The nanomedicine landscape of South Africa

Abstract

Nanomedicine is one of the most exciting applications of nanotechnology and promises to address several of mankind’s healthcare needs. South Africa is one of the countries engaged in nanomedicine research and product development on the African continent. In this article, we provide a top-level description of the policy, infrastructure, and human capital development programs supported by the South African government. We also highlight the nanomedicine outputs (publications, patents, and products) that have emanated from South Africa. This description of a “newly industrialized” country engagement in nanomedicine is important within the global context of nanomedicine development.

Full text

Nanotechnol Rev 2017; 6(4): 339–344
Nanotechnology Institutions contribution
Admire Dube* and Naushaad Ebrahim
The nanomedicine landscape of South Africa
DOI 10.1515/ntrev-2016-0108
Received December 11, 2016; accepted February 14, 2017; previously
published online March 20, 2017
Abstract: Nanomedicine is one of the most exciting appli-
cations of nanotechnology and promises to address sev-
eral of mankind’s healthcare needs. South Africa is one
of the countries engaged in nanomedicine research and
product development on the African continent. In this
article, we provide a top-level description of the policy,
infrastructure, and human capital development programs
supported by the South African government. We also high-
light the nanomedicine outputs (publications, patents,
and products) that have emanated from South Africa. This
description of a “newly industrialized” country engage-
ment in nanomedicine is important within the global con-
text of nanomedicine development.
Keywords: nanomedicine; nanoparticle drug delivery;
nanotechnology in South Africa; nanotechnology policy.
1 Introduction
Nanotechnology is recognized as one of the most important
scientific fields of the 21st century. Nanotechnology is the
application of engineered structures in the nanometer-scale
size range (often 100nm or smaller, but also 1–1000nm),
which possess desirable properties, e.g. magnetic, optical,
biochemical, or electronic properties, and are generally
applied to the benefit of mankind. Nanomedicine is the
application of nanotechnology in the field of health and
has demonstrated capability to improve the diagnosis and
treatment of diseases by providing novel disease biosen-
sors and improved drug delivery [1, 2]. Nanomedicine is
a multi-disciplinary field, encompassing pharmaceutical
and biomedical sciences, medicine, and physical sciences,
and is a field of intense global research and product devel-
opment [3]. To illustrate the extensive ongoing product
development, a study by Bobo et al. reported that there
are currently 51 US Food and Drug Administration (FDA)-
approved nanomedicines, 77 products undergoing clinical
trials, and approximately 40% of clinical trials were listed
in the clinicaltrials.gov database in 2014 or 2015 [4].
On the African continent, South Africa is one of the
countries engaged in nanomedicine research and product
development. South Africa is part of the five major emerg-
ing economies or newly industrialized countries, together
with Brazil, Russia, India, and China. The South African
government has made extensive investment toward creat-
ing a critical mass of infrastructure, equipment, and human
capital for nanotechnology research [5, 6]. In this article, we
provide a top-level overview of the nanotechnology policy,
funding, equipment, and human capital development pro-
grams supported by the South African government. We also
highlight the nanomedicine outputs (publications, patents,
and products) that have emanated from South Africa. This
description of a “newly industrialized” country engagement
in nanomedicine is important within the global context of
nanomedicine development [7–9]. Finally, we provide our
opinion of future strategies to leverage existing framework
and investment to support translation of nanomedicine
research findings for commercial and public benefit.
2 The South African disease
landscape
To contextualize nanomedicine research in South Africa,
it is important to describe the disease landscape. Africa,
in particular Sub-Saharan Africa, is disproportionately
challenged by a burden of infectious diseases (IDs)
including tuberculosis (TB) and HIV/AIDS, which nega-
tively impact its economy and the quality of life of African
people [10, 11]. The burden of TB in South Africa is among
the highest in the world. Total TB incidence (TB alone
plus TB-HIV co-infection) in South Africa is estimated to
be 834 per 100,000 population; and the mortality rate
is unacceptably high at 133 per 100,000 population [12].
TB that is resistant to existing drug therapies, i.e. multi-
drug resistant TB, is on the rise globally, more so in South
Africa, which is ranked among the high burden countries
[12]. A large number of people are living with HIV in South
*Corresponding author: Admire Dube, Nanomedicine Research
Group, School of Pharmacy, University of the Western Cape,
Bellville, South Africa, e-mail: adube@uwc.ac.za.
http://orcid.org/0000-0002-5684-6094
Naushaad Ebrahim: Nanomedicine Research Group, School of
Pharmacy, University of the Western Cape, Bellville, South Africa

340 A. Dube and N. Ebrahim: Nanomedicine in South Africa
Africa, and the country has the largest number of people
on treatment in the world (approximately 3.4 million
people on treatment) [13].
In recent times, a new threat has emerged in the form
of non-communicable diseases (NCDs), i.e. cardiovascu-
lar disease, cancer, chronic respiratory disease, and dia-
betes. In Africa, the probability of a person dying from one
of the four main NCDs (in persons aged between 30 and
70years) is over 20%, among the highest in the world [14].
Mortality due to NCDs is also high in South Africa [14].
Despite technological advances in medical diagno-
sis and treatment, deaths due to IDs and NCDs are still
common. Among the current requirements to mitigate
deaths is the need for more simple, inexpensive, rapid,
and sensitive point-of-care diagnostic tools, and drug
therapies providing uncomplicated treatment regimens
(e.g. short-duration oral treatments, once daily to weekly
dosing intervals) reduced toxicity and side effects [15, 16].
Nanomedicine has the potential to provide solutions to
these needs, enabling improved disease detection and
delivery of drugs. The reader is directed to some reviews
on the application of nanoparticles in diagnostics and
drug delivery [17, 18]. It is against the backdrop of disease
burden and the promise of nanomedicine that research-
ers in South Africa, with the support of the government,
have embarked in research and product development in
this field.
3 South African nanotechnology
policy and funding framework
National strategic leadership in nanotechnology is pro-
vided by the Department of Science and Technology (DST)
(www.dst.gov.za) and is described in National Nanotech-
nology Strategy (NNS) (http://www.gov.za/documents/
national-nanotechnology-strategy) published in 2005.
The publication of this strategy essentially heralded the
start of public funding in nanotechnology, with an invest-
ment of ZAR170million (approximately USD 12.2million at
an exchange rate of 1 USD = 14 ZAR) over the first 3years.
The NNS is aligned to the broad development goals of
South Africa and compliments other national strategies,
in particular, the Advanced Manufacturing Technology
Strategy, as well as the Biotechnology Strategy and the
Skills Development Strategy. The strategy emphasizes
nanotechnology research and development, i.e. mate-
rial synthesis, characterization, and fabrication. Health
(nanomedicine) is among the focus areas of the strategy.
The key initiatives of the NNS include establishment and
support of nanoscience characterization centers, funding
for research, and human resource development. Com-
plementary to the NNS is the Nanoscience and Nano-
technology 10-year Research Plan (http://www.gov.za/
documents/nanoscience-and-nanotechnology-10-year-
research-plan), which was released by the DST in 2010,
whose main purpose is to focus national research efforts
to deliver on the goals of the NNS. Key research ques-
tions within the nanomedicine scope of the research plan
include development of nanotechnology-based rapid,
simple, and user-friendly point-of-care diagnostic kits
for HIV and TB, nano-biosensors for in situ detection of
glucose levels, and the development of nanoparticle-
based drug delivery systems for TB treatment.
4 National nanotechnology
infrastructure
Public funding has facilitated the acquisition of nano-
technology-specific equipment for various research
councils and universities, through the National Nano-
technology Equipment Programme (NNEP) (http://hicd.
nrf.ac.za/?q=node/19). The NNEP was a specific funding
instrument as part of the implementation of the NNS,
intended to acquire, upgrade, or develop research equip-
ment for the analysis and characterization of nanoma-
terials in South Africa. The NNEP ended in 2015, after a
10-year investment and over ZAR400 million (over USD
28.6 million using an exchange rate of 1 USD = 14 ZAR)
invested. This amount excludes funding provided by
other equipment programs, e.g. the National Equipment
Program, which also provide for purchase of equipment
used for nanotechnology research. Table 1 summarizes
the key national facilities for nanotechnology research in
South Africa and some of the equipment and instruments
available at the facilities.
5 Human capital development
By and large, nanotechnology education (including
nanomedicine) is provided at postgraduate level [6, 19].
The flagship program in nanoscience and nanotechnol-
ogy education is the DST-funded 2-year Master’s degree
program leading to an MSc Nanoscience qualification.
This program is offered through collaboration between
the University of the Western Cape (the program-manag-
ing institution), University of Johannesburg, University

A. Dube and N. Ebrahim: Nanomedicine in South Africa 341
of the Free State, and Nelson Mandela Metropolitan Uni-
versity. Students undergo 9 months of didactic learning,
followed with a research project completed at any one of
the participating universities, under the stream of either
nanochemistry, nanophysics, or nanomedicine. In 2006,
the DST and the National Research Foundation (NRF)
established the South African Research Chairs Initiative
(SARChi) (http://www.nrf.ac.za/division/rcce/instru-
ments/research-chairs). The major expectation of SARChi
grant recipients is the production of high-quality post-
graduate students and research and innovation outputs.
To date, there are seven research chairs in nanotechnol-
ogy (with at least one chair focusing on nanomedicine).
6 Nanomedicine research in South
Africa
6.1 Drug delivery
We performed a review of publications emanating from
South Africa in the field of nanomedicine. We conducted
a search on PubMed (https://www.ncbi.nlm.nih.gov/
pubmed) using a Boolean search string, which included
the keywords nanoparticle or liposome, drug, protein and
gene delivery, and included an author/co-author based
at a South African institution. PubMed was selected as it
is one of the largest archives of biomedical literature and
also conducts a review of scientific quality of journals
prior to indexing. Therefore, we have some indication of
the level of quality of the publications captured by our
search.
We retrieved 137 eligible articles (published up to
December 2015), with the earliest article published in 1991.
Analysis of the number of articles per year is shown in
Figure 1. In the past decade, a surge in nanoparticle drug
delivery publications has been observed. This trend could
be related to the availability of nanotechnology funding
through the NNS and the NNEP. Of the articles published
during this period, 46% was in the ID space, with the
rest being related to NCDs, or not focused to a particular
disease, e.g. general nanomedicine reviews. This statistic
reflects the balance of the disease landscape in Africa.
All articles retrieved were preclinical studies, except for
two clinical studies, although it should be noted that
these clinical studies involved evaluation of the efficacy
and safety of commercially available nanomedicine prod-
ucts and were not a clinical evaluation of nanomedicines
developed by the researchers [20, 21].
Publications emanated primarily from 14higher edu-
cation institutions and science councils, i.e. the Univer-
sity of KwaZulu-Natal, University of the Witwatersrand,
Stellenbosch University, CSIR, University of Pretoria, Uni-
versity of Cape Town, Rhodes University, University of the
Western Cape, Tshwane University of Technology, North-
West University, University of Zululand, Nelson Mandela
Metropolitan University, South African Nuclear Energy
Corporation, and MINTEK. Higher education institutions
Table 1: List of the key national nanotechnology facilities in South Africa.
Facility name and location Equipment
Centre for Nanotechnology Innovation
Rhodes University, Grahamstown
https://www.ru.ac.za/nanotechnology/equipment/
TOF-SIMS
Microscopy Centre for High Resolution Transmission Electron
Nelson Mandela Metropolitan University, Port Elizabeth
http://chrtem.nmmu.ac.za/
ARM-TEM, STEM, FIB-SEM, AFM and nanoindenter
National Centre for Nano-Structured Materials
Nelson Mandela Metropolitan University, Port Elizabeth
http://chrtem.nmmu.ac.za/
FIB-SEM, small- and wide-angle X-ray scattering, AFM, TEM, SEM
National Cleanroom Facility
DST-Mintek Nanotechnology Innovation Centre (NIC)a, Pretoria
http://www.nic.ac.za/
Clean room, TEM, SEM, AFM
Selected key pieces of equipment available at a facility are listed.
ARM, atomic resolution microscope; SEM, scanning electron microscope; TEM, transmission electronic microscope; STEM, scan-
ning transmission electron microscopy; FIB, focused ion beam; AFM, atomic force microscope; TOF-SIMS, time of flight-secondary-ion
mass-spectrometer.
aNIC composed of research nodes located at three universities, i.e. Rhodes University (focused on the development of sensor technologies),
the University of the Western Cape on bio-labeling and drug delivery and the University of Johannesburg (focused on water treatment).

342 A. Dube and N. Ebrahim: Nanomedicine in South Africa
and science councils are also the focus of the NNS. We
retrieved three patents that relate to nanoparticle drug
delivery systems [22–24] by applying similar search cri-
teria (as used in PubMed) using the search site Google
patents.
It is notable that MINTEK has commercialized its
research outputs and markets gold, nanospheres, and
nanorods, including polyethylene glycol (PEG)-gold
nanoparticles and PEG-Biotin-gold nanoparticles to the
research community and industry (http://www.nic.ac.za/
products.html).
6.2 Diagnostics
We performed a search on PubMed of articles reporting
research into diagnostics for diseases, which incorporate
nanoparticles. Fogel and Limson performed an excellent
review of general biosensor research in South Africa [25],
and the reader is also directed to this review. Our search
string included the words surface plasmon resonance,
lateral flow, sensors, biosensors and cantilever/nano-
cantilever, disease, as applied by Wagner etal. [1]. The
search resulted in 15 articles meeting the criteria. Most
articles were published in 2014 (6) (Figure 1) with the first
PubMed-identified article published in 2007. An equal
distribution of publications was found when comparing
research for IDs versus NCDs (7), with one article includ-
ing both. These publications emanated mainly from six
academic institutions and science councils, namely, Uni-
versity of Johannesburg, University of Pretoria, University
of the Western Cape, University of the Free State, Univer-
sity of the Witwatersrand and Nanotechnology Innovation
Centre, Advanced Materials Division, MINTEKAt this time,
no research outputs have been commercialized.
7 Concluding remarks
Over the past 10years, the South African government has
laid a strong foundation for research and product devel-
opment in nanotechnology, establishing policy frame-
work and making significant investments in equipment
and infrastructure, research funding, and human capital
development at universities and science councils through-
out the country. The reader is directed to further reviews of
the education and nanotechnology (in general) research
activities in South Africa [6, 19, 26].
Moving forward, we believe the foundation laid is
sufficient to enable increased research outputs, and their
translation to the clinic, to benefit South Africans and
the global community. However, to accelerate progress,
the government and other stakeholders may need to con-
sider nanomedicine-specific program initiatives. Such
initiatives could include nanomedicine-specific funding
opportunities and development of nanomedicine centers
of excellence having a critical mass of experienced
researchers, postgraduate students, and requisite in-
house equipment. An example of such an approach can
be drawn from the current eight Nanomedicine Develop-
ment Centers in the US, funded by the National Institutes
of Health (https://commonfund.nih.gov/nanomedicine/
index). Postgraduate teaching and research programs
under such an initiative could focus more toward devel-
opmental/translational aspects of the technology.
0
5
10
15
20
25
30
35
1991 1996 2001 2006 2011
Figure 1: Nanomedicine publications emanating or including a South African institution up to December 2015. The source of the publica-
tions is PubMed, and publications were retrieved based on key words outlined in the text. ( ) indicates drug delivery articles, and ( )
indicates articles in the nanoparticle diagnostics space. No eligible research articles in nanoparticle-based diagnostics, on PubMed,
meeting the inclusion criteria were identified for 2015 and, therefore, are not shown.

A. Dube and N. Ebrahim: Nanomedicine in South Africa 343
Technical difficulties experienced in the nanomedicine
space in South Africa include limited intra-country col-
laboration and the absence of structured network chan-
nels between various institutions. One way to facilitate
collaboration and greater investment in the field is to
create an online interactive geographic map of nanotech-
nology activities in South Africa, such as the one pro-
duced in Germany (http://www.nano-map.de/). Such a
map can provide current information including research
and commercialization projects at the various universities
and science councils, nanotechnology infrastructure and
equipment available, and details of funding bodies and
industry partners. Enhanced coordination has obvious
benefits. A pitfall to avoid is the funding of a broad port-
folio of nanomedicine projects, as this may miss the req-
uisite concentration on important topics and research
questions needed to advance the national agenda [27].
Borrowing from global best practices, South Africa
could establish a technology platform to advance nano-
medicine, similar to European Technology Platform for
Nanomedicine (ETPN) (http://www.etp-nanomedicine.
eu/public). Such a platform could also be established at
continental level. With respect to the industry’s involve-
ment, it is not only an issue of resource support and
collaborative research, but it would be critical to also
ensure employment opportunities for the nanomedicine
graduates.
In summary, the future of nanomedicine in South
Africa looks bright given the foundation established by
the government, and with greater coordination, more
products are likely to be produced to the benefit of the
public.
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Bionotes
Admire Dube
Nanomedicine Research Group, School of
Pharmacy, University of the Western Cape,
Bellville, South Africa.
http://orcid.org/0000-0002-5684-6094
adube@uwc.ac.za
Admire Dube is a pharmaceutical scientist and Senior Lecturer in
Pharmaceutics at the School of Pharmacy, University of the Western
Cape (UWC) in Cape Town South Africa. He previously held a posi-
tion as Senior Researcher at the Council for Scientific and Industrial
Research in Pretoria South Africa where he was involved in commer-
cializing nanomedicines for malaria and tuberculosis treatment. At
UWC, his research group focuses on developing immune-modulatory
nanomedicines for treatment of infectious diseases. He holds a PhD
in Pharmaceutical Sciences from Monash University, Australia, and
Post-doctoral training in nanomedicine from the University at Buffalo,
USA. He has an interest in seeing Africa commercialize its first nano-
medicine, as well as enhancing pharmaceutical production in Africa.
Naushaad Ebrahim
Nanomedicine Research Group, School of
Pharmacy, University of the Western Cape,
Bellville, South Africa
Naushaad Ebrahim obtained his Bachelor of Pharmacy degree at
the University of the Western Cape (UWC), South Africa, and a PhD
at the same institution. He is a Pharmacist by training. Dr. Ebrahim
is currently a Senior lecturer in the Discipline of Pharmaceutics
and a Deputy Director at the School of Pharmacy at UWC, where he
has served as an academic for the last 15years. His research field
is in nanomedicine focusing on liposomal and phytosomal carrier
systems, which include the development of percutaneous absorp-
tion models for medicinal plants. Current projects he is involved
with include polymer coating of liposomes and phytosomal struc-
tures for increased drug delivery and stability.