Phumla Sinxadi

“Umntu Ngumntu Ngabantu” (“a person is a person through other people”) is a South African saying that strongly resonates with Phumla Sinxadi, a recipient of TDR’s Clinical Research and Development Fellowship (CRDF) who became the first black South African female clinical pharmacologist. The saying has a two-fold meaning for her: she has got to where she has through the support of others, and now in turn she has a responsibility to pay it forward.

Phumla was born in Zwelethemba (about an hour from Cape Town) and grew up in a village called Mokhesi on the Eastern Cape, a rural area with limited resources. “Frankly, we grew up relatively poor, in a poor community,” says Phumla. “Our primary school didn’t have a library, flushing toilets or running water to drink. I remember distinctly drinking water from a dam and using our uniform as a sieve to ensure that we didn’t drink any tadpoles. That’s what I think about when I look back at how far I’ve come.”

As in many poorer families, Phumla grew up in an extended family. Her grandmother raised her and her siblings with her cousins while their parents went to work. “Both [parents] were extremely hardworking and were supportive of my career choices,” she says. “But it was my mother and grandmother’s love for education that had the biggest influence on me.”

It was her teachers that first encouraged Phumla to become a doctor. While doing her elective as a medical student the possibility of being able to help more than one person at a time “through promoting rational drug use” drew Phumla to clinical pharmacology. 

After graduating with a Bachelor of Medicine and Bachelor of Surgery (MBChB degree) in 2001 and gaining a Diploma in Anaesthesiology and a Master of Medicine in clinical pharmacology, she gradually transitioned towards drug development. “It was a combination of circumstance and opportunity,” she says. “I was almost done with training as a specialist, but there were no consultant posts available. Instead, I was fortunate to secure funding for full-time PhD study.” 

While doing her PhD on antiretroviral pharmacogenetics, Phumla had the “incredible” opportunity to be lead investigator (with Professor Karen Barnes as principal investigator) in a “first-in-man” study for a novel antimalarial compound, MMV390048, developed by an African-led international collaboration. “It was this pivot that led to my interest in drug development,” she states.

In 2015 Phumla applied for the TDR CRDF, having heard about it from the Medicines for Malaria Venture (MMV). Her aim was to learn advanced skills in drug development. For her fellowship she was seconded to the Diseases of the Developing World Research and Development unit at GlaxoSmithKline in Stockley Park in the United Kingdom, under the supervision of Justin Green. They worked on the clinical development of tafenoquine, which has since been approved by the United States Food and Drug Administration for prophylaxis against malaria and as a radical cure for Plasmodium vivax malaria.  That proved to be “an incredible experience,” where she learnt a great deal about research in Big Pharma. She remains in touch with Justin and other CRDF fellows he supervised.

As well as being the first black South African female clinical pharmacologist, Phumla is also the first pharmacologist trained at the University of Cape Town (UCT) to hold the Head of Division of Clinical Pharmacology post in the University’s Department of Medicine. She credits the CRDF with making her much more confident to take up leadership roles.

“I’m hopeful that [the promotion] will offer opportunities for growth,” she said. “It’s an important leadership role and will bring forth recognition and potential for collaborations with people I’ve not yet had an opportunity to work with.”

There are many to whom Phumla is grateful: the Discovery Foundation, The Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), the South African Medical Research Council, the National Research Foundation’s Thuthuka and Black Academics Advancement Programme (BAAP) awards and the Novartis Next Generation Scientist Program. She says she was inspired to “think big” by the late Professor Bongani Mayosi and is grateful for mentorship from Professor Maartens and collaboration with renowned pharmacogenomics expert Professor David Haas. Of course, she is also grateful to TDR for the CRDF.

Phumla’s research has focussed on antiretroviral pharmacogenetics and pharmacokinetics in an African population; the latter, naturally, is very important to her. “Africa has the oldest population with the most genetic diversity, yet we are still underrepresented in pharmacogenetics or exploratory drug development studies. There is so much potential to do more work and possibly find novel variants that can lead to druggable targets,” she says.

Phumla is pleased that she will continue to teach in her new role as Head of Department. She has a clear vision for South Africa and for Cape Town, where she lives and works. “South Africa is a great country with its own challenges and opportunities. Health challenges include COVID-19, TB, HIV and their intersection with noncommunicable diseases such as obesity. We need to grow pharmacogenomics research and exploratory drug development, which must include Africans, so we can give the optimal doses to our patients. My vision is to demystify what we do and improve access to clinical pharmacologists.” Asked to describe her passion, she simply states: “Train more pharmacologists. We need more of us!”

Reflecting on what her family thinks of her achievements, Phumla remarks: “Sadly, my mother passed away when I was an intern (2002), and my father passed away before I could finish specializing (2009). Both were very proud of having a doctor for a daughter. I hope I continue to make them proud.”

For more information on the CRDF, please contact Dr Pascal Launois.