​​​In his young days, Prof Gerhard Walzl was an ambitious internist and lung specialist wanting to put his expertise to use in intensive care units. However, the position he had hoped for after his PhD studies overseas was no longer available. As a Plan B, he reluctantly accepted a research position focusing on tuberculosis (TB). Today, this driven extraordinary professor leads a research team at Stellenbosch University (US) of about 75 people, and a research group that has pioneered the use of biomarkers to ID biomarkers of the disease.

Prof Walzl is the next speaker at the Research Development Division's Forward with Research Impact lecture series, on 3 October 2019 in the Old Main Building (room 1028).

He is a distinguished professor in the Department of Biomedical Sciences of the SU Faculty of Medicine and Health Sciences, an entity that he has led since 2017. He also heads the Molecular Biology and Human Genetics Division, is director of the Immunology Research Group (SU-IRG) and leads the NRF Chair for Tuberculosis Biomarkers.

Advances

He is a man with much weight on his shoulders, yet colleagues say that he always has a smile on his face, and always makes time for them amid his many responsibilities, meetings and perpetual funding applications.

Walzl, on the other hand, describes himself as intense. Driven. Focused on the work to be done.

Because TB is still a big problem.

“I was hoping that by this time research would have been further," admits Walzl, whose research team was the first to determine specific biomarkers for different TB strains.

These biomarkers indicate what someone's chances are of developing the disease, or how he or she will respond to treatment. The work has since 2005 received three cycles of funding from the Bill and Melinda Gates Foundation.

“With a biomarker we can make predictions long before the clinical outcome is reached. It can show who is going to do well or fare poorly with treatment, for whom a drug is going to work and who is at high risk of developing a disease - long before standard tests can do so. It reads the body's own defence mechanisms against disease," he explains.

His team's finger prick test using TB biomarkers was launched in 2018. The apparatus reminds one of a standard diabetes test, because it also allows for an analysis to be done fairly quickly thanks to a drop of blood. Walzl hopes it will one day be endorsed by the World Health Organization. It will soon be put to the test in South African communities.

“TB is a difficult disease because the Mycobacterium organism has adapted so well to survive in the body," Walzl reckons.

It frustrates him that relatively little money is made available for TB studies. It receives, for example, 20 times less funding than HIV research, and far less than so-called first world conditions such as cancer, asthma, heart conditions and aging-related diseases such as Alzheimer's.

"The diseases of poverty get little money, even though these are potential time bombs that could hit the entire world due to increasing migration from the developing world," warns Walzl.

He rates the way in which germs that cause diseases such as TB, pneumonia and wound infections are becoming drug resistant due to the large-scale abuse of antibiotics as another time bomb.

"People who work with infections are worried that we're moving back to a pre-antibiotic age, and that some infections will simply be untreatable," he mentions pessimistically. "For the first time in 60 years, we have new antibiotics for TB, but unfortunately we already know that in a few years' time there will already be widespread resistance to it."

That said, Walzl remains passionate about science and especially biology: “I want to know how things work. And I think I'm in the very fortunate position that I can live my passion through my profession. "

People are important to him, and that's why he wants to use his profession to make a difference: “I would like to see better living conditions for our population. I would like to see that there are opportunities for people, in the wider society or simply here around me in our research group. I want to provide opportunities for my students by which they can develop and become the best they can be. That's important to me. "

Life as a TB researcher

Walzl reckons his decision to become a doctor has to do with the fact that his father came from Austria to South Africa after the Second World War, with a half completed medical degree. In South Africa, he worked as a chemical pathologist at Onderstepoort.

Following his own successful medical studies at the University of Pretoria, Walzl Junior spent two years in Austria in the late 1980s as a young doctor. There, an older specialist noticed that he had a flair for emergency medicine. He went on to give Walzl far more on-the-job experience in intensive care units than he could dream of. He started setting great ambitions for himself in the medical world, first specializing as an internist and then in pulmonology.

By the time he left for England in 1997 to complete a doctorate at Imperial College London, on the recommendation of his colleagues, he was already head of Tygerberg Hospital's Medical Intensive Care Unit. His PhD was about how an infection can change someone's immune system to such a degree that it responds differently to any subsequent infections by other pathogens.

He returned to South Africa in 2002 to find the post that he had set his sights on already filled. There was, however, a position available in a tiny TB research group that had suffered greatly after the untimely death of its driving force.

Initially, he was not too excited about having to exchange medical thoracoscopy and interventional pulmonology for laboratory work. As a high school boy, he wasn't too thrilled to have to help his father in his home laboratory. Fortunately, during his PhD years he began to develop an affinity for experimentation. He had learnt how to get the maximum benefit out of an experiment.

TB would eventually become his life's work – and last year he received an award from the South African Medical Research Council for it.

In the early 2000s, only two other colleagues were part of his research group, of which one is still at his side. Today, that same group constitutes about a third of the more than 200 students and staff in the Molecular Biology and Human Genetics Division.

“I'm just the conductor; they do the work. These are people I can trust," Walzl says about the loyal team he has gathered around him.

Focused

Walzl jogs to relax and unwinds by taking 4x4 trips. In his university years, he learnt how to fence, but in between work and family responsibilities he has not had time to pursue it.

Has he learnt anything from fencing that he could use in his career as a scientist?

"Definitely. It teaches you to focus. It teaches you to look for an opportunity, or to create one, and then to react lightning fast. It's a sport for an intense person," he muses.