After having matriculated with good grades from the Montebello High School in Durban, applying for medical school seemed like a no-brainer to Dr Sengeziwe Sibeko. All her school friends with good grades opted for life sciences.
But the 18-year old who grew up in the Umlazi township and had boarded at Montebello High, could never have imagined that by age 44 she would be an obstetrician and gynaecologist, an epidemiologist and a mucosal immunologist, with a PhD to boot. All this was achieved in her quest to help ﬁnd a way to prevent HIV transmission to women.
“Back then, I had no vision of my own. I never dreamed that I could end up in the ﬁeld of medicine, let alone become a scientist!”
After having specialised in obstetrics and gynaecology at the University of KwaZulu-Natal (UKZN), Sibeko successfully completed the Fogarty Global Health Training Programme at the National Institutes of Health in Washington DC in 2007. She went on to pursue even loftier goals, and in 2009 she was awarded another fellowship to complete an MSc in epidemiology at Columbia University’s Mailman School of Public Health in New York. In 2011 she was awarded the prestigious Oxford Nufﬁeld Medical Fellowship to study towards her PhD at Oxford University, from which she graduated in 2017.
However, these are only a few of the highlights that illuminate Sibeko’s career path.
Throughout her research career of 12 years she has immersed herself in various projects, all with a common theme: HIV-1 prevention in women. This interest was sparked during her registrar training under UKZN’s Prof Jack Moodley, when she became involved in community health rotations and discussions about maternal morbidity and mortality.
“I became aware of the extent to which HIV/Aids was changing how it presented itself clinically and in altered disease manifestations, and the natural progression of the disease,” she recalls. This was the catalyst that sparked her interest in research after ﬁve year of specialisation. She joined the Centre for the Aids Programme of Research in South Africa (CAPRISA) at UKZN as a research gynaecologist, where she worked until moving to the United Kingdom for her PhD. Upon her return she was scooped up by the Department of Obstetrics and Gynaecology at Stellenbosch University’s Faculty of Medicine and Health Sciences, where she currently works as a senior researcher.
She says sub-Saharan Africa is a region where women uniquely bear the brunt of the HIV epidemic. “My research interests are thus aimed towards improving women’s health, with a particular focus on the HIV/Aids epidemic.”
To this end she has been involved in HIV-1 prevention and pathogenesis research programmes, looking at the female genital tract (FGT) from all angles: clinically, epidemiologically and in laboratory sciences. “Following my involvement in the multi-award-winning CAPRISA 004 tenofovir gel clinical trial, I wanted to conduct research aimed at understanding biological mechanisms responsible for increased HIV acquisition risk in women.”
The CAPRISA 004 trial was the ﬁrst trial undertaken at an international level to demonstrate that tenofovir gel, a microbicide applied intra-vaginally, reduces HIV risk by 39%. “However, it also showed that this reduction in HIV risk was much smaller in women with evidence of pre-existing or underlying inﬂammation and immune activation in the FGT.” This was the motivation for her current research, aiming to provide more insight into mucosal immunity and the correlates of protection or vulnerability to HIV. The ultimate purpose is to develop an effective HIV preventative strategy for women in the form of either a microbicide or a vaccine, says Sibeko.
“My specialty within mucosal immunology is at the interface between the epithelium (the inner lining of the womb) and the virus, focussing on the cervix (mouth of the womb).” She explains that studies on monkeys provided most of the insight into the transmission of HIV-1. “My research is with human models, looking at early transmission events, and hence bridging the gap between humans and monkeys.”
Sibeko’s passion for public health has not come without a personal cost. She says her worst trait is living to work, resulting in an unbalanced life. “But I am working towards ﬁnding more balance by pushing myself to do other things.”
If she could leave behind a legacy, she would like it to be as someone who was part of ﬁnding a solution for this century’s women’s health problems.
IT’S NOT ALWAYS EASY…
Dr Sibeko encourages staff and students to persevere and take advantage of every opportunity to improve themselves, even if it proves difficult.
The greatest challenges in her career arose due to a lack of support, often with no one to cheer her on. But she is proud of having achieved what she has in the face of adversity.
“For instance, when I went to Columbia University, I had no laptop. While everyone in the class took notes and did their assignments on their laptops, I had to learn how to use the computers in the computer lab, while also typing out assignments on statistics. It meant having to be in the lab seven days a week, often only going home at three in the morning.
“In the end I got really good grades and even received an award for one of my classes.”
During her PhD studies at Oxford she also experienced a scarcity of support and mentorship. “Somebody told me that they wait for you to drown and pack your bags to go home. Every moment was difficult. There were things that took me months to figure out. With enough guidance, it could have taken a few weeks.”
She decided to stick to her mantra: “If somebody else can do it, so can I”. And, against the odds, she completed her PhD, sustaining herself with sourced funding and sheer determination.“When I’m 60 years old, I would like to look back and say I have fought the good fight, finished the race, and have no regrets.”