A ‘shift in direction’ for immunodeficiency pioneer

Prof Monika Esser.
Prof Monika Esser, a Paediatric Rheumatology and Immunology Specialist and Head of the Immunology Unit of the National Health Laboratory Services (NHLS) at Tygerberg Hospital and Stellenbosch University’s Faculty of Health Sciences, will retire in July. 
Her retirement might mean she has more time on her hands, but Esser said she would be keeping busy with numerous medical commitments, including research, freelance work and supporting a range of not-for-profit organisations. 
“I feel very excited about my retirement from the NHLS because it means I will have more time to work flexibly on various things that really interest me,” Esser said in an interview. 
“It’s a shift in direction, and will involve a far less formalized work schedule. I don’t have to stick to certain hours, but will remain working in the paediatric rheumatology and immunology clinics of the Department of Paediatrics and Child Care in an honorary capacity, until we have enough trained people in those fields.” 
Esser took up the joint position of Head of the Immunology Unit within Medical Microbiology in the NHLS Tygerberg in March 2005. 
“It’s been such an interesting part of my life. I am actually a paediatric rheumatologist, but was asked to take over as head of the immunology unit, which is part of the medical microbiology department of the Department of Pathology at the hospital. 
“I was asked to come on board as a scientist, even though I am not a trained scientist. I did some laboratory-related training in infectious diseases in the 80s in the US, but other than that my training was clinical. It took about three years for me to re-define the position as a clinician with an interest in Immunology but not as a scientist. It was a big challenge but definitely a worthwhile one. 
Esser said her position enabled her and colleagues to develop some of the translational research, including looking at HIV-exposed but uninfected infants. 
“It had become obvious in the clinics that these children were more at risk of serious infections in the first year of life. This led to collaborative research and resulted in a different way of looking at these children as being at risk and not as immune-competent as HIV- unexposed children. 
“This research is ongoing – and it is very exciting work.” 
Esser said another highlight of her years in this position include that she managed to develop the immune-deficiency clinic further through facilitating research linking immune deficiencies to genetics. For this research, a group, PIDDGEN, was established in 2013. 
“This is also ongoing a very exciting part of my work which I hope to continue to support through helping to find genetic reasons for commoner and also rarer immune-deficiencies,” she said. 
“Our predominant scope of interest in this area is among children and adolescents with recurrent and unusual forms of tuberculosis. The link with existing research structures for more common diseases in our country means that our work in this field has very good prospects for becoming a long-term project, with growth of scientists as well as fellowships and it has great translational potential. 
A founder member in 2008 and past chairperson of the board of the African Society for Immunodeficiencies (ASID), she said she will continue to do work for the society in an honorary position as well as with the International Patient Organisation for Immunodeficiencies. “On top of this I will also carry on with our work towards a national registry for immunodeficiency which we have been running for the past fifteen years,” she said. 
“I will also be involved in African workshops to develop awareness and train doctors to identify immuno-deficiencies so that they can be treated.” 
One of the NPOs she supports – and will continue to work with – is Hope Cape Town – an HIV outreach and education project whose board Esser chairs. 
“In terms of research, I am excited to look at the link between the laboratory and the clinical applications of immunology and translate some of the findings we’ve come up with into further research projects and into algorithms of better care in the clinic,” she said. 
“So I will definitely not stop working!” 
Her retirement means she will also have time for fun, Esser said. “I have a very active husband, who still works as a cardiac surgeon, but we will make time for our hobbies, mountain biking, kayaking and exploring the wild. We intend doing much more of that together – as well as spending time with our three daughters and two grandchildren on wonderful holidays.” 
Sue Segar