Tracey Naledi, a star is born

The profound words of Prof. Tracey Naledi’s brother about ego made her turn down the possibility of completing a prestigious fellowship at Harvard University, US, in favour of working and studying at the University of Cape Town (UCT).   

Naledi is one of the most revered public-health doctors in South Africa, and it was no surprise when the Ivy League school showed interest in her.    

“I said to my brother that I didn’t not know which one to choose [UCT or Harvard] and he said, ‘One of them is God testing you about your ego and the other one is your purpose,’” Naledi says.  

It turns out that UCT was indeed her purpose, and she is currently an associate professor and deputy dean of health services at the institution that has educated her since she was 18. Now 50, she graduated with her PhD in medicine last month. We meet at her office in the Barnard Fuller Building in Observatory, Cape Town.  

The Hammanskraal-born and Duduza-bred doctor says she was inspired to go into medicine after her first encounter with a Black doctor when she was a child.    

“When I was a girl, about seven years old, I was inspired by this young man in Duduza who came to our township to open a practice when we didn’t have a doctor. Before he came, we used to go to Nigel to see a white or Indian doctor,” she remembers. “I was inspired by him and how he lived in our community and was part of our community. One of the things that taught me was the importance of representation, because I saw someone who looked like me and I thought, ‘This is something I could do.’”

The importance of representation is one of the reasons she decided to lecture at top universities such as UCT.   

“One of the reasons I continued to lecture at UCT was because when I was an undergrad, there were very few people like me who were lecturers. Even when I was working in government, I always made sure that I [gave] at least one lecture. For me it is always that I want those who come behind me to see somebody wo looks like them who has had some semblance of success,” she says.  

Naledi qualified as a doctor in 1998 and went to work as an intern at Tambo Memorial Hospital in Boksburg, then returned to Cape Town and worked in Khayelitsha before specialising in public health.   

“When I was doing my clinical training, I called my dad in tears, telling him I didn’t like medicine, I wanted to change degrees, even though I was nearly at the end. He encouraged me to finish. Even though I’d always wanted to be a doctor, I never settled well into clinical practice,” she says.  

She sought counselling from some of her former lecturers on how to find more fulfilment in her career.   

“I spoke to a whole lot of people, including my former lecturer Prof. Leslie London. I made an appointment and spoke to him about what was then called community health. In the early 2000s, public health was not really popular, so there were posts that people weren’t vying for — by the end of that meeting I was offered a registrar post, which today would never happen because of how highly competitive it is,” she says.

Naledi says she works on an overview of health in our communities. Public-health specialists do not work with individual patients but instead research diseases such as HIV/Aids and TB that affect the broader community. She then sets out policies and guidelines for doctors to follow when treating patients to make sure there is a standardised practice of care.   

Naledi has an impressive career, marked by notable achievements. Among the highlights is her involvement in initiating the first Prevention of Mother to Child Transmission programme in the national public sector. Her work proved the feasibility of delivering this programme through the primary-healthcare platform. Additionally, she played a key role in the African Comprehensive HIV/Aids Partnerships, collaborating with the government of Botswana, the Bill & Melinda Gates Foundation, and the Merck Foundation.   

Her leadership extended to the establishment of intersectoral wellness programmes such as Western Cape on Wellness and the First Thousand Days initiatives. She also worked as chief of party for a USAID-funded primary-healthcare project that provided support to five provinces in the country.   

In her career of more than 20 years she has co-chaired the Burden of Disease Reduction Project in the Western Cape, focusing on social determinants. This project played a pivotal role in shaping an intersectoral agenda for the Western Cape Department of Health and the provincial government. Notably, she founded the first Health Impact Assessment Directorate in the Western Cape Department of Health and developed a structured programme for public health registrars. Furthermore, she established the first Provincial Health Research Committee, ensuring representation from all academic and research institutions in the province.

Naledi says the high point of her career has been taking part in creating the non-profit organisation Tekano, which focuses on developing leadership in the health sector. She is its founding chairperson. “It’s the thing I am proudest of because I love what it stands for, which is creating value-based leaders. We need leaders to take their place and lead South Africa to its full potential,” she says.   

One of the social issues closest to her heart is how poverty directly contributes to poor public health, an example currently seen in her hometown of Hammanskraal with the cholera crisis. Clean water, safe transport, healthy masculinity, and nutritious food are all key to making sure society is healthy and safe.   

“I want to minimise the things that make people unhealthy in an unfair way — just because you are poor or a woman or born somewhere you [end up having] a high risk of illness or death,” she says.  

Naledi says the biggest problem in public health is a lack of resources and posts for much-needed doctors.   

“State capability and capacity is really cracking and it’s not just in health, it’s in education and electricity. Our state capacity is in trouble and we have doctors who are unemployed, even though we have a high burden of disease and the highest number of people living with HIV,” she says.

But, she adds, South Africa does have some positives, including a more consolidated health system.   

“We have the best university in Africa, and when you look at our researchers in TB, HIV, and mental health, we have some of the world’s best right here in our country. We are the ones who define policy for the world. There is a lot that our academic colleagues have done to contribute to knowledge and solutions in health,” she explains.   

Looking to the future, she hopes that the healthcare system will be set up in such a way that it convinces people to make the right choices for their health by providing as much information as possible.    

“As practitioners we need to spend a lot more time with our patients, and make sure we understand them and that they understand what it is we have to offer,” she says.  

Her focus continues to be Africa and contributing to the mentorship of upcoming physicians. “I stand on the shoulders of those who came before me and I will make my contribution. Others will also stand on my shoulders and will continue to contribute to society.”