAKER_00That's great to know. And I mean, all of us have these um stories, and uh I'm sure many think that um what they have they uh can appreciate and and have uh this kind of guidance. So uh for you having gone through that kind of environment, uh clearly uh uh it's been important. I've read uh your previous insights about that. I also read you were a ballroom dancer and a runner. So is that continuing or do you have any new hobbies?
SPEAKER_01Well, I mean I ran throughout uh high school and throughout college uh and um really enjoyed it. Uh I was very competitive and I at the same time uh danced um at a high level. Similarly, I had won the South African Junior National Championships and uh North American um ballroom dance championships uh in my youth. Uh but sadly I don't do either of those at that level. I continue to run for fun to try and stay healthy.
SPEAKER_00Right.
SPEAKER_01I try to read as much as I can uh in my spare time, so I've got a great passion uh for reading. Um and I also enjoy cooking and uh any particular type of dishes?
SPEAKER_00I cook everything.
SPEAKER_01Everything I try to cook as often as I can, and at home I cook most evenings, which I find uh very relaxing.
SPEAKER_00Right, it's uh it's a good way, kind of unwind and um separate from the busy world through ingredients and and recipes. Um thanks for that. Uh very, very interesting um to get to know you better. Uh you've held uh several leadership positions. You were the Dean of Medicine at the University of Cape Town. Uh now obviously you hold this position as the president and CEO of South African MRC, which is um one of very few African uh research councils that uh really has contributed and contributes to supporting research uh both in South Africa and beyond. Um you've said that um hope is valuable but uh can't be a strategy. And that was to uh refer to how sort of South African ecosystem needs to move beyond uh the current uh sort of uh arrangement and continue to produce medical research that is needed of high sort of um academic merit and power. Um and uh maybe you can give us a bit more insight in this particular time. What's your vision, how you're working as a council, um as a strategy rather than just a hope, as you mentioned previously in some of your speeches. Give us a bit of insight what what you're thinking for the future and what's happening now.
SPEAKER_01So, my view is that successful science councils are able to articulate the value proposition of science and society and beyond the work that they do to improve the health of their populations, but also are able to state the value of science as a key catalyst for human capital development and the generation of a knowledge economy. And by doing so, they are able to convince their governments of the value of investing uh in uh human health and in health research. And in order to be able to do this well, there needs to be a clearly articulated set of priorities that are aligned uh with national interests. And it goes without saying that um local governments uh need to prioritize uh funding the health of their own populations, uh supported uh by these uh highly uh successful science councils. And in doing so, it becomes easier for these governments to be able to attract additional funding uh from outside. And so in South Africa we have for a long time uh prioritized our funding towards the key drivers of morbidity and mortality, and these are largely related to our quadruple burden of disease.
SPEAKER_00Quadruple now. Indeed.
SPEAKER_01This includes uh endemic infections like HIV and tuberculosis, non-communicable diseases like cardiovascular disease, cancer, chronic lung disease, chronic kidney disease, and of course, very importantly, mental health. And number three, uh interpersonal violence, trauma and injury. And fourth, maternal, neonatal, and childhood morbidity and mortality. As the SAMRC informed by key stakeholder interviews, the work of our national health research committee, as well as uh other stakeholders, we have articulated a number of other key priorities. These include having an investment strategy for climate and health, uh, digital health and AI applications, antimicrobial resistance, pandemic preparedness. And as the seventh administration in this country has articulated that universal health coverage is their key priority. We also do a lot of work on health systems and trying to produce the evidence that may inform both the planning and implementation of the national health insurance in this country.
SPEAKER_00And do you do you see that governments or uh communities, they are there any tricks you use or ways you use or any strategies you use to explain this to them? How is it easy? Uh is it hard? Is it challenging? Are there things that work better than others? I think it would be good to hear.
SPEAKER_01I think it's challenging because um, you know, as scientists, uh, we are often uh trained um to do the science uh well and to work in clinical settings, uh, and many of us ultimately take up leadership roles, but uh the ability to communicate science in a way that is compelling and uh can convince others uh to be able to act based on what you say is an important skill that many of us uh are not trained in. So it is something we take seriously as the SAMRC, uh affirming the value of science and society, particularly in the era of resetting trust, not only in governments, but in science itself. And as the South African government's arm on research on health, we are very fortunate to be able to spend a lot of time engaging with many of the portfolio committees in parliament, with our Office of the Presidency, our National Planning Commission, but also key ministries like the Ministry of Health, Ministry of Science, Technology and Innovation, Ministry of Um Correctional Services and Constitutional Justice, uh inter alia others, where we give input into many planned interventions as well as uh policy considerations. Um but um as we have a very uh close working relationship with our National Department of Health, we are able uh to have a voice that is trusted uh and a voice that they take very seriously that can influence uh a lot of the work that they do.
SPEAKER_00And do you find basically to be a trailblazer in this area, you need to be able to speak to all of these different groups? And do they all speak different languages or do you have to adopt? They all speak different languages.
SPEAKER_01Um and I think uh the key uh lesson for me has been uh the importance of consistency in your message, uh, as agendas are very different in the different engagements uh to try and show up um with the same uh key messages to everybody uh rather than um being um swayed uh by the dominant narratives in the room at the time.
SPEAKER_00So key messages the same, how do you deliver them or how you present them, you adapt, you adapt, but you keep on your main key message. One other thing I I'm sure our um uh listeners and viewers would appreciate maybe a little bit more about one of the four areas that you mentioned, the quadruple uh sort of burden, was this area of violence and violence prevention. And and it's it's something that is um maybe particularly specific in South Africa, or there are um uh specific programs or um efforts that you have. And and for our viewers in similar situations where they have not yet maybe prioritized or they're thinking about, would be good for them to hear what you're thinking about, how to tackle this, because this is also a societal issue, not just health research.
SPEAKER_01Sure, indeed, yeah. So South Africa probably is a consequence of our history, is a very violent society. There is uh interpersonal violence that uh, you know, I used to be surprised every evening as a young doctor working in the acute tender emergency unit where somebody would come with a knife to their chest or a gunshot to their leg and ask them what happened, and they would point at somebody else who similarly has a huge um uh injury and say, uh, he did that to me. And that often be friends who are drinking together and they get into a fight. But there's also a huge uh societal challenge with gender-based violence. Right. Um, and um one of our large intramural programs within the SAMRC is a research unit on uh gender and health. They lead uh scholarship um in this country and region, understanding uh the drivers of gender-based violence and some of the um uh mitigation strategies that uh we should consider. They also uh perform um a regular survey to understand uh femicide uh in this country. Uh they look at um intimate partner violence that um may be perpetrated uh by men against female partners, by females against their male partners, people in same-sex relationships, um, and they produce a huge amount of uh scholarship that informs uh a lot of the policies of our government. So we take a decidedly scholarly approach uh to understanding uh the issue of violence in this country, um, and uh we work closely with uh key decision makers. Another unit um within the SAMRC is one that focuses on um mental health, uh alcohol, uh, and substance abuse. Right. Um and again, um these are important uh contributions uh to violence in our society. Uh and one of the most striking illustrations was how in this country, during uh our V Draconian lockdown periods where alcohol was not sold, we saw rates of um violence just plummet. And as soon as we opened up and people started drinking again, our emergency uh units would be full. Um and so um we do give uh again a lot of uh policy input into considerations our government should be thinking about how to deal with this at a societal level. But ultimately, the point you made at the beginning is that these are not just. Health issues, they are societal issues, and they need a whole of government and a whole of society approach.
SPEAKER_00Right, right. But it's good to have the evidence that really would help the choose the right things to do and not to kind of do anecdotal. I mean, at the end, obviously other things come into play, but at least being able to produce that evidence is extremely critically important. Despite the um changing face of global health, and obviously in 2025 and beyond, I've heard that you believe, and I've seen you write about that, that there is an opportunity for change in global south and take this uh time as an opportunity. Um can you tell us more about the vision you would have for the future of global health? And this is actually a theme of our season of the podcast, and speaking with people like you to better understand what you think is the future of global, what we call global health.
SPEAKER_01So this is a key part of my work. Um and um I don't like using the term global south because um it positions the north in an asymmetrical relationship with the south, uh, which is often uh pejorative, and I like to use a more descriptive term, um, the global majority. Okay. Because um 85% of the world's population in low and middle-income countries resides in what I call the global majority. Um and uh the first acknowledgement is that global health is failing in measures of equity by whatever measure one uses. Um so the challenge is to look to see how we deconstruct the drivers of these asymmetries in partnerships and relationships, and to build both a more sustainable and a more equitable global health. I think a number of things are important if we think about uh the kind of global health we'd like to see in the future. Uh the first, uh, which goes without saying, is that governments in countries in the global majority need to fund health research and to reduce the dependencies uh on uh countries in high-income uh settings. Right. And by doing this, uh it um um um allows them to be able to define their own priorities to ensure that funding is aligned with those priorities rather than the current situation where donors in the global north decide which organizations should be prioritized, which interventions should be prioritized, which groups and individuals should be funded, and who gets to have a voice in global health and often support institutions that are led predominantly by white males based in high-income countries who lead activities remotely in the global majority and the benefits of that research. Despite the global majority being the site of knowledge production, the benefits often accrue to players in high-income countries. And so, in thinking about how we decolonize our global health, we need to look at the systems of knowledge production, equity in partnerships, um, and also how we need to move from these um uh perverse uh drivers of professional conduct um related to publication incentives and advancement of individuals, but rather to focus on impact. The other really important uh consideration is how we think about supporting enduring equitable partnerships between players in the global majority. If you look at most researchers uh from um low and middle income settings, they often will have partners in high-income countries, but very limited, meaningful collaborations with others in the global majority. And I think this needs to be something that we prioritize to build a community of practice, but also to share learnings, to share experiences, and in areas where there are common goals, common challenges, we can start to build mutually beneficial collaborative and enduring pieces of work. But ultimately, um in thinking about the future of global health, I think we need to constantly be calling on high-income countries to yield their power in these relationships, which many are unfortunately not willing to do. But also for players in the global majority to claim uh their space and to really take up a role which is proportional to the size of their populations represented in global health, the size of their challenges and the size of their aspirations are improving the health of their nations.
SPEAKER_00Do you think the government or leadership in the global majority you've described are recognizing and are making any steps to kind of uh in that direction? And are there any uh ways that you work with some of them that to kind of help uh each other or uh help define things rather than all doing things in different ways? What what's uh what's what's happening around that?
SPEAKER_01Yeah, in my view, I don't think uh many governments uh in the global majority are doing nearly enough. And what I've seen uh is we are contending with the current funding crisis. Many of these governments are looking to move from one kind of dependency to another rather than building their own sovereignty and uh agency in driving uh the future health of their own nations. Um and um I've had some engagement with ministries of health on the African continent, and my message has been consistent, which is that African governments are not poor. If you look at the proportion of funding that goes towards militaries for wars that we don't need to fight, or the proportion of um budgets that is misappropriated and corruption, if people prioritized uh health and other development aspirations, uh these governments could make significant uh advances in um in that all these countries should be aspiring to move towards the aspirations of their budget declaration, uh which is to invest in health and health research.7 percent uh of their um budgets are coming from ODA systems.
SPEAKER_00Right, right, right. Finally, um just to also put this as a good learning kind of experience for our listeners who are in similar situations and are looking for advice of all the personal attributes that a successful health sector leader such as yourself needs to have, what is for you the most important attribute?
SPEAKER_01I think the most important attribute is self-awareness, uh being aware of your own strengths, uh your own uh areas of growth, but also the awareness in how you are able to align your own aspirations as a leader with the aspirations of individuals and um uh institutions uh within the organizations uh that you lead. But also importantly, um the aspirations of your external stakeholders uh to ensure that there is alignment uh in the work uh that is being done and everybody is pulling uh in the same direction. And this awareness, I believe, also translates in how you communicate as a leader uh your strategy for what, when, and how you choose to communicate and ultimately thinking about how you uh ensure significant buy-in uh in the priorities uh that you articulate.
SPEAKER_00No, I I love the uh the answer, and also this um um self-awareness is really important because that's the only way you can actually um you know um grow. Uh there is no other way, no one is made leader uh overnight. Um wonderful conversation. Thanks so much for spending this time uh with me and with our uh listeners. Again, um we've been uh discussing with the CEO president of the South African uh Medical Research Council, Professor Ndussi.
SPEAKER_01Wonderful, thank you so much, Gary.
SPEAKER_00Thank you for joining me for this episode of Trailblazers with Gary, brought to you by the Global Health Matters Podcast. The audio and video versions of this episode are available wherever you get your podcasts. Be sure to visit the Global Health Matters webpage for more information about my guests in this series.
