South Africa’s Contribution to Science and Medicine

Patrick Soon-Siong

Patrick Soon-Shiong was born in the South African city of Port Elizabeth in the Eastern Cape, South Africa, on July 29th, 1952.

His parents had fled from China to escape the Japanese army occupation during the Second world War.

Unfortunately, there is no record of either the primary, or high schools he might have attended before matriculating, and going to university.

However, as the Apartheid system was in place at the time, we can assume that as an Asian, he was considered a second-class citizen, and would not have been enrolled in any of the Eastern Cape’s many first-rate schools, but would probably have attended a school for “Coloureds”, as mixed-race people were then called.

If this is true, then it says something about the young Soon-Shiong’s intellectual abilities and determination, that he not only matriculated at the 16, two years younger than would usually have been the case, but that his grades were sufficiently impressive that he was accepted into the University of the Witwatersrand’s Medical School!

Again, considering the repressive politics of the time (1968), his admission to an almost entirely white — both in terms of students and faculty — university, indicates that he must have impressed those who reviewed his application.

Their confidence was not misplaced, and in 1975 Soon-Shiong graduated 4th out of a class of 189, receiving a Bachelor’s degree in medicine (MBBCh) at the age of 23.

After completing his internship at the Johannesburg General Hospital, he relocated to Canada, and was accepted by the University of British Columbia, completing his Masters degree in 1979, having also been awarded research awards from the American College of Surgeons, and the Royal College of Physicians and Surgeons of Canada, as well as a Fellow of the American Association of Academic Surgery.

Patrick Soon-Shiong became a resident at the Vancouver General Hospital with the University of British Columbia, and he spent most of his evenings working towards his Master’s degree and in long discussions with another researcher, who specialised in pancreatic cancers.

Soon thereafter, he moved to the United States, and began his surgical training at the University of California, in Los Angeles (UCLA), becoming a board-certified surgeon in 1984.

He remained at UCLA for the next 8 years, as a specialist transplant surgeon.

Soon-Shiong was the youngest professor of surgery in the university’s history, and he proved his worth when he performed the first whole-pancreas transplant ever done at UCLA!

At that time, only approximately 900 pancreas transplants had ever been attempted world-wide, and UCLA was only one of four transplant centres in the USA.

Soon-Shiong says that he chose to specialise on the pancreas, because the pancreas was by far the most complex organ in the body.

However, despite his success, Soon-Shiong eventually realised that such a lengthy and complex surgical procedure carried too great a risk to the patient, and he asked his director, the UCLA chairman, if he might take a sabbatical on a reduced salary to research the feasibility of islet cell transplants. When the chairman, denied his request, his wife Michelle Chan, who was a successful actress in her own right, offered to sponsor him, while he conducted his research!

When Soon-Shiong returned, he was had developed a method for extracting the islet cells from the pancreas, and wrap them in a membrane, which could then be transplanted into the recipient at a much lower level of risk.

Despite his success, Dr. Soon-Shiong realised that such a lengthy and complex procedure carried too much risk to the patient, and he requested that he be allowed to take a 6-month sabattical to develop safer alternative.

When his director refused to grant him the sabattical, he voluntarily took the time off without pay, thanks to the support of his wife who was earning a good salary as an actress! (See notes below)

When he returned, he has developed a method for extracting the islet cells, and wrapping them in a membrane, which would then be transplanted into the recipient. This would be a minimally-invasive procedure compared to a complete pancreas transplant, and had the additional advantage of offering better glycaemic control, which would benefit a wider range of patients

Thanks to the generous support of his wife, he performed the revolutionary transplant of the islet cell at the St. Vincent Hospital Medical Centre.

Soon-Shiong also developed and performed the first experimental Type 1 diabetes treatment (Encapsulated-human Islet Transplant), and also pioneered the first pig-to-man islet cell transplants into patients with diabetes.

In 2009, Dr. Soon-Shiong returned to UCLA, as a professor of micro-biology, immunology, molecular genetics and bio-engineering.

During 2011, he also served as a visiting professor at Imperial College in London.

Whilst he had focussed primarily on medical and surgical matters, Soon-Shiong was soon to show that his interests were far wider than surgical matters!

He had purchased a company named Fujisawa in 1998, which manufactured injectable generic drugs, and with the revenues he earned from Fujisawa, he developed Abraxane, which took an existing chemotherapy drug called Taxol, and encapsulated it in a protein that made it more effective in attacking tumours.

Once Abraxane had received regulatory approval, it earned Soon-Shiong a fortune, and set him on an entirely different trajectory.

He left UCLA in 1991, and founded a diabetes and cancer bio-technology firm called VivoRx Inc. This led to the establishment of APP Pharmaceuticals in 1997, of which he held an 80% share of outstanding stock, and which he eventually sold to a company called Fresnius in 2008.

Soon-Shiong also founded Abraxis BioScience (manufacturer of Abraxane), which he sold to Celgene in 2010, in a cash-and-stock deal for over $3 billion.

Soon-Shiong had also founded NantHealth in 2007, to provide fibre-optic, cloud-based data infrastructure to share healthcare information. He had followed this with the founding of Nantworks in 2011, to “converge ultra-low power semi-conductor technology, super-computing, high performance, secure advanced networks, and augmented intelligence to transform how we work, play and live”.

In October 2012, Soon-Shiong announced that NantHealth’s supercomputer-based system and network had the ability to analyse the genetic data from any tumour sample in 47 seconds, and transfer the data in just 18 seconds!

The goal of developing infrastructure and digital technology, was to enable the sharing of genomic information amongst sequencing centres, medical research units and hospitals, and to advance cancer research and scientific projects like the Cancer Genome Atlas.

In 2010, in conjunction with the University of Arizona and Arizona State University, Soon-Shiong founded the Healthcare Transformation Institute (HTI), which he describes, not as a “think-tank”, but as a “do-tank”. HTI’s mission was to promote a shift in health-care in the United States, by integrating the three then-separate domains of medical science, health delivery and health-care finance.

In 2013, he founded yet another biotech company called NontOmics, to develop the next generation of cancer drugs, based on protein kinase inhibitors. NantOmics and NantHealth were both subsidiaries of NantWorks.

Soon-Shiong’s long-term vision was that NantWorks’ vision for the future of cancer treatment, was a high-tech marriage of multiple technologies that would include diagnostics, network modelling of sharing data on tumour genes and personalised cocktails of cancer drugs in multiple-target attacks, utilising the power of super-computing, to achieve a sustained disease-free outcome.

Other Interests

In 2014, Soon-Shiong founded an on-line streaming music service AccuRadio, America’s fastest-growing music streamer, for an initial investment of $2.5 million. Later in the same year, NantWorks LLC, another company headed by Soon-Shiong invested a further $2.5 million into AccuRadio, and in 2015, NantWorks LLC invested $8 million in Wibbitz.

Also in n 2015, Soon-Shiong initiated an IPO for NantKwest , the highest IPO in history, at a market value of $2.6 billion!

The Los Angeles Times reported in April 2016, that Soon-Shiong’s remuneration package at NantKwest was worth almost $148 million, making him one of America’s highest-paid CEO’s!

Also in February 2016, the Los Angeles Times reported that Soon-Shiong’s investment firm Nant Capital had purchased both the Los Angeles Times and The San Diego Union-Tribune from Tronc Capital, for approximately $55 million in cash, as well as the assumption of $490 million in pension obligations!

In September 2018, NantEnergy announced the development of a zinc-air battery, with a projected cost of $100 per kilo-watt hour, less than one third of the cost of a lithium-ion battery!

Dr. Soon-Shiong is reputed to be the richest doctor in the world, and in April 2021, Forbes estimated his nett worth as $11.5 billion!

Dr. Soon-Shiong has pledged to give at least half of his wealth to philanthropy, as part of the Giving Pledge.

Notes

Dr. Patrick Soon-Shiong is married to Michelle Chan, who was born in East London, South Africa, which is very close to Soon-Shiong’s birthplace in Port Elizabeth! Her father also arrived in South Africa as a refugee from China!

As an actress, she is best known for her role in the series McGyver as Mei Jan, and she also appeared on screen in American Ninja 3: Blood Hunt, the television series Hotel.

Chan is currently the CEO of NantStudio which she founded in 2015.

Hjalmar Rall

Here’s another young South African, who has already re-written the history books!

Hjalmar Rall grew up in the small Western Cape town of Riebeeck Kasteel, where he was home-schooled until the age of 12, as his parents realised that none of the local schools could offer him sufficient stimulation.

Rall completed the Cambridge pre-IGCSE, followed by the IGCSE and A-levels which allowed him to apply to the university.

At the incredibly young 14 years of age, Rall moved to Pretoria with his parents and enrolled at the University of Pretoria, to begin his physics degree.

Now, a mere 4 years later, Hjalmar Rall has just completed his second degree, and is the youngest two-time graduate in the university’s history!

Having graduated cum laude with a BSc Honours in physics, Rall will now be completing a Master’s degree in physics at Stellenbosch University in the Western Cape, and will then move abroad to complete his PhD in Quantum Information Theory, which is unfortunately not offered at any of the local universities.

Hjalmar hopes to become a physics lecturer like his hero — American physicist Richard Feynman.

Max Theiler

Max Theiler was born on January 30, 1899, in Pretoria, South Africa, one of the four children of Sir Arnold and Emma Theiler. His father, Arnold Theiler was of Swiss origin, and was a veterinary bacteriologist.

Max Theiler attended Pretoria Boys High School, and after graduating attended Rhodes University College in Grahamstown, before enrolling at the University of Cape Town Medical School, graduating in 1918.

Upon graduating, Theiler travelled to London to study at St Thomas’s Hospital Medical School, King’s College London, and at the London School of Hygiene and Tropical Medicine. In 1922, he graduated with a diploma in tropical medicine and hygiene, becoming a licentiate of the Royal College of Physicians of London and a member of the Royal College of Surgeons of England.

Theiler then relocated to the United States of America, where he joined the Department of Tropical Medicine at the Harvard Medical School, Boston, Massachusetts.

In 1930, Theiler joined the staff of the International Health Division of the Rockefeller Foundation, where he eventually reached the position of Director of Laboratories of the Rockefeller Foundation’s Division of Medicine and Public Health, New York, in 1951.

At Harvard, his interests were both wide and varied, covering rat-bite fever, dengue fever, Japanese encephalitis and amoebic dysentery, but eventually, his main focus became Yellow Fever and rat bite fever.

By 1927 he and his team had established proved that the cause of yellow fever was not a bacterium but a virus.

In 1930, when he joined the Rockefeller Foundation, where he headed the team that was focused on the problem of yellow fever, an acute viral haemorrhagic disease transmitted by infected mosquitoes, and which is often fatal.

Theiler and his colleagues worked on vaccines against the disease and in 1937 Theiler succeeded in developing an even weaker variant of the virus. This variant, 17D, was a safe, standardized vaccine, which could readily be mass produced, and thus became the vaccine for treatment of humans.

For his work on developing a vaccine for Yellow Fever, Max Theiler was awarded the Nobel Prize for Medicine in 1951.

Other honours awarded to him include the Chalmer’s Medal of the Royal Society of Tropical Medicine and Hygiene (London, 1939), the Flattery Medal (Harvard, 1945), and the Lasker Award of the Lasker Foundation (1949).

Max Theiler died in in New Haven, Connecticut, on August 11, 1972.

Sir Aaron Klug OM FRS FMedSci HonFRMS

Aaron Klug was born in Zelva, Lithuania on August 1th, 1926, to Jewish parents Lazar and Bella Klug, with whom he emigrated at the age of two.

He was educated at Durban High School, in what was then, the province of Natal.

It was here that he first became interested in microbiology after reading Paul de Kruif’s 1926 book, Microbe Hunters.

Upon graduation from Durban High School, he enrolled at the University of the Witwatersrand in Johannesburg, where he started to study microbiology, but then moved into physics and mathematics, eventually graduating with a Bachelor of Science degree. Klug then enrolled at the University of Cape Town, majoring in physics, and obtaining his Master of Science degree in

Klug was awarded an 1851 Exhibition Scholarship which enabled Klug to relocate to England in 1949, where he completed his PhD in research physics at Trinity College, Cambridge in 1953.

Upon attaining his PhD, Klug moved to Birkbeck College in the University of London in late 1953, where he began a collaboration with virologist Rosalind Franklin in the laboratory of crystallographer John Bernal. His experiences at the laboratory aroused a lifelong interest in the study of viruses, and during his time there he made major discoveries in the structure of the tobacco mosaic virus.

In 1962 he moved to the newly built Medical Research Council Laboratory of Molecular Biology in Cambridge, and over the course of several years, Klug experimented with various methods including X-ray diffraction, microscopy and structural modelling to develop crystallographic electron microscopy in which a sequence of two-dimensional images of crystals taken from different angles which are combined to produce three-dimensional images of the target.

Klug also studied the structure of transfer RNA, and made several discoveries, including the engineering phenomenon known as is known as “zinc fingers” as well as the neurofibrils in Alzheimer’s disease.

Klug also took up the opportunity for a teaching Fellowship at Peterhouse, Cambridge.

After receiving the Nobel Prize in Chemistry in 1982, he went on teaching because he found the courses interesting and was later made an Honorary Fellow at the College.

Klug was Director of the Laboratory of Molecular Biology in Cambridge between 1986 and 1996, and also served on both the Advisory Council for the Campaign for Science and Engineering, as well as on the Board of Scientific Governors at The Scripps Research Institute.

Along with Dai Rees, Krug was instrumental in the founding of the Wellcome Sanger Institute, sponsored by the Wellcome Trust, which was a key player in the Human Genome Project.

Apart from being awarded the Nobel Prize for Chemistry, Klug has also received many other awards in recognition of his ground-breaking research in such varied fields as mathematical physics, crystallography, electron microscopy and much more.

In 1969, Klug was elected a Fellow of the Royal Society (FRS), the oldest national scientific society in the world, and he served as its president from 1995 to 2000.

He was appointed to the Order of Merit in 1995, as is customary for Presidents of the Royal Society.

He was knighted by Queen Elizabeth II in 1988.

He was elected a Fellow of the Academy of Medical Sciences (FMedSci).

In 2000, Klug received the Golden Plate Award of the American Academy of Achievement.

In 2005, he was awarded South Africa’s Order of Mapungubwe (gold) for exceptional achievements in medical science.

Sir Aaron Klug was also a ‘Foreign Associate’ of both the United States National Academy of Sciences and the French Academy of Sciences

Klug died on November 20th, 2018, in Cambridge, United Kingdom, aged 92.

Sydney Brenner

Sydney Brenner was born in the town of Germiston in what was then the Transvaal (now Gauteng) South Africa, on January 13th, 1927.

His parents, Morris and Leah Brenner, were Jewish immigrants, who both came to South Africa from Eastern Europe, his father from Lithuania in 1910, and his mother from Rega, Latvia in 1922.

He attended Germiston High School, and upon graduating, enrolled at the University of the Witwatersrand in Johannesburg to study medicine, at the young age of 15!

Due to his age, he was informed that as he would be too young to qualify practice as a medical doctor at the conclusion of his medical degree, he was advised to rather complete a Bachelor of Science degree in Anatomy and Physiology, which he subsequently did.

Upon completion of his BSc. He spent the following 2 years completing first and Honours degree, and finally a Master’s degree in which his thesis was in the field of cytogenerics.

In 1951, he received the Bachelor of Medicine, Bachelor of Surgery (MBBCh) degree.

Two of his tutors at this time were Professors Raymond Dart and Robert Broom of Sterkfontein fame, where the fossilised remains of man’s earliest ancestors!

Sydney Brenner also received an 1851 Exhibition Scholarship from the Royal commission for the Exhibition of 1851, which enabled him to complete his Doctor of Philosophy (DPhil) degree at the University of Oxford as a postgraduate student of Exeter College, Oxford, supervised by Nobel Prize laureate Cyril Hinshelwood.

Brenner then relocated to the University of California, Berkley to do postdoctoral research, and subsequently spent the next 20 years at the Laboratory of Molecular Biology in Cambridge, where he did pioneering work in the field of molecular biology.

Equally interesting, is the fact that Brenner was one of the first people to see the first model of the structure of DNA, constructed by James Watson and Francis Crick, in April 1953, when Brenner was working at the University of Oxford, in the Chemistry Department.

Brenner subsequently assisted Crick at the Cavendish Laboratory at the University of Cambridge, and made some important contributions to the emerging field of molecular biology in the 1960’s, one of which led to Crick proposing the concept of what is now known as ‘transfer RNA” (tRNA), which proved that information only flows from nucleic acid to protein, never from protein to nucleic acid, which essentially became the central dogma of molecular biology!

Brenner later proposed the concept of concept of “messenger” RNA and later demonstrated the triplet nature of the code of the protein translation through the Crick, Brenner, Barnett, Watts-Tobin experiment in 1961.

This was critical for deciphering the code.

Brenner, with George Pieczenik, created the first Computer matrix analysis of nucleic acids using TRAC, and also collaborated with Crick, Pieczenik and fellow South African, Aaron Klug, who would also go on to win a Nobel Prize for Chemistry!

Soon after this, Brenner changed course and began using Caenorhabditis elegans a long, soil round-worm for genetic analysis, which led to the identification of new sets of proteins. Interestingly, the humble C. elegans round-worm continues to be used by researchers to this day, with researchers working on a wide spectrum of problems

It was for this work, that Brenner shared the 2002 Nobel Prize in Physiology or Medicine with H. Robert Horwitz and John Sulston.

Brenner’s impact on science cannot be under over-stated!

He founded the Molecular Sciences Institute in Berkeley, California in 1996. As of 2015 he was associated with the Salk Institute, the Institute of Molecular and Cell Biology, the Singapore Biomedical Research Council, the Janelia Farm Research Campus, and the Howard Hughes Medical Institute. In August 2005, Brenner was appointed president of the Okinawa Institute of Science and Technology.[43] He was also on the Board of Scientific Governors at The Scripps Research Institute,[44] as well as being Professor of Genetics there.

Awards and Honours

· Nobel Prize for Physiology of Medicine in 2002

· Fellow of King’s College, Cambridge since 1959.

• Elected an EMBO Member in 1964.
• Elected a Fellow of the Royal Society (FRS) of London in 1965.
• Albert Lasker Medical Research Award in 1971.
• Royal Medal from the Royal Society in 1974.
• Gairdner Foundation International Award in 1978 and again in 1991.
• Novartis Medal and Prize of the Biochemical Society in 1980.
• Rosenstiel Award in 1986.
• Member of the Order of the Companions of Honour in 1986.
• Genetics Society of America Medal in 1987.
• Kyoto Prize in 1990.
• Copley Medal in 1991.
• Nobel prize in Physiology or Medicine in 2002.
• Dan David Prize in 2002.
• March of Dimes Prize in Developmental Biology in 2002.
• In recognition of his pioneering role in starting what is now a global research community that work on C. elegans, another closely related nematode was given the scientific name Caenorhabditis brenneri.
• The National Science and Technology Medal by the Agency for Science, Technology and Research awarded Brenner in 2006 for his distinguished and strategic contributions to the development of Singapore’s scientific capability and culture, particularly in the biomedical sciences sector.
• In 2008, the University of the Witwatersrand named the Sydney Brenner Institute for Molecular Bioscience (SBIMB) in his honour.
• In 2019, a newly discovered species of bobtail squid, Euprymna brenneri, was named in his honour.

Sydney Brenner died in Singapore on April 5th, 2019. He was 92.

Allan MacLeod Cormack

Allan Cormack was born in Johannesburg, South Africa on February 23rd, 1924.

He attended Rondebosch High School, and after matriculating, he enrolled at the University of Cape Town, receiving hisB.Sc. in physics in 1944, and his M.Sc. in crystallography in 1945, from the same institution.

Cormack later entered St. John’s College, Cambridge University in London, as a doctoral student in the Cavendish Laboratory from 1947 to 1949, and it was here that he met his future wife, American physics student Barbara Seavey.

He and his wife returned to South Africa, and Cormack lectured at the University of Cape Town until 1956, when Cormach took a sabbatical at Harvard University, in 1956–57. At this point, he and his wife decided to remain in the United States, and Cormack became a Professor at Tufts University, late in 1957, working primaily on particle physics.

While at the University of Cape Town, at working at Groote Schuur Hospital (where Professor Chris Barnard would later perform the world’s first successful human heart transplant), Cormack had developed an interest in X-Ray technology, which led him to develop what would later become the basis of CT (Computerised Tomography) scanning technology.

Because the CT scanner rotates around the body, and combines a continuous series of images — not just of bones, but organs, blood vessels and other soft tissue.

This obviously provides a far more detailed and accurate depiction of the interior of the body, and once fully developed, was a quantum leap in diagnostic medicine!

Once at Tufts University, Cormack again oursued his interest in X-Ray technology, and subsequently had sufficiently developed the theoretical basis of CT scanning technology, the results of which he published in the Journal of Applied Physics in 1963 and 1964.

However, these papers did not generate much interest at the time, and it was not until British sound engineer Godfrey Hounsfield built the first commercially available CT scanner at the EMI Music Laboratories in London, in 1972, that this revolutionary medical device becane universally available, changing the face of modern medicine overnight!

In 2015, more than 80 million CT procedures were performed in the United States, and the techniques and equipment are commonly used in non-medical fields such as materials testing and imaging the contents of archaeological specimens, sarcophagi or ceramics.

For their independent efforts, Cormack and Hounsfield shared the 1979 Nobel Prize in Physiology or Medicine. It is notable that the two built a very similar type of device without any collaboration in different parts of the world

At Tufts, Cormack progressed up the academic ladder at the physics department to become an associate and then a full professor.

Despite not having a doctorate, his promotions and eventual chairmanship of the department bore testimony to his remarkable research discoveries. He received the Hosea Ballou Medal for Distinguished Service from Tufts in 1978.

Awards and Honours

· 1979 Nobel Prize for Physiology or Medicine.

· Gold Medal of Merit from the University of Cape Town.

· Member of the International Academy of Science, Munich.

· Fellow of the American Physical Society.

· Member of the American Academy of Arts and Sciences.

· When he retired in 1980, Tufts awarded him an honorary doctorate and bestowed upon him its highest professional rank, university professor.

· In 1990, United States President George Bush awarded him the National Medal of Science in the physical sciences.

· Awarded the Order of Mapungubwe, South Africa’s highest honour, in the gold category in 1998. Cormack died of cancer in Winchester, New Hampshire on 7 May 1998, at the age of 74.

In his acceptance speech for the Nobel Award, Allan McLeod Cormack demonstrated a typically South Africa sense of self-deprecating humour —

It is not much of an exaggeration to say that what (Godfrey) Hounsfield and I know about medicine and physiology could be written on a small prescription form.