Cardiologist Bongani Mayosi is something of a rarity in the medical streets of Groote Schuur. At only 38, he's collected a National Research Foundation President's Award, or P-rating, not bad for a man who completed his clinical training only seven years ago. And not bad for the scholar from rural Ngqamakhwe whose mother taught him in a church hall.

P-ratings usually go to the under-35s, gifted young researchers the international community believe will mature into world leaders in their fields. Medics are handicapped by the long lead-in to their research careers; in Mayosi's case it was 14 years of clinical training before he was ready to fasten the last button of his lab coat.

Fortunately, the NRF offers a leg-up: medics get a concessionary five years to produce research of the required depth and innovation.

"It's very hard [as a medic], so it does give me a sense of achievement," Mayosi says, joking that he's the madala, the old man among the President's posse.

The P-rating recognises his contributions in three areas of heart disease. In his research on cardiomyopathy he has forged new knowledge by identifying the genetic factors causing heart disease. These are often triggered by environmental factors.

"If you look at Africa's 800 million people, heart disease is caused mainly by non-ischemic causes." His other foci are rheumatic fever and pericarditis, both prevalent in societies experiencing famine and pestilence. These are diseases of the developing world, persisting when they should have been eradicated years ago.

Rheumatic fever attacks the heart valves and is prevalent among children between five and 15 years. It's often brought on by the accumulation of antibodies developed as a result of strep throat. Untreated, is has serious repercussions.

As an African he's concerned that poverty is the presage of these "old diseases", all aggravated by the rise of HIV.

"It's preventable," he argues. "It's indicative of neglect. We need to educate our doctors, health care staff, and the general public. And we need to use penicillin more widely."

Pericarditis, inflammation of the sac surrounding the heart, is commonly caused by tuberculosis in the African environment. A year ago Mayosi started Africa Study (Impi means 'warriors' in isiZulu ), the first pan-African collaboration of its kind, with South Africa, Ghana, Cameroon, Nigeria and Uganda at the vanguard of an effort to eradicate the problem and reduce the death rate.

Working with epidemiologist Dr Charles Wiysonge, an Africa MRC Fellow from the Cameroon, and UCT/GSH cardiologist Dr Mpiko Ntsekhe, Mayosi says the project has attracted a lot of interest and he hopes to make the study available worldwide.

"These diseases must be eradicated from Africa in our lifetime," he states. "We need to be more ambitious. It's a question of will."

His P-rating brings UCT's tally to four; (his forerunners are Dr Maano Ramutsindela [Engeo], Dr Justin O'Riain [zoology], and Assoc Prof Anton Fagan [law]) two whites and two blacks, an equitable racial ratio at least. (Mayosi has lots to say about the plight of young women researchers, with an age cap on achievement, but that is another chapter.) Has the tide turned? He believes 10 years [since democracy] is too soon to say.

"But we are beginning to see the normalisation of society. We're beginning to see the emergence of a pattern of doing things right. And it is important that UCT becomes a home to all."