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22 February 2024 | Story André Damons | Photo SUPPLIED
Prof Robert Bragg
Prof Robert Bragg is a researcher in the Department of Microbiology and Biochemistry at the University of the Free State (UFS) and believes hospital-acquired infections (HAIs) might already be “Disease X”.

During the World Governments Summit, the World Health Organisation (WHO) warned world leaders about the likelihood of a Disease X outbreak, saying it is “a matter of when, not if” a new pathogen and pandemic will strike. If there is an outbreak of this disease tomorrow, the world still would not be ready. 

During his speech earlier this month at the summit in Dubai, Tedros Adhanom Ghebreyesus, Director-General of the WHO, said COVID-19 was a Disease X – a new pathogen causing a new disease. He said: “There will be another Disease X, or a Disease Y or a Disease Z. And as things stand, the world remains unprepared for the next Disease X, and the next pandemic. If it struck tomorrow, we would face many of the same problems we faced with COVID-19.”

Though Disease X is a hypothetical placeholder representing yet-to-be-encountered pathogens, Prof Robert Bragg, researcher in the Department of Microbiology and Biochemistry at the University of the Free State (UFS), believes hospital-acquired infections (HAI) might already be “Disease X”. He says data shows that deaths from HAIs will become the leading cause of human deaths. This problem is rapidly growing as most of the pathogens which people contract while in hospital are now resistant to antibiotics, making them very difficult to treat.  

Prof Bragg, whose main research is in disease-control, first in the agricultural industry, and now human health, also previously warned about a disease that would make COVID-19, which killed more than seven million people to date globally, look like a dress rehearsal. His PhD student, Samantha Mc Carlie, investigating how bacteria become resistant to disinfectant and sanitiser products. This is a serious problem for the future, as disinfection could be our last line of defence.

Heading for a crisis in health care

“The world is rapidly heading for a crisis in health care regarding hospital-acquired infections. It is common knowledge that we are quickly running out of antibiotics (and antifungals) to treat bacterial and yeast infections. Without antibiotics and antifungals, the outcome of many of these bacterial and yeast hospital-acquired infections will be very severe. They will, unfortunately, in many cases, result in the death of the patient,” says Prof Bragg. 

According to him, the WHO suggests that 30% of patients in ICUs in developed countries and 70% in underdeveloped countries will contract a HAI. Of these, the mortality rate can be as high as 70%. 

“Most of these infections are caused by multiple drug resistance strains of bacteria such as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species. Additional bacteria and yeast, which can also cause HAIs, such as Serratia species, are also becoming a concern due to their intrinsic higher levels of disinfectant resistance.”

Prof Bragg explains that in 2014, a high-profile review was first published, commissioned by the UK Prime Minister, entitled, “Antimicrobial Resistance: Tackling a crisis for the Health and Wealth of Nations” (the AMR Review). This review estimated that antimicrobial resistance (AMR) could cause 10 million deaths annually by 2050 (The Review on Antimicrobial Resistance 2016). This is the same number of deaths caused by cancer today, making AMR the leading cause of human mortality by 2050. When it was finalised, this report was highly criticised as an over-dramatisation, as when this prediction was made, the number of mortalities related to HAIs was around 700 000 – a very long way off 10 000 000. However, according to recent estimates, five years later, in 2019, 1.27 million deaths were directly attributed to drug-resistant infections globally, and this had reached 4.95 million deaths associated with bacterial AMR (including those directly attributable to AMR) by 2022 (Murray et al. 2022). 

The overuse of disinfectants during the COVID-19 pandemic, according to Prof Bragg and Mc Calie, has contributed to the crisis by fostering resistant strains and contaminating environments. Based on the current trajectory of mortalities, the 10 million mark will be reached way before 2050.

Need for a paradigm shift

The researchers say an urgent need to change the paradigm in medicine from “treatment” to “prevention” is necessary and that the old saying ‘prevention is better than cure’ has never been truer. 

According to Bragg: “The golden era of antibiotics is rapidly coming to an end. It is highly unlikely that we will discover new antibiotics, and even if we do, the likelihood that the bacteria will already have or will be able to develop resistance in a very short time is highly likely. 

“We need to think of what happed with quinolones, where we thought we had won the war with a groundbreaking new antimicrobial agent. The bacteria did not have millions of years of evolution to develop resistance to quinolone, yet in only three years, the first resistant bacteria were isolated. There is currently great excitement around AI-derived new antibiotics. However, the end result is likely to be the same. We need an alternative to treatment – in other words, a paradigm shift.” 

Improved biosecurity 

Prof Bragg says highly improved biosecurity is the only viable option for disease control in a post-antibiotic era. By using good biosecurity in poultry production, he says the mortality rates were reduced by 50%. 

Research has shown a direct link between the environmental microbial load in a hospital and HAIs; with a lower microbial load linked to lower incidence of HAIs including C. difficile infections (Boyce et al. 2008; Suleyman et al. 2018; Umemura et al., 2022). Therefore, the new paradigm is to reduce microbial contamination in the hospital environment to prevent HAIs. If there are fewer dangerous microorganisms in an environment, patient and staff exposure to these microorganisms will decrease, reducing the level of HAIs for staff and patients. However, to reduce the microbial loads in healthcare settings, effective cleaning and disinfection products need to be used. 

News Archive

Official opening ceremony of the UFS Qwaqwa Campus
2006-02-15

Official opening ceremony of the UFS Qwaqwa Campus
11th February 2006 – Multipurpose Hall

Opening Speech:
Prof. Peter A. Mbati
Campus Principal

Successfully rising to the challenges of incorporations and mergers – developing a vibrant and academically stimulating satellite campus of the University of the Free State.

Thank you Mr. Program Director and good morning ladies and gentlemen.

I wish to once again welcome all of you to the official opening ceremony of the University of the Free State QQ campus.  Thank you for taking time to share with us an important date in our campus academic calendar.  I bring you greetings from our Rector and Vice Chancellor Prof. Frederick Fourie.

During such occasions we try and reflect on important matters that have affected us as an institution in the preceding year, commit ourselves to specific objectives for the current year, while planning for the proceeding year.

Today I shall be talking on Successfully rising to the challenges of incorporations and mergers – developing a vibrant and academically stimulating satellite campus of the University of the Free State’.

SRC inauguration
I would like to congratulate the SRC President and the entire SRC leadership for being elected into important positions of student leadership and authority. 

As a university we are proud of the quality of our student leadership on the Qwaqwa campus.  I am confident that you young leaders will rise to the challenges of your office and discharge your duties with diligence and without fear or favour.  That you will rise above your party affiliations and provide effective leadership to the entire student body on campus.
                              
Leadership is complex and requires you to be objective, just and fair in your approach to the many challenges that you will encounter.  You will be judged not by the populist decision that you take when confronted with difficult choices, but rather, on the wisdom that you exercise in reaching consensus in decision making processes.

The era when management and student leadership viewed each other with suspicion and as adversaries is long gone.  Management, academic and administrative staff, parents and students must have common agendas in as far the  quality growth and development of our university is concerned and to strive towards academic excellence.  I leave the challenge to you students, and more so to the inaugurated student leaders to define your agenda in achieving this noble objective.  I trust that you will make the right choices.

Brief history of incorporation
On the recommendations of the National Working Group of Higher Education, the Qwaqwa Campus of the then University of the North was incorporated into the University of the Free State on 1st January 2003.  We suddenly had to move from a campus that was originally semi-autonomous and with its own culture developed over almost 20 years, into a campus that had to operate as a fully integrated campus of the UFS, a 100 year old institution with its distinct culture.

Following incorporation, we not only had to continue with our core business of teaching, learning, research and community service, but we also had to engage in other important aspects such as exploring the most appropriate models of governance for the campus, encouraging dialogue and interactions at all levels between personnel at the different campuses with a view to developing trust between colleagues. And with the added dimensions such as participation in the transformation task team we in effect are at the fore front of developing a new institutional culture at the UFS and a truly South African University.

UFS Strategic objectives
The strategic and transformation priorities of the University of the Free State for 2006 – 2008 as approved by the Executive Management at its retreat in January 2006 are:

  • Quality and Excellence
  • Equity, diversity and redress
  • Financial sustainability
  • Regional co-operation and engagement

Central to this priority is the integration of the Qwaqwa campus as a valuable constituent part of the UFS, and the strategic reconfiguration of the campus in order that the UFS can play a meaningful role in regional engagement and development.

  • National leadership

The five strategic objectives cannot be viewed in isolation and run simultaneously and in concert with each other. 

The Question must therefore be what we on the QQ campus, staff and students, parents and our broader community are willing to do to achieve these strategic objectives. The reconfiguration and strategic planning of this campus, and therefore its success, must be a collaborative effort between colleagues at QQ and on the main campus.  We must all be ready to work together, to plan together, to shoulder responsibilities together and sometimes, to share the pain and disappointments together. 

The second question must therefore be: are we prepared to go that extra mile for our campus to ensure that we claim our rightful stake within the ranks of well respected academic institutions of higher learning in this country?  At this point in its history this campus requires committed men and women from across the cultural spectrum who appreciate the challenges ahead of us and who are ready to give of their best and to constructively engage at all levels to make this dream a reality.  Because this dream is possible and this dream will be realized!

Quality and Excellence (1st strategic objective)

As mentioned by the Rector in his speech at the official opening ceremony of the university on the main campus on Friday 3rd February, the university will in 2006 pay extra attention to Quality and Excellence.  This is informed by the Higher Education Quality Committee’s (HEQC) institutional audit which is scheduled to take place this year.  Our university as well as several other HEI’s will be subjected to this audit.  This will call for a lot of hard work on your part in preparation for a successful audit and in this regard therefore I request for your cooperation.

As a further step in confirming our commitment to quality and excellence, we have simultaneously introduced on the QQ campus and the main campus workshops on performance management systems to a cohort group.  This will be expanded in 2006 to a wider group of managers on the QQ campus to include among others all Program Heads and Subject Heads. PMS is an invaluable tool for fair, effective and efficient management of a very important resource on campus – the human resource.  Benefits of PMS include among others:

  • Instilling and enriching a culture of performance management (quality assurance) as an integral part of the day to day functioning of staff at the campus
  • Improving staff performance through mentoring, development and training

Tri campus project
One of the more important projects that we as a university undertook in 2005 was the Tri Campus Project which was coordinated by the Free State Higher Education Consortium (FSHEC) through Niel Butcher and Associates consultants.

The Tri-Campus project focused on the strategic planning for higher education campuses in the Free State that have been incorporated with UFS and CUT during the reshaping of the South African higher education landscape. The Bloemfontein Vista campus and the Qwaqwa campus of the University of the North were incorporated with the UFS, and the Welkom Vista campus with the CUT.

The planning process involved a range of research and consultation activities during the course of 2005. This included:

  • Conducting situational analyses of the Qwaqwa campus during which staff and students were widely consulted;
  • Consulting with the campus and with a range of stakeholders in the sub-region
  • Review of the Free State Provincial Growth and Development Strategy and Integrated Development Plans (IDPs) of the regions and other research of relevance to the sub-regions, province and country.

An operational framework for the reconfiguration of the campus with a range of possible Program Qualification Mixes has been produced.  In December 2005, the Rector, the Vice Rector Academic Planning Prof. Magda Fourie and I discussed this document with senior members of the DoE in Pretoria, and we will soon be meeting with the National Minister of Education Me Naledi Pandor for her guidance and to seek support in the further refinement of the document and subsequent implementation.

Recapitalization
This year a further R 6 M has been budgeted for recapitalization.  In about two weeks time the third of phase of renovations on campus will commence and attention will be given to the administration building, the humanities and the outstanding work in the lecture hall complex.  There- after the library, sciences and education buildings will follow.  As you will recall a substantial portion of the R 8.4 million in 2005 was used to upgrade the student residences and the lecture hall complex.

I am certain that the renovations and upgrading of our infrastructure and physical facilities including landscaping will create an enabling environment for you to enjoy your work and studies on this campus.

Renovations come with some measure of inconveniences and I therefore wish to request for your patience and support during this period.

Closing remarks
There is a heightened spirit of optimism on what the future holds for this campus.  This is evident when I talk to a large cross section of staff and students of this campus – and I therefore invite all of you to come and be partners with us on this journey of optimism and hope of what the future holds for the UFS – QQ campus.

Thank you and God bless!

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