The NS Interview: Linda-Gail Bekker

“So many of our people live daily with the effects of HIV”

Your work focuses on HIV and tuberculosis. What does that involve? What's the plan?
Here in Southern Africa, children are getting TB in huge numbers. They don't get the disease immediately, but they become infected. When you superimpose the HIV epidemic on top of that, you speed up the progress of the illness - so the TB infection becomes TB disease in young adulthood because of their immune deficiency. We have to think of TB and HIV together almost as a new disease. That requires us to go back to fundamentals, but also to think outside the box. What will be the new interventions? What else could we be doing?

What drew you to work in the field?
I was born in Zimbabwe, and came to UCT [the University of Cape Town] to do my medicine degree. It was the late 1980s and the HIV epidemic was just breaking for us. I remember a strong sense of frustration, anxiety, impotence - I didn't fully understand what was going on and wanted to know more. I went on to do my PhD in host immunology, which I am still fascinated by. But as time has gone on, I've been drawn to the hands-on side of things. I'm really a closet social worker these days.

Are you engaged in the politics of South Africa?
Well, I think we are activists at heart simply because, again, you can't work in this field and not be politically aware. We work hard to change policy, but through evidence. And that's a slow and often arduous process.

Do you personally feel political? Do you vote?
Oh, yes. I came from Zimbabwe, perhaps politically quite naive, to UCT, which was a very liberal university in those days. I had quite a political awakening as a result of that.

In what way?
I came to university in the 1980s, an incredibly volatile time in SA's history. And the 1990s was the most extraordinarily liberating period. That initial starry-eyed, honeymoon phase is a little bit over. We really need to roll up our sleeves and say: "What are the issues at hand?"

Do you think there's been a lack of political leadership in South Africa?
Yes. Civil society became the leaders: we have had to take on the government on some occasions. On other occasions we've taken on the pharmaceutical companies with the government. SA has huge challenges still - some days you kind of recognise that it's a big job, and how ever are we going to meet all the challenges? But the little triumphs along the way do count. I think we are making progress.

You've just won the Royal Society Pfizer Award for your research into HIV and tuberculosis. What does the prize mean to you?
I'm overwhelmed. I think one of the aspects of working in this part of the world is that you get on with the job, you get lost in the day-to-day work. So when somebody stops and acknowledges you, it's a very pleasant surprise.

It's said you marry science and humanity.
HIV and TB are just so much a part of our lives. A good part of our workforce lives openly with HIV. I have had TB and had to take treatment.
It really is very tangible for us: you're dealing with it not only at work, but in everyday life.

How do you balance your work with the rest of your life?
I married someone in exactly the same field. He's the director of the HIV centre at UCT and I'm deputy director, and we run the foundation together, so a lot of our work comes home. But we have a great work team who can be relied upon. We have two grown-up children and a seven-year-old, Oliver, who started life with an embryonic carcinoma, so the first three years of his life we camped at the Red Cross children's hospital because he needed chemotherapy. Once you've got beyond that, you pretty much feel you could cope with most things!

Is there anything you regret?
I've loved being a mother. I could have quite enjoyed another child. But no, I don't think I have any regrets at all. The only thing is that I would have done more of everything.

Would you ever like to live anywhere else?
I'm inherently an African: I'm fourth-generation. It's hard for me to think of living anywhere other than Africa. Certainly, the work I do seems most relevant here. I lived for some time in New York and I loved it. But what makes me want to stay here for the moment is just the relevance. I'm a hands-on person. I like to engage with the community, with the staff. I think that's where my talent is.

Are we all doomed?
I don't think so, but I can see why you would ask. When you look at TB-HIV figures you wonder what the next terrible virus or pathogen is that's waiting around the corner. But the thing that strikes me daily is the resilience of humanity. Human beings find a way.

Linda-Gail Bekker is deputy director of the Desmond Tutu HIV Centre at the University of Cape Town and chief operating officer of the Desmond Tutu HIV Foundation.

Read a longer version of the interview.