The sustainability of radiation biology (radiobiology) is under threat in South Africa because of underdevelopment in the discipline, despite the
fact that South Africa has been a user of radiation since radioactivity and X-rays were discovered. The widespread use of radiation in medicine,
nuclear reactors, particle accelerators and other sophisticated nuclear facilities in South Africa makes it imperative that the interaction of
radiation with biological systems is understood. For example, radiobiology is critical in radiation oncology and cancer treatment. Radiobiology is a
distinctly biological science and its uniqueness and value should be highlighted to provide insight for authorities and other relevant parties.
Regrettably, radiobiology has been largely neglected despite the importance of maintaining expertise and competence in this discipline. Many
radiation-associated disciplines require radiobiology for their training and practice yet few radiobiologists are available nationally. The
scientific community needs to be informed of the predicament of radiobiology in South Africa so that the situation can be addressed. Radiobiology is
a scarce skill that needs to be developed to support South Africa’s mature radiation infrastructure. The country has too few radiobiologist
training programmes and there is a lack of succession planning. Radiobiology is required for training and practice in a number of disciplines that
use radiation, but, as a result of a shortage of qualified personnel, teaching of radiobiology has frequently been conducted by non-experts. To
reinvigorate radiobiology in South Africa, a collective effort by government, academia, industry and allied professionals is required.
South Africa is a developing country with an advanced nuclear industry, yet some radiation sciences, particularly those in the Life Sciences domain,
are severely underdeveloped. Despite exposure of humans to ionising radiation in the nuclear industry, in mining and in medicine, the country
currently functions in most centres without radiation biologists. Radiobiology is the discipline dedicated to the understanding of effects of
radiation in living systems. This branch of science is essential, yet it is poorly developed and under-represented in South Africa.
Ionising radiation is extremely useful in many spheres that contribute to human health and the economy. Thus, it is appropriate in a modern,
technologically driven country like South Africa to use radiation technology. It is also important, therefore, to maintain competence in the
radiation sciences, including radiobiology, to ensure the effective and safe use of radiation. In medicine, radiation is extensively used in
radiological procedures and more than half of all cancer patients in South Africa receive some form of radiotherapy. In addition, the country has
nuclear power and a sophisticated nuclear industry served by a considerable number of personnel. It is, therefore, reasonable and desirable for the
biological aspects of radiation, in addition to the physical radiation sciences, to be comprehensively addressed.
Radiobiology, as a science, has a major role to play in radiation research and academic development of the radiation sciences. Radiobiologists also
have a critical role in training radiation workers in the various radiation-related disciplines, particularly in radiation oncology, which requires
a good understanding of radiobiology. However, the number of radiobiologists in South Africa and worldwide is dwindling and has become too small to
meet demand. Initiatives need to be started urgently to develop radiobiology and to increase the number of specialist radiobiologists in South
A brief history and overview of radiation technology in South Africa
Given South Africa’s long history of radiation usage, it is surprising that radiobiology, as a discipline, has not been developed more. South
Africa has been a user of radiation since radioactivity and X-rays were discovered. To provide some background to the country’s experience
with radiation spanning more than a century, an overview of radiation usage in South Africa is provided. The geographical locations of some of the
major centres mentioned are shown in Figure 1.
Location of centres of radiobiology within the South African radiation
Within a year of the discovery of X-rays in 1895 by German physicist Wilhelm Conrad Röntgen, basic X-ray apparatus was being operated in South
Africa.1During the Anglo–Boer War (1899–1902), several X-ray units were in service in the country,
nation at the forefront of medical diagnostic radiation usage at the time.
It was soon discovered that X-rays could induce biological effects in tissue and it was not long before their application in the treatment of
cancer became apparent. South Africa, once again, was quick to absorb the new technology and radium tubes were imported for this purpose as early
as 1904.3In addition to radium treatments, X-ray machines were developed specifically for radiotherapy. Initial
limitations were as a
result of poor beam penetration into the body with the result that only superficial tumours could be treated effectively. After many years of use of
these poorly penetrating X-ray machines, which often yielded severe skin reactions, the first megavoltage therapy units were introduced. These
higher energy machines allowed effective treatment of deep-seated tumours. Cobalt units for radiotherapy were installed in South African
radiotherapy departments in the late 1950s,3less than 10 years after the first cobalt treatments, which were delivered in Canada in
1951.4Subsequently, linear accelerators were introduced in South Africa in the 1970s.
Radiotherapy) is common, with some centres now using the most modern image-guided radiotherapy equipment. Specialised radioactive implant treatments
(brachytherapy) for specific sites including prostate, breast, eye and gynaecological tumours are also commonly employed.
Several particle accelerators have been developed in the country over the past 50 years and a number of cyclotrons are now in operation. The 1980s
saw the development of particle radiotherapy at Faure near Cape Town with the building of the cyclotron at the National Accelerator Centre, now
called the iThemba Laboratory for Accelerator-Based Sciences (iThemba LABS). Neutron and proton particle beams are available at this facility for
treatment of cancer patients. In addition, research in several radiation sciences, including radiobiology, as well as isotope production, are
undertaken at iThemba LABS.
Each stage of the evolution of diagnostic radiology and radiotherapy has appeared in South Africa since the discovery of X-rays and radioactivity,
with well-developed infrastructure now present in all main centres. Nuclear medicine is no exception. Nuclear medicine was first conducted in South
Africa in 1948 in Pretoria using imported isotopes,5and local accelerator-produced nuclides have been produced
5Both SPECT (single photon emission computed tomography) and PET (positron emission tomography) imaging and
hybrid imaging techniques, as
well as therapeutic nuclear medicine, are now available in major South African cities.
When considering radiobiological effects in humans, medical radiation is by far the largest contributor to radiation exposure from human made
sources.6Radiotherapy is a mainstay of cancer treatment with more than half of all South African
cancer patients requiring some form of
radiotherapy during their treatment.7Whilst radiotherapy delivers large cytotoxic doses of radiation to
individuals during tumour
treatment, imaging using ionising radiation is the fastest growing source of radiation exposure8and
population risk. Notably, CT
(computed tomography) scanning, notwithstanding its great benefits to diagnosis, is one of the major contributors to radiation dose and its
associated carcinogenic risk to the population at large.8The invention of the CT scan was remarkably a
South African contribution to
medical imaging. The South African radiation scientist Allan Cormack, was awarded the Nobel Prize for Physiology or Medicine, together with Godfrey
Hounsfield, in 1979 for conception of the CT scanner. The original concept was developed by Cormack while working at the University of Cape Town at
Groote Schuur Hospital.9
South Africa has an established nuclear industry, which is strong in the radiation physics and nuclear engineering sciences in terms of training and
professionals in service, but also suffers from a lack of development in radiobiology. Nevertheless, the local nuclear industry has an interesting
history, which in many ways has mirrored international developments as South Africa’s radiation technology has progressed with advances in
South Africa’s nuclear industry originated in the 1940s with the creation of the Uranium Committee, and then later the Atomic Energy Board,
and has been evolving and developing until the present day. South Africa’s nuclear weapons programme was developed under the apartheid
government during the 1970s and then voluntarily dismantled in the 1990s.10In 1999, a parastatal, the Nuclear
Energy Corporation of South
Africa (NECSA), was instituted. Its role is to undertake research and development of peaceful uses of nuclear energy and radiation science and to
process nuclear material.10NECSA operates the Safari-1 nuclear research reactor at Pelindaba, which is
situated approximately 30 km
west of Pretoria (Figure 1). The Vaalputs nuclear waste site situated approximately 600 km north of Cape Town (Figure 1) is also managed by
NECSA.11NECSA’s subsidiary, NTP Radioisotopes, is a leading international supplier of radioisotopes
and radiopharmaceuticals. They
are currently the world’s largest supplier of molybdenum-99,10a precursor of technecium-99, which is used
extensively in nuclear
medicine departments around the world.
South Africa also uses nuclear fuel as a source of energy. Approximately 5% of the country’s electricity comes from nuclear
power10generated at the Koeberg Nuclear Power station near Cape Town (Figure 1), which has been in operation
since 1985. There are plans
for additional power reactors in the country.12
Other sources of radiation
Mining, which has played a significant role in the South African economy for over 100 years, is a notable source of radiation exposure because of
the radioactive materials found in the earth. South Africa is a major producer of uranium, which is largely a by-product of gold and copper mining.
As a result, radioactivity in and around mines is often considerable. Indeed, radiation from mining operations may have an impact on the health of
mine workers and others exposed to mine waste.13As a consequence, the mining industry, which is a major
employer, has been acutely aware
of radiation hazards and the management thereof, and thus has had a large vested interest in radiation protection. As a result of mining operations,
human exposure from radioactive mine waste dumps requires monitoring. Monitoring is one of the roles of the National Nuclear Regulator. A recent
report in local newspapers described how radioactivity levels of mine dumps in certain areas adjacent to human populations in Gauteng may approach
levels similar to those found at Chernobyl.14
Radiobiology – A distinctly biological science
Whilst radiobiology may sometimes be associated with radiation protection and monitoring, radiobiology is a distinctly biological science
that seeks to understand the specific interactions of radiation with living systems, while borrowing from cell and cancer biology, physiology and,
more recently, molecular biology. Radiation has been present since life began and mammalian cells have developed certain capacities to respond and
adapt to radiation through damage response cascades, which depend critically on dose rate and how the radiation is fractionated. Although cellular
radiation responses resemble the effects of genotoxic drugs, radiation effects in living systems are complex biological processes that are uniquely
affected by temporal and spatial factors.
Major applications of radiobiology
In general, radiobiology has two major applications where it is essential that intellectual capital be maintained, (1) the understanding and
management of radiobiological risks to human populations and (2) the use of radiotherapy in the treatment of cancer.
The benefits of radiation are well known but radiation usage carries risks. Radiation exposure increases the chance of
developing cancer and may induce genetic effects. Both are radiobiological consequences that need to be understood and minimised. In addition, risks
to special groups, such as pregnant women and children, have to be considered. Developing tissues and immature organisms tend to be more
radiosensitive. For example, the foetus is particularly sensitive to radiation during the first trimester of pregnancy and thus it is important to
limit doses during this critical period. Children are more radiosensitive than adults and, therefore, may be at greater risk of radiation effects.
While limits for radiation exposure are prescribed, no exposure is completely safe and there is still some radiobiological uncertainty regarding
human response to low doses of radiation. There is good evidence for a dose-effect relationship in the high dose region but it is necessary to
extrapolate to estimate the risks at lower dose levels. Thus, there is some doubt as to the true relationship between low doses and the induction of
biological effects. Several extrapolation models have been proposed, including the simple linear, the super-linear, linear quadratic and the
hormesis models, as well as the possibility of a threshold below which no risk exists.15The linear no threshold model is often adopted by
regulatory bodies in the interests of conservatism when defining radiation dose limits for human exposure. However, there is much debate as to the
most appropriate models to use.16It is often assumed that any dose, no matter how small, carries some risk.
On an individual basis, risk from low-dose exposure may often be considered negligible but, when compounded for human populations, may contribute
significantly to the number of radiation-induced cancers and genetic effects in the population at large and thus become a public health issue.
Whilst extensive use of medical radiation contributes to significant population exposures in everyday life, radiation can also affect human lives
in times of accidental exposure or during natural disasters. The 2011 tsunami disaster at the Fukushima nuclear power station in Japan has
highlighted the need for radiation preparedness and an understanding of the biological consequences of radiation. With extensive use of radiation,
despite extensive safety measures being in place, accidents can and do happen. Recently, in South Africa, 91 workers at Koeberg nuclear power
station were contaminated with radioactive material whilst performing maintenance.17Fortunately, the exposure
levels were fairly low
but such incidents do highlight the need for radiobiological collaboration in radiation safety planning, assessment and response to radiation
It is important to maintain expertise in the fundamental sciences of radiation oncology in order to preserve intellectual capacity and effectiveness
in this area. Radiobiological effects induced by radiotherapy need to be understood and modified for the benefit of cancer patients. Radiotherapy
for cancer exploits radiobiological principles to create a therapeutic advantage, that is, to maximise the amount of tumour damage whilst
minimising the amount of healthy tissue affected. A sound knowledge of radiobiology should thus be a prerequisite for anyone working in
Radiobiology is important for radiation oncology research and practice. A detailed discussion of research areas in radiobiology is beyond the scope
of this article, but an overview is provided in Table 1. Subjects range from the basic interactions of radiation with cells and tissues to the
applied use of radiotherapy in the treatment of cancer.
Overview of key areas of research in radiobiology – the science that
studies the effects of ionising radiation on living systems.
Some South African scientists who have made significant contributions to radiobiology internationally are featured in Box 1.
Overview of key areas of research in radiobiology – the science that
studies the effects of ionising radiation on living systems.
Development opportunities for radiobiology in South Africa
Research, training and service in radiobiology have great potential for development in South Africa. Each of these aspects is important for the
country to develop expertise for support of South Africa’s significant radiation establishment. There are many aspects of radiobiology in
South Africa that make it both challenging and unique. While many specifically South African problems can be addressed, many issues in radiobiology
are universal and it is important to encourage research into diverse areas.
With the increasing burden in Africa of non-communicable diseases such as cancer, radiotherapy will become increasingly relevant. It is thus
important that some resources are directed towards South Africa’s own unique problems in this area. For example, compared with the developed
world, many cancer patients in South Africa are diagnosed with advanced tumours, which may present particular radiobiological challenges. In
addition, South Africa’s burden of infectious agents, such as HIV and human papillomavirus, may influence patient susceptibility to disease
and response to therapy.
An understanding of the radiobiology of HIV and HIV-infected individuals is an area that presents an opportunity to make a contribution to the
treatment of South Africans and others, particularly in Africa, who also are significantly affected by HIV. The high incidence of people with HIV
(approximately 5.5 million South Africans in 200918) means that many people in the country that are
exposed to radiation also carry HIV,
which has been reported to affect radiosensitivity.19Many people are also receiving antiretroviral
therapy, which extends the lives of
HIV-infected people, but which may also influence their radiation sensitivity. The implications for public health and radiation therapy are
potentially large, as most radiation guidelines are based on international evidence-based protocols that were developed in populations that are
largely free of HIV.
Another challenge facing radiobiologists in South Africa concerns radiobiology services in clinical radiotherapy departments. Radiobiologists can
provide valuable input into treatment design and modification, as well as advice in a range of scientific aspects of clinical radiobiology. For
example, treatment delays and interruptions frequently occur in South African radiation oncology centres. Long treatment waiting lists, poor patient
compliance and interruptions for medical reasons as well as machine breakdown may compromise the success of radiotherapy, because extended
treatments may allow, and even stimulate, tumour cell proliferation. Radiobiologists can provide solutions that compensate for treatment gaps and
give advice about treatment protocols and tissue reactions. However, few South African radiation oncology departments have access to
radiobiologists. Clinical radiobiology is a key area for development in South Africa, as well as in neighbouring states, where radiation oncology is
The importance of developing scientific competence in radiobiology
As with any discipline, experts are an important part of a nation’s economy and welfare. It is therefore imperative that expertise in
radiation science, including radiobiology, is developed and nurtured. The ability to make informed decisions, weigh up risks and design new
approaches requires a certain level of sophistication, especially when it comes to radiation.
It would seem logical, given South Africa’s large radiation infrastructure, that there should be significant resources channelled into
radiobiology as a basic science. The major universities should support radiobiology programmes to develop and maintain intellectual competence in
the discipline. Yet this has not been the case. To some extent, radiobiology remains an orphan discipline which has failed to achieve a critical
mass, yet is of immense relevance to a modern radiation-consuming society like South Africa. The number of radiobiologists currently employed in
South Africa is at a critical level (Table 2) with approximately half within 10 years of retirement. This situation is unsustainable and needs to
be addressed urgently.
The number and locations of radiobiologists in South Africa.
The introduction of radiobiology sections in radiation oncology departments in the Western Cape Province during the 1980s was associated with the
interest in particle radiotherapy at the then National Accelerator Centre at Faure. This initiation of activity in radiobiology was the beginning
of a productive period in South African radiobiology history. Radiobiologists from Groote Schuur and Tygerberg Hospitals and the National
Accelerator Centre undertook biological calibration experiments and conducted scientific investigations using the latest techniques, which
contributed to the clinical utilisation and better understanding of these novel radiation modalities.
Research and teaching activities were cultivated and, up until 2002, the radiobiological momentum produced over 20 postgraduate degrees from
Stellenbosch University and the University of Cape Town, but none have been produced since. During this period, both of these institutions made
significant international research contributions to the radiobiology of photons (X-rays and gamma rays) and published notable studies in areas
such as dose-modifying drugs,26,27repair,28,29the oxygen
Regrettably, after 2000, the cutting of posts and poor prospects for graduates resulted in a sharp decline in radiobiology studies. The three
once-thriving laboratories at Groote Schuur Hospital, Tygerberg Hospital and iThemba LABS continue with a much reduced capacity of only five
remaining staff members.
Having described a once-vibrant era in radiobiology in the Western Cape followed by a period of contraction, it is fair to state that radiobiology
has never been prominent in other regions of the country. Thus, despite pockets of activity nationally, radiobiology has not been well represented
in South Africa as a whole. There are, as far as can be determined, no radiobiologists in any other African country.
It is important for South Africa to have scientists and other academics who are active in radiobiology and who can advise on matters pertaining to
biological and health effects of radiation. As a scientific discipline, radiobiology both complements and draws from radiation oncology practice
and research. Therefore, whilst radiobiology can exist as a science in its own right, its traditional partner has been cancer therapy, and,
consequently, this is where it has found its main niche. An example of such a partnership is evident at Groote Schuur Hospital in Cape Town, where
the Radiobiology Section is an integral part of the Department of Radiation Oncology.
Although radiation oncologists study radiobiology during their training, it is important to maintain appropriate depth and expertise in the
subject, which can only be properly achieved through maintaining a strong specialist radiobiology presence in radiation oncology departments around
the country. This importance is especially relevant for centres that provide radiation oncology training.
There are eight academic training centres for radiation oncology in the country (Figure 1) as well as an expanding private sector, which has grown
significantly since the 1997 report of Levin and Goedhals3which gave an overview of radiation oncology in South Africa at that time.
According to the International Atomic Energy Agency, there are 41 institutions within South Africa that offer radiotherapy.
despite the extensive therapeutic irradiation of patients, the number of radiobiologists in the country is fewer than 10 (Table 2).
The roles of radiobiology in teaching, research and service to radiation medicine have become a logical fit. In addition to the academic
programmes for radiobiologist training (Table 3), radiobiology forms a mandatory part of the curricula of many of the radiation-associated
disciplines (Table 4). However, at present, non-radiobiologists frequently teach the subject out of necessity. Research is an important part of any
science and is crucial if scientists are to remain current and relevant in their fields. Radiobiology services within clinical departments have
also become increasingly necessary, as paradigms for cancer treatment planning are changing. For example, treatments may be optimised by the
application of radiobiological models that may be incorporated into treatment prescriptions – such as Normal Tissue Complication Probability
and Tumour Cure Probability models. As mentioned previously, others not trained or conversant in radiobiological principles have been
inappropriately tasked with advising clinicians. This situation is obviously undesirable. The role of the professional radiobiologist requires
specific competencies, as recognised by the Health Professions Council of South Africa (HPCSA), which distinguishes radiation biology as a medical
science profession. Radiobiology responsibilities should thus be undertaken by qualified professionals.
Training opportunities for radiobiologists in South Africa.
Overview of radiobiology training in South Africa.
Training of radiobiologists
Masters and doctoral studies in radiobiology are offered at the Universities of Cape Town (UCT), Stellenbosch and the Witwatersrand (Table 3).
Students have generally been drawn from other disciplines in the Life Sciences. At UCT, an undergraduate course in radiobiology is offered for BSc
students and a comprehensive BSc(Med)(Honours) programme in radiobiology is offered in the Faculty of Health Sciences. Entry into the BSc(Med)
(Honours) programme requires a major subject in the biological or radiation sciences.
In order to conduct scientific work related to human health or to provide advice that may have an impact on medical decisions, radiobiologists are
required to register with the HPCSA. Initial registration as a trainee, formal competence and experiential training are required before full
registration and practice as a professional radiobiologist in the medical environment is permitted. Training centres need to be accredited for this
role. At present, no radiobiology training centres are accredited by the HPCSA. However, radiobiologists recognise the need for establishing future
training and accreditation facilities and this need is currently being addressed by the South African Radiobiology Society (SARS).
For interested parties, a basic syllabus in radiobiology has been compiled by the International Atomic Energy Agency.
Training of radiation oncology registrars (residents)
The training of radiation oncologists is perhaps one of the most crucial roles for radiobiologists. A sound knowledge of radiobiological principles
is required to practise radiation oncology and, therefore, radiobiology is a major subject in the training programme of this speciality.
(Radiobiology is part of the syllabi of all the radiation medicine specialities.) The College of Medicine of South Africa requires that candidates
become proficient in radiobiology as part of their training to achieve their qualifications in radiation oncology, as is the case in other parts of
the world.43Zeman et al.44recommended that a radiobiology programme,
in order to satisfy the requirements of the US board
exam, should comprise approximately 80% classic and clinical radiobiology and 20% molecular and cancer biology. This requirement is similar to
those in South Africa. In the USA, for accreditation of a radiation oncology training institution by the Accreditation Council for Graduate Medical
Education, a comprehensive course in radiobiology is mandatory. In addition, the faculty must have a radiobiologist or cancer biologist who has a
PhD on their staff to teach radiobiology and cancer biology, and who will provide a ‘scholarly environment’ for research and
teaching.45South Africa falls far short of these constraints in most radiation oncology training centres.
Several publications have addressed the issue of radiobiology training for radiation oncologists outside South Africa.
recent survey by Rosenstein et al.49, several conclusions were reached, which may in some ways echo the South African experience. In the
USA, there is an aging cohort of radiobiologists (with an average estimated age of 52), who are responsible for passing on radiobiology knowledge.
There is a similar trend in South Africa, albeit with a much smaller cohort. It was also noted that there was a disturbing decrease in the
proportion of educators specifically trained in radiobiology and that many responsible for teaching radiobiology were not adequately versed in
radiation science – only approximately 30% of the group were trained as radiobiologists. Rosenstein
et al.49recommended, on the
basis of their findings, that radiobiology teaching resources be improved and they motivated for new radiobiology graduate programmes. Given that
the situation is more extreme in South Africa, it follows that these recommendations should be equally relevant, if not more so, in this
While there is a place for short courses in radiobiology for registrars, short courses are not a substitute for proper teaching at the current
training centres. Through necessity, because of the dearth of radiobiologists, short courses may be a stop-gap solution, but in the long term it is
appropriate for academic centres to develop their own comprehensive radiobiology teaching platforms.
National plans for the advancement of radiobiology
Having considered the significance and relevance of radiobiology, in light of South Africa’s extensive current and past radiation usage, it is
clear that failure to address radiobiology’s status as a scarce skill is detrimental to the country’s development. However, this failure
can be rectified. In a modern and technologically proficient nation such as South Africa, the importance of radiobiology needs to be promoted and
publicised. Not only will the development of radiobiology fulfil current needs, it will also enhance South Africa’s capacity and relevance in
radiation sciences. Development of radiobiology in South Africa should also contribute to development of the discipline in the rest of Africa,
which, as far as can be determined, has no radiobiologists whatsoever. However, it is important for South Africa to ‘get its own house in
order’ first. A significant effort at many levels will be required to stimulate radiobiology and put it on a firm footing. This transformation
will require buy-in from government, science councils, universities and those in allied professions. New graduates in the science of radiobiology
must be produced and positions for radiobiologists created for these graduates to fill. Recommended courses of action for stakeholders in
radiobiology are presented in Table 5.
Recommended actions for stakeholders in radiobiology in South Africa.
The national Department of Science and Technology, the Department of Health and the Department of Higher Education and Training have roles to play,
as radiobiology is important in the realm of each. Provincial health departments should also play a critical role in the development of
radiobiology, which is important in radiation medicine. Science councils, such as the National Research Foundation and Medical Research Council,
should recognise the need to develop radiobiologists and help to support and grow the discipline. The Nuclear Technologies in Medicine and the
Biosciences Initiative under NECSA has been implemented as a first step to assess the state of the science and to direct appropriate actions.
However, resources have yet to be allocated to the challenging task of building a sustainable radiobiology infrastructure.
Universities need to embrace and promote radiobiology as an important academic discipline. Academic programmes must be created to train
radiobiologists, create expertise and provide quality instruction in the subject for numerous other groups of radiation users. In order to do this,
academic positions and laboratories must be created and research programmes initiated. It is reasonable that radiobiological education and training
in radiation medicine and medical physics should be offered by specialist radiobiologists and that this condition should ideally become mandatory
for accredited training centres.
The malady afflicting radiobiology is not unique to South Africa. The worldwide shortage of radiation scientists has been recognised in the USA
and in Germany, where measures are already being taken to rectify this deficit. For example, the National Cancer Institute, which is part of the
National Institutes of Health in the USA, is promoting a radiobiology education initiative in collaboration with US and international
societies.50In Germany, the need for a revitalisation in radiobiology has been recognised under the kompetenzerhaltung
(maintaining competence) agenda.51This agenda has already led to new appointments and the creation of
significant research infrastructure
by the Bundesministerium fur Forschung und Technologie. Similar initiatives may also be appropriate in South Africa for radiobiology to achieve its
own identity and profile in national planning. SARS is the professional society that promotes the interests and standards of the discipline in
South Africa. As the representative body, SARS strongly recommends that the development of radiobiology is treated as a matter of national
importance and urges politicians and administrators to incorporate the development of radiobiology into their future plans. It is clear that the
reinvigoration of the discipline can only be achieved by collective will and effective lobbying and that this will be to the benefit of South
I declare that I have no financial or personal relationships which may have inappropriately influenced me in writing this article.
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