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12 May 2020 | Story Prof Francis Petersen | Photo Sonia Small
Prof Francis Petersen.

In a rapidly changing, uncertain and complex world, the role that universities are playing as the engines of social mobility, as drivers of the economy and as generators of new ideas, is now more critical than ever.  Due to the universal nature of knowledge, universities are global in scope – a space that encourages new ideas, controversy, inquiry, and argument and challenges orthodox views, but they are also deeply entrenched in their local environment, influenced by socio-economic and political dynamics.  There is an expectation that universities should exhibit great levels of responsiveness and public accountability, with higher levels of trust in higher education, and between higher education and government, and higher education and the public.  The challenge for both higher education and government is to allow institutional autonomy without oppressive accountability.  

Over the past few years, the purpose of universities has been challenged in relation to their role in society, their advocacy for speaking truth to power, their continuous strive to be great universities without being elitist, and their ability to function in an age of populism. The Trump administration and, more recently, Brexit have demonstrated that there is a decline in the respect for evidence and advice from subject-specific experts.  It seems (as in the case of the Trump administration) as if empirical reality does not matter, nor does empirical reasoning form the basis of public policy – a political place that is becoming increasingly anti-intellectual.  Emotion and personal belief have been shown to carry more weight than objective facts and evidence in terms of influencing public opinion.  Fake news and ‘the alternative truth’ have also challenged the fundamental principles of a university – academic freedom and the generation of new knowledge in the pursuit of truth.

A digitally unequal society
The COVID-19 pandemic has shown deep fault lines in our society – stark poverty and inequality – that universities should engage with (and they do); however, they cannot eliminate it on their own, but can be part of the solution.  South Africa is the most unequal society in the world.  Before the COVID-19 pandemic, the South African economy was already in deep trouble, with sovereign downgrades by all the rating agencies and with an unemployment rate close to 30%.   The national lockdown, in an attempt to ‘flatten the infection curve’ and hence manage the response of the national health system to COVID-19 cases, has added to the pressure on the economy.  It is envisaged that a large number of people (estimated between 3 and 7 million South Africans) will lose their jobs after the national lockdown period, adding to poverty and an already high unemployment rate.  Even during the lockdown period, there are many South Africans living in crowded spaces, hence finding it difficult to practise social distancing, may not have running water and proper sanitation, and possibly do not have regular access to food.  

As schools and the post-school education and training sectors move online with their learning, it further shows how digitally unequal our society really is – access to connectivity, data, and an appropriate digital device is a challenge, and electricity is not evenly distributed or is non-existent in our society.  These institutions, within the environment of digital inequality, are ensuring that digital equity is maintained as far as possible.  Many churches, business leaders, and certain politicians have called for a different social pact between business, labour, and government to address the state of the economy – any such action, however, must be supplemented by concrete measures for social reform.

Regaining trust in universities
But perhaps this pandemic has also created an opportunity for science and evidence to regain credibility in informing government decisions and public trust, and for universities to demonstrate respect for evidence. During the initial stages (early March) of COVID-19 in South Africa, the epidemiologists and virologists have shown through confirmed data from the National Institute of Communicable Diseases (NICD) that South Africa was in the early phase of the infection curve – also interpreted to be the relatively low-risk phase of the curve; this would be the right time to apply the principle of social distancing.  It allowed certain organisations (such as universities) to pro-actively suspend part of their activities so as to minimise the number of people in their operational environment, well before the national lockdown was announced on 26 March – a decision based on science.

Through data and proper analyses, the NICD, other scientific bodies and the Ministerial Advisory Committee on COVID-19 provided evidence-based information to government and the public, from which meaningful decisions could be taken.  The South African government has made it perfectly clear that decisions around COVID-19 will be made based on the science associated with this pandemic – a stance to be applauded.  Hence, the risk-adjusted approach of ‘opening up’ the economy through easing the lockdown measures but constantly monitoring the infection curve is an excellent example of risk management while continuously assessing the risks.

Universities, science laboratories, and pharmaceutical companies around the globe are hard at work to develop an effective vaccine for COVID-19, which is another opportunity to demonstrate how science can assist in protecting people from this terrible virus. Universities are making advances in personal protective equipment (PPE), the development of new technologies for non-ICU provision of oxygen to COVID-19 patients, more advanced methods of testing (for the virus) to reduce turnaround times, and various other scientific studies.  

This platform is giving universities a renewed impetus to use science and scientific developments to advance societal agendas such as climate change, poverty and inequality, public health and social justice (ethics of care) – and more immediate – assisting in re-building a strong South African economy.  It is an opportunity for the public and politicians to regain trust in universities, but it is also an opportunity for universities to profile their public intellectuals so that the value of science and evidence-based output is part of policy debates and informed decision-making.  However, in doing so, universities must strengthen their relationship with society at large, be inquiry-driven, and at the same time be learning and co-creating.

Prof Francis Petersen is Rector and Vice-Chancellor of the University of the Free State.

News Archive

Nuclear Medicine on the forefront of cancer research
2017-07-10

Description: Nuclear Medicine on the forefront of cancer research Tags: Nuclear Medicine, cancer research, Dr Je’nine Horn-Lodewyk’s, tumour detection method, cancer, Department of Nuclear Medicine 

Dr Je’nine Horn-Lodewyk’s tumour detection method
could be the cost-effective breakthrough needed to decrease
the mortality rate in breast cancer patients.
Photo: Anja Aucamp

The field of Nuclear Medicine in South Africa and the rest of the world are expanding rapidly due to the development of hybrid cameras and new radiopharmaceuticals. These developments have a huge impact on the diagnosis and therapy of cancer.

The most advanced of these cameras, Positron emission tomography combined with normal CTs (PETCT), are not yet widely available in South Africa due to the cost of the cameras and the radiopharmaceuticals. A more cost-effective alternative can be of great benefit. To achieve this, the focus should be on developing new radiopharmaceuticals that can be used with the current cost-effective gamma cameras, according to University of the Free State researcher, Dr Je’nine Horn-Lodewyk from the Department of Nuclear Medicine.

Fluorodeoxyglucose (18F-FDG), a radiolabelled glucose analogue, is currently the radiopharmaceutical most commonly used in PET/CT imaging for mainly oncology indications. Although it is considered the gold standard for imaging in several malignancies, it does have certain disadvantages. An 18F-FDG PET/CT diagnostic imaging study can cost between R25 000 and R35 000 for a single patient in the private sector. The 18F-FDG is also more radioactive, which requires much stricter handling and shielding to avoid high radiation dosages to staff and patients.

Successful research potential innovative solution
In the search for the ideal radiopharmaceutical for tumour detection, the South African National Nuclear Energy Corporation (Necsa) developed a local synthesis process for ethylenedicysteine-deoxyglucose (EC-DG). EC-DG is also a glucose analogue similar to FDG. They succeeded in labelling the compound with Technetium-99-metastable-pertechnetate (99mTcO4-), the most common nuclear medicine isotope used for approximately 95% of nuclear medicine procedures, creating 99mTc-EC-DG.

In partnership with Dr Horn-Lodewyk, this compound was successfully used in various animal models and clinical scenarios, resulting in approval by the Medicine Control Council to use it in a human study. Research is also planned in order to investigate diagnostic accuracy in other cancers like lymphoma.  The end result of this research can produce a radiopharmaceutical that is cost effective, does not require the use of costly specialised equipment, has no significant side-effects, no special patient preparation, renders late imaging possible, and has decreased radiation risks.

Dr Horn-Lodewyk is grateful for the support of her mentor, Prof Anton Otto, as well as Dr Gert Engelbrecht, Head of the Department of Nuclear Medicine, Prof Jan Rijn Zeevaart from North-West University’s Preclinical Drug Development Platform and Necsa, and Judith Wagener from Necsa. This innovative research would also not have been possible without the financial assistance of Dr Glen Taylor and Eleanor van der Westhuizen in the Directorate of Research Development.

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