For 20 years, Kwanele Asante told health systems to listen to patients. Then the UN gave her the mic - TimesLIVE

A breast cancer diagnosis and the illnesses that followed transformed Kwanele Asante into one of Africa’s most prominent voices for people living with noncommunicable diseases (NCDs) and mental health conditions. You may not know her name, but the South African lawyer and bioethicist has spent years pushing local and global health institutions to listen to the people whose wellbeing their policies are meant to serve. In September last year, that journey took her to the United Nations General Assembly in New York, where she was chosen to deliver the lived-experience address at a global meeting on NCDs and mental health. Then she came home and a wave of new health challenges washed over her, forcing a step back from activism.

“In February, Google AI referred to me as ‘the late Kwanele Asante’ — almost like a premonition,” says Asante, who developed abdominal pain in her right side a few weeks later, and was urgently admitted for surgery to remove an inflamed appendix.

“Then all these other things started happening. When I was finally discharged 19 days later it was April, the month (she first says “anniversary”, then shakes her head and says, “no, no, that’s not the word”) of my diagnosis with breast cancer 20 years ago.”

Asante, who has always rejected the designation “breast cancer survivor”, talks about her health in an all-encompassing way, to make a larger point: people don’t necessarily experience the health system as a series of separate diseases and specialist programmes. We are the sum of our ailments, not defined by any one illness.

“I am in chronic treatment for chemotherapy-induced congestive heart failure, bipolar mood disorder [a mental health disorder that causes mood swings], anxiety and now functional neurological [brain] disorder, which means the brain software is not functioning properly. The cancer survivor label doesn’t quite cover it,” she says.

Even in name, Asante refuses to remain static. She was born Anne Molebatsi Pooe but called herself Molebatsi Anne Pooe at university, and later Molebatsi Pooe-Shongwe, before legally changing her name to Kwanele Asante-Shongwe in 2012 (although she mostly goes by Kwanele Asante in her professional life).

Every change has been a waymarker in a life that began like an unwritten Zakes Mda novel, in a TB sanatorium in Soweto.

“My mother and father met in Charles Hurwitz [TB hospital], probably in the canteen from that famous Ephraim Ngatane painting. I was reflecting the other day that my entire life has been defined by health care,” says Asante, who was born in Meadowlands in 1969.

Asante’s parents met in a TB sanatorium in Soweto, possibly in the canteen that was painted in 1964 by late South African artist Ephraim Ngatane, and titled Canteen. Her father, Aaron Sonnyboy Pooe, and mother, Lerato Nokoane (born Dikeledi Lydia Nokoane), were divorced before Asante turned five. She and her younger brother Lesele never saw their father again.

Her tone changes when she begins talking about her mother.

“She was a very tenacious woman,” Asante says, chuckling.

“My father was her second husband, and she had six children before my brother and I. We were very poor, and to provide for us after our father left she took a job as a teacher at Batswana Teacher’s Training (BAT) College in Mafeking (now Mahikeng), later becoming a live-in boarding master to supplement her salary.”

It was a solution that held until the 1976 Soweto Uprising, which triggered student protests across the country.

“We were kicked out of our little room because the kids felt we were leeching off them,” recalls Asante, who was in Grade 1 at the time, at Diphetogo Primary School.

“It was a difficult time because mum was reinventing — she went away to Baviaanspoort [Zonderwater Prison and Training College near Tshwane] for six months to train as a prison officer, leaving us with a relative we only met the day before she left,” says Asante, who wasn’t coping at school.

“One particular teacher used to split the class into ‘smart ones’ and ‘donkeys’. I was in the donkey group. I was unhappy. Then I met a woman who saved my life.”

Dineo Mpofu, a teacher at Diphetogo, saw something in the struggling seven-year-old.

“She told me, ‘You are actually smart. Come to me during break and we will work on your cursive writing.’ She was by my side until standard four, by which time I was a very strong student,” says Asante, who moved across to the new middle school that had been established at BAT.

Asante with friend and mentor Nana Beth Kgosidintsi, formerly the African Development Bank Group’s health sector specialist. “She has been my secret weapon, fiercely schooling me on the behind the scenes shenanigans in African health financing and policymaking,” says Asante, who considers herself fortunate to have found mentors and champions at key points in her life. (Supplied) The BantustansIt was the early 1980s and Mafeking had just been incorporated in the recently proclaimed Republic of Bophuthatswana. To combat liberation ideologies in the Bantustans, the South African Defence Force had started sending conscripts with university degrees and teaching diplomas to teach in certain Bantustan schools, including the new Batswana high and middle schools. And so Asante’s teachers were mostly white servicemen.

“They saw it as a way of winning hearts and minds. We saw it as a sneaky way of getting a kind of private school education,” Asante recalls.

There were some civilian teachers, too, and Asante remembers one man with particular fondness — Denzil Fincham, her Standard 5 English teacher, who would go on to become the headmaster of Kingswood College in Makhanda.

“He used to say, ‘Anne, stand up, give us an unprepared speech. You need to learn to speak properly because you’re going to be an important person one day.’ At first I thought, ‘Oh no! This man is really irritating me,’ but it was actually really formative,” says Asante, whose polished elocution saw her through door after door later in life.

Before her world cracked open, however, it was unusually cloistered.

“Mum took a job at Rooigrond Maximum Security Prison [now Rooigrond Maximum Correctional Centre], and here we lived for years, on this prison base in the middle of nowhere, surrounded by prisoners.”

White prison officers, says Asante, “stayed in their own quite opulent section, literally called ko makgoweng [the white side]” whereas black families stayed in a row of tiny houses on “the black side — ko Batswaneng”. She can’t quite recall when this changed but change it did, and by this time her mother was a senior officer at the prison, so the family moved across into one of the nice houses.

If Rooigrond embodied the racism that was coded into South African society at the time, it also provided object lessons in what Asante refers to as “the inequality of power”.

“There was a lot of saluting. Even when mum was in civilian clothes, the other officers would strek [stand to attention], whereas the prisoners would drop to their knees and take off their hats. For me, as a teenager, this was like, ‘Joh, weird’.”

The prison nevertheless provided a form of stability, which ended when her mother transferred to Odi prison in Mabopane, north of Pretoria (she was later reposted to Rooigrond, and appointed inspector of prisons for the Republic of Bophuthatswana).

“I had attended six schools by the time I reached matric. It was very destabilising,” says Asante, who was taken in hand by the principal of Pelotona Middle School in Mabopane, ZK Mogodiri.

“He was a pan-Africanist: a short man who would stand in front of us at morning assembly and say, ‘African child, we are not going to be door mats of other nations.’ He was strict but he took a liking to me, and when he realised that we were about to move again he drove a 100 kilometres to Motswedi in Zeerust to find me a place at the boarding school there, so that I would have some stability,” says Asante, who matriculated in 1987. The following Easter she met Isaac Shongwe, whose family paid lobola for Asante in 1989.

“I was a fast-moving girl,” she chuckles, adding, “I didn’t change my surname, which is the only thing I have from my father.”

Shongwe — today a prominent South African business personality — had just graduated from Wesleyan University in the United States, and suggested Asante might want to apply.

“I had been fascinated with America most of my life until then. I needed no urging. We moved abroad in August 1989.”

Like her husband before her, Asante received a full scholarship. She studied sociology and psychology, and felt very at home in Wesleyan’s vocal liberal arts culture.

“I was the only black African woman there at the time, so naturally I was the most oppressed person on campus,” she says, with a wink.

“People would ask, ‘You’re African, yet your name is Anne. How?’ and so I switched it around, and became Molebatsi Anne.”

Asante and former husband Isaac Shongwe. Shongwe, by this time a Rhodes Scholar, was at Oxford, and so the two travelled between England and America, with a trip home in 1991 for the birth of their first child, Sibusiso Mandla Shongwe, today a well-known film director and multimedia artist (better known by his alias Sibs Shongwe-La Mer). Their second child, Mbali-Pfeiffer Shongwe (today a notable young mental health advocate and gender-based violence activist), was born in 1999.

After graduating in 1994 Asante returned to South Africa for good. Her memories of the job market at the time have her smiling before she speaks.

“It was that time when everybody was looking for a black. The moment you accepted a role others would be knocking, looking to poach!”

From Pretoria Portland Cement, where Asante worked as an internal communications coordinator, she was employed by First National Bank as a group journalist, writing articles and booklets (including one on breast cancer) for the bank’s 36,000 employees, before being lured across to Anglovaal Minerals (since incorporated into African Rainbow Minerals) to oversee their internal communications.

“Women were only just being allowed underground at the time, and I remember I would get into my white things — boots, overalls, helmet — and at some point the men underground would see the curves and they would scream that the earth was gonna fall down,” says Asante, who witnessed firsthand the toll HIV was taking on mineworkers, and became frustrated with management’s apparent reluctance to “walk the talk” of safer sex practices in their own lives and professional spaces. (“There were no condoms in the head office or mining office bathrooms, even though it was well known that many of the metallurgists, geologists and mining engineers, 95% of whom were white men, practised unsafe sex!”). Faced with this hypocrisy, and seeing the sector’s stark social inequality on her daily commute to work, she felt increasingly conflicted about her high salary.

“I’m not sure that any of the corporations I worked for actually had a job for me, and that’s a heavy suspicion to live with, especially when you see things happening that you don’t agree with,” says Asante, who often complained to family friend (and former Constitutional Court judge) Edwin Cameron about her ethical conundrums.

“I think Edwin grew tired of hearing me complain, because one day he said, ‘Listen, when I first met you at 19, you said you wanted to become a lawyer. I think you’re a natural-born lawyer. I think you should go to law school.’”

Asante was 32 at the time. She thought about it, and remembered her mother’s uncle, the writer JB Leseyane (author of the classic Setswana novel Monageng), who lived in a village in Swartruggens. She, her brother and their cousins all called him Ntatemogolo [grandfather], and visited often.

“He would wash on the patio in the morning, and the rest of us ‘grandchildren’ would bathe in the same water in order of seniority. ‘It will make you smart like me,’ he used to say, and he was indeed a smart man. He would invite me to attend these kgotlas [traditional court sessions] under a distant tree, where people could come and report their issues — how somebody stole somebody else’s cow, or beat their wife, and so on — and I would be the only child at these things, but he kept taking me, until he was murdered when I was 10. Looking back, I realise this was my introduction to law.”

Asante decided to take Cameron’s advice, enrolling for an LLB at Wits University, and afterwards joining Deneys Reitz to do her articles.

“Candidate attorneys were basically messengers, serving summonses and doing pagination. I was 35, from a campus activist background. I had worked three corporate jobs. I was like, ‘Guys, I’m not here to photocopy.’ I was a difficult candidate attorney, and in fact the experience just worsened from one rotation to the next.”

Asante had one champion during this lonely period, an institutional aviation law specialist called Pierre Naude, who treated her as a colleague, taking her out to crash sites and commending her written opinions. When she was not retained as an attorney after her two years’ candidature he walked across to her office.

“He closed the door, asked if he could sit, and said, ‘You are a very good lawyer — don’t let this make you forget that. I know that you love human rights, perhaps your future lies in this direction.’ He wrote me the most beautiful letter of recommendation as a lawyer and a thinker.”

Three months later, at 37, Asante was diagnosed with breast cancer.

“The lump had been in my breast for some time, and I knew from that booklet I wrote for FNB that it was more than likely a problem, but I was just hoping it would miraculously disappear.”

A breast biopsy confirmed breast cancer — Asante received the news on the way to fetch her daughter, then seven, from school.

“Suddenly, I was a very sick woman. I found my heart would be palpitating after chemo sessions, but when I reported this to my oncologist, he was dismissive.”

She read on the website of the American Society of Clinical Oncology that some of the chemotherapy medicines can cause heart damage, and immediately called her GP, who had a cardiologist meet her in a nearby emergency room.

For 20 years South African lawyer and bioethicist Kwanele Asante was at the forefront of the push for a better, more patient-centred response to cancer and other noncommunicable diseases. Here she leads a march of members of BreastSens, the organisation she founded in 2009, in Snake Park, Soweto. “The cardiologist greeted me with, ‘I believe you are a Google self-diagnosed patient’, but the moment he listened to my heart he shouted, ‘Code Blue!’ and people descended on me.”

It was discovered that Asante had chemotherapy-induced cardiomyopathy, a disorder of the heart muscle. Three years later, during a routine check-up (and shortly after her divorce from Shongwe), her cardiologist told her she was at imminent risk of a fatal heart attack.

“He said I needed a machine implanted under my skin, called an implantable cardioverter defibrillator, which detects irregular heartbeats and gives an electric shock to restore it to normal. I had the procedure, and when the bill came to my apartment I saw how much it had cost, and I cried and cried. My medical aid had covered it. All I could think to say was, ‘Kwanele, Baba. Asante.’ Kwanele is isiZulu for ‘it is sufficient’. Asante is Kiswahili for ‘thank you’.”

In 2012, Asante formalised her gratitude by taking these words as her legal name, or what she calls her “healing name”. Her experience had left her with troubling questions, however.

“In the Sandton Oncology Centre I was struck by how few black women there were in the waiting room — I only saw two the whole time, and they were from Botswana. I asked my cardiologist, ‘Am I the first black woman to have breast cancer?’ and he said, ‘No, there are many. Most go to Helen Joseph, Charlotte Maxeke and Chris Hani Baragwanath hospitals. Some come here, but they come at odd hours because they don’t want people to know.’”

Asante decided to find out for herself.

“I visited Chris Hani [Baragwanath Hospital], and there were about 30 women sitting in a little room, all half-naked from the waist up with decaying breasts. It was before they had the breast clinic, and there were no gowns. It was a mess.”

Asante confronted the surgeons, one of whom countered that the patients were all women (so why would they mind?).

“I said, ‘Would Gogo traditionally be sitting like this with a woman half her age?’ and he got it. The next week — because the clinic was only held on Wednesdays then — everyone had gowns. My friends in the northern suburbs and I pooled together to buy some things but that doctor bought the first 20 gowns himself.”

Out of this experience came BreastSens, the NGO Asante founded to promote health rights, human rights and breast cancer education among indigent black women in Soweto.

“It was nothing new, I simply copied Edwin and others’ work on treatment access for people living with HIV, and I transposed it to breast cancer,” says Asante.

While it is true that South Africa’s HIV response is rich in transferable lessons, they are lessons that advocates for NCDs such as cancer, diabetes and high blood pressure have struggled to take up and apply with similar success. In Soweto, Asante demonstrated it was possible to take a health rights approach to breast cancer.

Her legal training proved invaluable (Asante never did work as a lawyer) although she acknowledges that it, and her relative privilege, were also barriers that needed to be overcome.

“I was coming at it with the self-importance of an activist lawyer. The women who let me into their lives were my saving grace. I spent six years working in Soweto’s communities. I met the families, and came to know their realities. Three of the women I knew developed cardiotoxicity [when the heart or cardiovascular system is damaged during or after cancer treatment], like I had, and died. They didn’t get defibrillators, like I did. They died, and they were all remarkable, single mothers of young children. They all died at 35. At that time, I was 44.”

Kwanele Asante (then Molebatsi Pooe-Shongwe) at the 2009 summit of Lance Armstrong’s Livestrong Foundation, discussing cancer stigma with (from left to right): Xishan Hao, president of the Chinese Anti-Cancer Association; MR Rajagopal, founder and chairman of Pallium India; Alejandro Mohar, director of the National Cancer Institute of Mexico; and prostate cancer survivor Rick Lyke. Asante is far right. Off pinkAsante says she did join the “pink ribbons” for a time, meaning the established network of breast cancer advocacy organisations, “but very quickly got to understand what they were: the commodification of a woman’s disease by marketing companies. So I stopped wearing the pink outfits,” she says, demonstrating the (at times acerbic) contrarianism that has been a hallmark of her advocacy. (Another hallmark has been her vivacious style: an orange polo neck sweater today, with pearl drop earrings.)

Her community-based approach saw her nominated by Soweto communities to join the inaugural ministerial advisory committee on the prevention and control of cancer, which she was later elected deputy chairperson of. She then served a second term, chairing the committee. In parallel, she decided to study again.

“I was often the loudest ‘lived-experience’ person in the room at the conferences I was attending at home, on the continent and abroad, and cancer researchers and cancer doctors would say, ‘What’s this lawyer doing in medicine?’ A very dear and faithful mentor and friend [the retired academic and education champion Gillian Godsell] advised me to do a master’s degree with the word medicine in it, and after some scouting around I enrolled for an MSc in bioethics and health law, health and human rights at Wits’ Steve Biko Centre for Bioethics,” says Asante, who was asked to stay on and lecture upon graduating in 2016.

“I loved my students but only lasted one year because teaching is very exhausting, and little paid!”

Asante returned to patient advocacy, deepening her commitment to the African Organisation for Research and Training in Cancer, which she had been involved with for some years, eventually serving as the secretary general in 2020.

In the same year she became a member of the World Health Organization’s civil society working group on NCDs. With her well-honed sense for inequality in health care, Asante became a fierce critic of the global health advocacy system she had joined. In a 2025 BMJ article, for example, she and her co-authors argued that global NGOs and health organisations are often guilty of advocating for patients, families and communities in generic and potentially extractive ways, while remaining stubbornly headquartered in Europe or North America.

Kwanele Asante pictured with Marthinus CJ van Schalkwyk, deputy permanent representative to the South African permanent mission to the UN in 2025, while attending the interactive multi-stakeholder hearing on the prevention and control of noncommunicable diseases and the promotion of mental health and wellbeing at the UN Headquarters in New York. (Supplied) She travelled back and forth from Geneva, but at some point experienced a crisis of conviction.

“I found I was reacting to these white women doing their higher degrees in global health and development, who would come and say” — and here Asante affects an American accent with extraordinary disdain — ‘I’m here to talk on behalf of my community in Ndola, or Lusikisiki’ — and I’m sitting there thinking ‘your community?’ And after I had reacted that way three or four times over the years, I was like, ‘Actually, who appointed you [Kwanele Asante] a spokesperson for Black women? How well do you know your community?’ I was born in Soweto, but … hmm.”

It’s a fittingly self-aware and self-questioning ending to our conversation about her protean life — a life that I suspect (based on her grumbling about private medical aid billing practices, after her recent hospital stay) has strident activism in it yet.