Alan Pifer winner champions child, women’s heart health

The University of Cape Town’s (UCT) 2021 Alan Pifer Award recipient Professor Liesl Zühlke not only has a resume that exemplifies academic excellence, but also a deep commitment to seeing child and women’s health take its rightful place at the centre of the global health agenda.

A paediatric cardiologist and renowned continental leader in cardiovascular medicine, Zühlke has recorded several exceptional scientific breakthroughs in her focus areas of rheumatic heart disease (RHD) and congenital heart disease (CHD) with a considerable, measurable impact on heart health in Africa and internationally.

She shares the 2021 Vice-Chancellor’s annual prize, which rewards outstanding welfare-related research at UCT, with fellow heart-health pioneer Professor Karen Sliwa. The award also highlights UCT’s strategic goal of promoting socially responsive research, while honouring those who have helped advance the welfare of disadvantaged South Africans.

Both winners were lauded recently at the UCT Staff Annual Awards 2022 dinner, to honour exceptional UCT staff for their dedication and excellence in research, teaching and service, and at the UCT Research Excellence for Change annual research celebration.

“This award recognises the efforts of a team that is dedicated to conducting, supporting and empowering children’s heart disease research – with a special focus on the needs of Africa,” says Zühlke.

“I hope it will help highlight the needs of the most vulnerable population – children – within the massive burden of cardiovascular disease, which is the number one global killer.”

Historic resolution on RHD

Zühlke was nominated by her UCT colleagues for her commitment to improving the lives of children and women around the world, her innovative research methodologies and her unstinting mentorship of students and colleagues alike. She is hailed for contributing “significant new knowledge” within South Africa, Africa and globally.

In real terms, they stress, her work prompted – among other things – the development and worldwide adoption of guidelines on the prevention and control of RHD, providing a platform for controlling this neglected disease of marginalised communities.

This has been achieved through her work leading the global scientific and technical support initiative REACH, as well as research into the diagnosis and management of RHD in its earliest forms, through screening.

Zühlke also made a substantial contribution to the passing of a historic World Health Organisation Resolution on RHD in 2018, recognising rheumatic fever and RHD as global priorities for the first time.

“She has engaged with governments and ministries of health to improve the management, treatment and outcomes of patients with RHD. She has also led or played a pivotal role in almost every major RHD research and intervention since 2010,” her nominees wrote.

“She has played a pivotal role in almost every major rheumatic heart disease research and intervention since 2010.”

At the end of 2021, Zühlke joined the South African Medical Research Council as vice president of its extramural research and internal portfolio, from UCT, where she was the acting deputy dean of research in the Faculty of Health Sciences. She retains her UCT affiliation with the Department of Paediatric Cardiology at Red Cross Children’s Hospital and continues as director of the Children’s Heart Disease Research Unit. She is also continuing her research as a member of UCT’s Department of Paediatrics and Child Health.

Along with her focus on RHD and CHD, Zühlke’s research spans HIV in adolescents, grown-up congenital heart disease and cardiac disease in women of child-bearing age. She has more than 45 000 citations, eight published book chapters and 168 published articles.

She has managed several large-scale RHD projects in South Africa and further afield, including the Rheumatic Heart Disease Registry (REMEDY study). This first large, multi-country registry and cohort study of thousands of people in Africa demonstrated that the death risk from RHD was highest in low-income countries, reinforcing the impact of poverty on disease.

Top-cited paper in paediatric cardiology in 2019

Among her other breakthrough research was Zühlke’s paper on the global prevalence of congenital heart defects from 1970–2017, which was the most cited paper in paediatric cardiology in 2019. This prompted a renewed focus on timeous diagnosis and the highest quality of care for children with heart disease in Africa and other low- and middle-income regions.

Zühlke takes very seriously the reputation she has built as an effective teacher, mentor and adviser, creating support and supervision opportunities for her students and others within the faculty, department and the continent.

She has successfully supervised MMed, MPhil, MPH and MSc students, several of whom graduated with distinction and had their findings published in high-impact journals. The first African basic and advanced paediatric echocardiography training courses, which she convened in 2019, saw her secure substantial funding for African fellows.

“I am committed to creating empowering spaces for colleagues and students to grow and develop,” says Zühlke. “I fully support and am deeply involved in transformation endeavours and believe my strength lies in my inclusive, collaborative approach and servant leadership ethic.”

“I fully support and am deeply involved in transformation endeavours.”

Her leadership style has seen Zühlke honoured with many high-profile positions within cardiology in South Africa. These include president of the Paediatric Cardiac Society of South Africa (2012–2016) and of the South African Heart Association (2016–2018). She is the immediate past chair of both the Paediatric and Rheumatic Heart Disease Taskforces within the Pan-African Society of Cardiology. She also won the National Research Foundation award for public engagement in research (2020) and the 2022 Metrodora Award for Leadership in Public Health and Science in Emerging Economies.

In addition, Zühlke was the only person from Africa among 17 commissioners from 11 countries to serve on The Lancet women and cardiovascular disease commission, which published a landmark report outlining 10 priority recommendations last year.

“I am deeply grateful to the Vice-Chancellor and UCT for this award, which recognises my research focus on addressing the key challenges facing children with RHD and CHD, improving outcomes, and fostering collaborative, equitable and responsive partnerships,” she concludes.