IZINDABA

Obituary - Peter Ian Folb (1938 - 2022)

Prof. Peter Ian Folb (1938 - 2022), physician, scientist, artist, poet, defender of justice and truth, and climber of mountains, died in Cape Town on 26 September 2022.

During his career as a professor of clinical pharmacology, Peter Folb made a remarkable contribution to both local and international drug policy, focusing his efforts 'on addressing the rational use of medicines to serve the health needs of people in Africa, through teaching, mentorship, research and clinical consultation' (the current mission of the Division of Clinical Pharmacology at the University of Cape Town (UCT), which he headed for 27 years).

During his career he established the discipline of clinical pharmacology in South Africa (SA) (personally supervising 80 Masters and doctoral students), and supported the creation of a national drug policy with an essential medicines programme and a strong, scientifically robust regulatory framework. As founding director of the SA Medical Research Council's Traditional Medicines Research Programme, based jointly at UCT and the University of the Western Cape, he supported research in traditional medicines using rigorous scientific standards, while recognising the intellectual property of the communities that identified these medicinal plants. He also led the development of integrated primary healthcare guidelines for both traditional and allopathic healthcare professionals.

During his 18 years as the chairperson of the erstwhile Medicines Control Council (MCC) of SA (the progenitor of the current SA Health Products Regulatory Authority (SAHPRA)) he recognised the importance of building local and regional regulatory capacity and expertise, to which end he mentored and encouraged clinicians and scientists around the country to evaluate the merit of a medicine in terms of its safety, efficacy and quality. Under his leadership, the MCC was internationally recognised as a rigorous, respected regulator in Africa.

During his professorial inaugural speech he gave an account of the history of thalidomide, crystallising his appreciation of the balance between supporting drug development particularly for poverty-related diseases while maintaining vigilance to mitigate harm (establishing the first national pharmacovigilance centre in Africa) - and hence his nuanced understanding of the pivotal, albeit often misunderstood and sometimes unpopular role of the medicines regulator.

Crucially, under his leadership, the MCC took a principled, and scientifically appropriate, stand against the approval of a purported antiretroviral clinical trial using the toxic Virodene, despite enormous political pressure in the days of the Mbeki administration.

His spirit of activism, born of his unwaveri ng faith in justice through science and medicine, led him to apologise to Steve Biko's widow at the Truth and Reconciliation Commission in 1997, acknowledging the abject failings of the privileged medical fraternity - both in the inquiry into Biko's death, and more broadly in terms of the provision of healthcare during apartheid. With journalist Chandré Gould he meticulously documented the activities of the apartheid government's 'Project Coast', the chemical and biological warfare programme.

Through his poetry and art, Peter gave voice to a deep sense of awe and respect for nature, medicine and science, and his love for his friends, colleagues and family. As a mentor and teacher, he challenged us to be brave through creativity, reminding us that the work will never be finished - challenging us to envision a future that transcends our own lifetimes - and doing so by taking care to attend to the here and now.

Ushma Mehta

Centre for Infectious Disease Epidemiology and Research (CIDER), School of Public Health, University of Cape Town, South Africa. ushmaza@gmail.com