Working group & Research team

The ethics framework was developed by a multi-stakeholder working group across five meetings, facilitated and tested by the research team.

Working Group Members

Yusuf Saloojee (co-chair)

Yusuf Saloojee was the Executive Director of the National Council Against Smoking.

He has worked for the enactment of national tobacco control legislation, monitored its implementation and run smoking cessation programmes. Dr Saloojee has served on the boards of a number of international NGOs, including the African Tobacco Control Alliance, the International Union Against Cancer and the Framework Convention Alliance, and has been an expert advisor to several committees of the World Health Organization. He received his PhD from St Bartholomew's Hospital Medical School in London, England.

Karen Hofman (co-chair)

Professor Karen Hofman is the Director of PRICELESS SA (Priority Cost Effective Lessons for Systems Strengthening) based at the Wits School of Public Health

PRICELESS is a research programme providing information on “Best Buys” for public health using SA data. Analyses show how scarce resources can be used effectively and efficiently to have the most impact. PRICELESS also demonstrates how to achieve better health through the use of fiscal, legislative and regulatory levers. A medical graduate of the University of the Witwatersrand and trained as a paediatrician, Karen previously served as Director of Policy and Planning at the US NIH, Fogarty International Center and spent a decade on the faculty at the Johns Hopkins School of Medicine. She has consulted for WHO/PAHO and is published widely in international journals.

Duane Blaauw

Dr Blaauw is a senior researcher in health systems and health policy research at the Centre for Health Policy (CHP) in the School of Public Health (SPH) at the University of the Witwatersrand in Johannesburg,South Africa.

Dr Blaauw is a medical doctor and public health specialist with additional qualifications in public management, tropical medicine, occupational health and medical science. He has nearly 20 years of experience in supporting health service development at various levels of the public health system in South Africa with an emphasis on human resources, health policy analysis, health planning, health information systems and health management. At CHP he has participated in a number of international collaborative research programmes on health systems and human resources for health. His research is primarily quantitative, and he has led the application of new methods from organisational studies and economics to health systems research at CHP. His current research interests include human resources for health, health worker practice and motivation, antibiotic-prescribing behaviour, incentives, discrete choice experiments, behavioural and experimental economics. He is also involved in postgraduate teaching and supervision in health systems, health policy and health economics in the SPH postgraduate teaching programmes. In relation to the themes of the SAVE-UHC project, he is interested in inequality analysis, multi-criteria priority setting, mechanisms for public participation and procedural justice, and supporting the practical implementation of national health insurance in South Africa.

Cassey Chambers

Cassey Chambers is the Operations Director and Board Member of the South African Depression and Anxiety Group (SADAG)

Cassey started at The South African Depression and Anxiety Group (SADAG) as a volunteer counsellor in the call center helping to man the Suicide Crisis Helpline 10 years ago. With a background in Psychology, and experience as a volunteer in the call center she then took on the position of Call Center Manager managing over 100 volunteer counsellors. Now after 10 years with the organization and now the Operations Director and Board Member, being able to represent SADAG at national conferences, various press and media interviews, workshops and advocacy projects to help fight for patient rights and destigmatize mental health across the country. Focusing on various projects including the Teen Suicide Prevention School Programme, Rural Outreach Projects, Support Groups, Responsible Reporting initiatives with press and media, Mental Health in the Workplace and more recent advocacy projects including the Esidimeni crisis and Medical Aids.

Tobias Chirwa

Tobias Chirwa is an Associate Professor and Head of the School of Public Health (SPH) at the University of the Witwatersrand (Wits).

Prof Chirwa is also the Programme Director for the Wellcome Trust funded Sub-Saharan Africa Consortium for Advanced Biostatistics Training and co-leads the implementation science Fogarty training programme at Wits. Prior to this, he was the Head of the Division of Epidemiology and Biostatistics at Wits SPH, Senior Lecturer at the University of Malawi (UNIMA) and a Research Fellow in Medical Statistics at the London School of Hygiene and Tropical Medicine (LSHTM). Tobias has provided leadership to research and consultancy projects on STIs and Disease Surveillance in the SADC region; STI Care, Maternal and Newborn Health and Infection Prevention. He continues to work on tuberculosis (TB) diagnosis, treatment adherence and post-treatment survival; STIs and child health, specifically low birth weight infants. His methodological interests are in longitudinal and survival data analysis methods, including nonparametric inference and measurement error regression models.

Nonhlanhla Duba

Nonhlanhla Gloria Duba is the Clinical Health Specialist in the Advocacy Department at Cancer Association of SA (CANSA).

Dr Duba is involved in advocating for patients’ rights to access treatment and quality care when diagnosed with cancer and collaborate with other stakeholders to influence policy. Nonhlanhla is a professional nurse with BA Cur. Nursing Education, Administration and Community Health Nursing, Oncology Nursing science and Diploma in Nursing Education from Wits University. She also holds an MBA from the De Montfort University (UK). She has worked in the public health sector’s oncology and palliative care settings, both as an educator and administrator, then worked for HPCA before joining CANSA.

Liz Gwyther

Dr Liz Gwyther is Professor of Family Medicine and Palliative Care, University of Cape Town, South Africa.

Dr Gwyther has postgraduate qualifications in Family Practice and Palliative Medicine. She was CEO of Hospice Palliative Care Association of South Africa; chair of the Worldwide Hospice Palliative Care Alliance; and a director of the following organisations - African Palliative Care Association, hospice and Pain Society of South Africa. She is a member of the World Health Organisation ad-hoc Technical Advisory Group for palliative and long-term care. She heads the Palliative Care team within the School of Public Health and Family Medicine at the University of Cape Town. She is the convener for the postgraduate programmes in Palliative Medicine and is responsible for research supervision and support for publications of the postgraduate students. She is a member of the editorial board of the Journal of Pain & Symptom Management published in the USA. Her special interests are women’s health and palliative care and human rights in health care. In 2007, she was awarded the SA Medical Association’s Gender Award for Human Rights in Health and the SA Institute of Health Managers Leadership in Health Systems award.

Mark Heywood

Mark Heywood is the editor of the Citizen Maverick and was the Executive Director of SECTION27

Section 27 was established in May 2010. It incorporated the AIDS Law Project (ALP), one of South Africa's most successful post-apartheid human rights organizations. Mr. Heywood joined the ALP in 1994, becoming its head in 1997 and executive director in 2006. In 1998, he was one of the founders of the Treatment Action Campaign (TAC). In 2007, he was elected as deputy chairperson of the South African National AIDS Council. In 2009, Mr. Heywood was appointed as a member of the Ministerial Advisory Committee on National Health Insurance. Mr. Heywood has written extensively on HIV, human rights and the law, including co-editing the AIDS and the Law Resource Manual and Health & Democracy: A guide to human rights, health law and policy in post-Apartheid South Africa. He has been part of the legal teams of the ALP and TAC that have been involved in all the major litigation around HIV and human rights.

Leslie London

Professor Leslie London is Chair of Public Health Medicine in the School of Public Health and Family Medicine at the University of Cape Town for which he served as Director from 2007 to 2012.

Prof London heads the Division of Public Health Medicine. He is an active researcher in the field of Occupational and Environmental Health Research and leads the Health and Human Rights Programme in the School which has a broad research and training mandate addressing health as a socio-economic right and examining human rights and ethical issues in relation to the practice of health professionals. His most recent work focuses on participation is a crucial element of the Right to Health and the position of Health Committees as vehicles for democratic governance in the health system. His work on alcohol harm reduction has focused on alcohol policy and conflict of interest. He has served on national and international committees dealing with ethics and human rights in research and professional contexts and is active in the People’s Health Movement South Africa. He has published over 150 articles in peer-reviewed international and national journals and 15 books or book chapters, and is an NRF-rated scientist in the B3 category. He has supervised to completion 42 postgraduate masters and PhD students. In 2015, he was awarded the SAMA-Bonitas Housecall Doctor’s Awards for Equity and Justice and in 2017, a lifetime PHILA award by the Public Health Association of South Africa.

Neil McKerrow

Neil McKerrow is Provincial Paediatrician in KwaZulu-Natal (KZN) responsible for paediatric and child health services across the province.

Dr McKerrow has worked in South West Africa, Eastern Cape, Western Cape & KZN since 1988. He is the Chair of the Ministerial Committee on Morbidity and Mortality in Children under-5 and a member of the executive committees of the South African Paediatric Association as well as the Child Health Priorities Association. Additionally, Neil McKerrow is an honorary lecturer in the Departments of Paediatrics at UCT and UKZN. His interests are in social paediatrics, child health and health systems for children. He qualified from UCT for both his undergraduate & post-graduate degrees.

Olurotimi Modupe

Dr. Modupe is Senior Manager Clinical unit at the Council for Medical Schemes

Dr Modupe is a medical practitioner with extensive clinical and hospital management experience as head of health establishment. In the last few years he has been initially medical Advisor and later, Senior Manager Clinical unit at the Council for Medical Schemes where he manages the prescribed minimum benefits projects such as the PMB review, PMB benefits definitions as well as the PMB code of conduct. He is also tasked with the provision of clinical opinions towards complaints adjudication and resolution. The PMB review project is tasked with revision of the current benefit package for the private healthcare sector in South Africa. The project has been on since 2016 and aims to develop a new service based package that is comprehensive and robust in its approach to priority setting methodology. The benefit definition project entails the development of costed clinically appropriate and evidence based funding guidelines for each of the 270 Diagnosis and treatment pairs, chronic disease list and all emergency medical conditions as outlined in the Prescribed Minimum Benefit regulations of Medical Schemes Act. He chairs the Industry Technical Advisory Panel tasked with developing the value of managed care within the private healthcare sector. Dr Modupe is passionate about improving access to quality healthcare to all South Africans. He has training in Public Health, health financing, bioethics and medical law.

Noluthando Nematswerani

Dr Noluthando Nematswerani is the Head of the Centre for Clinical Excellence at Discovery Health, within the Strategic Risk Management Division.

Dr Nematswerani is also a media spokesperson for Discovery Health on clinical issues. She is Medical Doctor with 20 years healthcare experience. She holds Masters Degrees in Clinical Pharmacology and an MSc in Biostatistics and Clinical Epidemiology. In her current role she oversees Health Technology Assessments (HTA), Health Economics, Surgical Risk Management, Clinical Policy Development, Medicines Unit including Drug Risk Management and the Clinical Research Unit. Her unit is also responsible for the overall clinical strategy for Discovery Health and related businesses. She is the chair of the Clinical Exco, a forum comprising of healthcare experts from all Discovery businesses (local and international) with a combined health care experience (local and global) of over 320 years, and specialist representation in Public health, Paediatrics, Health Economics, Business Administration (MBA), Sports Medicine, Ethics, Anaesthetics, Epidemiology, General Practice, Pharmacology, Pharmacy and Physiotherapy. Prior to joining Discovery, she was a full-time senior lecturer in the Department of Pharmacology, at the University of Pretoria where she continues to offer her services as a part-time lecturer to date. She was appointed by the Minister of Health in 2014 to the Adult Expert Review Committee for the Hospital Level Essential Medicines List. She is a current member of the PMB Review Advisory Committee set up by the Council for Medical Schemes. She has also worked in both the public and private health sectors in South Africa as a Medical Officer /General practitioner.

Yuri Ramkissoon

Yuri is a Senior Researcher at the South African Human Rights Commission (SAHRC), heading the Economic and Social Rights unit.

Ms Ramkissoon started at the SAHRC in 2008 as a Researcher for Environmental Rights. She has a Master of Science in environmental science has a particular interest in the field of human rights and business, particularly the impact of business activities on human health and the environment. Working at the SAHRC, has led to a further interest in the right health, particularly the management of public sector facilities, disparities between public and private healthcare, reproductive health and the externals costs or burdens on public health that are not usually accounted for – such as the impact of an unhealthy diet or the consumption of fast food on the public health system. In addition, her work at the Commission regularly focuses on issues of maternal, infant and child mortality, the right of access to healthcare for vulnerable groups and improving access to primary healthcare. She is especially concerned with the improvement of the public sector to allow for the effectively functioning of a unified healthcare system, which will ultimately serve to alleviate inequality in South Africa.Yuri has begun work on a proposal for the PhD, which will deal with the impact of mining activities on mining communities in South Africa. She hopes to assess whether mining has had a positive or negative impact on such communities considering economic, social and environmental factors, including the health of people within these communities.

Prof Yosuf Veriava

Yosuf is a specialist Internal Medicine and Nephrology and the Director of the Wits University Steve Biko Centre for Bioethics.

Prof Veriava spent the whole of his clinical career in the Public Sector Health Services and the Faculty of Health Sciences at the University of Witwatersrand. He plays a pivotal role at the Steve Biko Centre for Bioethics. He was also the Chief Specialist and head of the Department of Medicine at the Helen Joseph Hospital as well as the Academic Head of Internal Medicine at Wits. Presently, Yosuf has just completed a two-term stint as the Chairperson of the Council for Medical Schemes. He is also the Chairperson of the Ministerial Task Team of the training of South African Students in Cuba.

Veriava was the convenor of committees involved in opposition to apartheid between 1970 and 1990, and a Trustee of the Abubaker Asvat Trust for nation-building. In 1976 he was the convenor of the Detainees’ Parents Support Committee in response to the detention and disappearance of children following the student uprising in 1976. He is the Director of the Wits University Steve Biko Centre for Bioethics.

He was part of the group that initiated the establishment of an internal Truth and Reconciliation Commission within the Wits Faculty of Health Sciences, overseen by Advocate Jules Browde. This was an initiative to critically review the faculty’s history under apartheid and identify shortcomings in terms of ethics, morality and justice.

He looked into the scoping of functions of the Department of Health’s Office of Health Standards Compliance. He was part of the team that performed the clinical review of cases involved in the recent Life Esidimeni tragedy. He is in the Ministerial Advisory Committee on Organ Transplantation, overseeing approvals of kidney transplants. He is in the Gauteng Patient Safety and Medical Litigation Panel and he served two terms as Ministerial appointee to the position of Chair of the Council for Medical Schemes.

Marije Versteeg-Mojanaga

Marije Versteeg-Mojanaga was at the helm of the Rural Health Advocacy Project (RHAP) since its inception in until 2019.

RHAP’s mission is to promote, protect and help realize people’s rights to quality rural healthcare by connecting practice, policy and partners. Marije’s expertise lies in health advocacy and social justice, organisational development and governance, coalition-building and partnerships for social change. She is currently working on issues relating to fair priority-setting of healthcare resource allocations, and the ethics of healthcare worker advocacy. Marije holds a Masters Degree in Culture, Organisation and Management from the Vrije Universiteit in Amsterdam and is studying towards a Masters in Applied Ethics at the University of the Witwatersrand, Johannesburg. She has spearheaded the development of the two flagship programmes of the RHAP, which are The Voice Project (Building a critical mass of advocacy competent healthcare workers) and the Rural-Proofing Policy and Budgeting Programme. Marije has authored peer-reviewed and popular publications, provides regular presentations on issues affecting human rights and health in public fora and represents RHAP in a number of civil society coalitions, committees and government bodies. She is a member of the Executive Committee of the Rural Doctors Association of South Africa and represents RHAP on the Treatment Action Campaign's National Council. Marije can be contacted at: marije@rhap.org.za

Victoria Mubaiwa

Dr. Victoria Mubaiwa was Chief Director of Strategic Health Programmes at the KwaZulu-Natal Department of Health. DoH Manager for Maternal and Child Health

Facilitation and Research Team Members

Principal Investigators

Karen Hofman

Professor Karen Hofman is the Director of PRICELESS SA (Priority Cost Effective Lessons for Systems Strengthening) based at the Wits School of Public Health

Nicola Barsdorf

Dr Nicola Barsdorf, MHS, PhD, Head of Health Research Ethics in the Faculty of Medicine and Health Sciences’ Research Development and Support Division.

Dr Barsdorf is a former Fogarty Bioethics scholar and received her Ph.D. in International Health and Global Justice from the Centre for International Health, University of Bergen, and an M.H.S. in International Health and Research Ethics from Johns Hopkins Bloomberg School of Public Health, USA. More recently, Dr Barsdorf was a bioethics fellow in the Department of Bioethics at the National Institutes of Health (NIH), USA. She was formerly the project coordinator for the Ethics, Law and Human Rights (ELH) Working Group of the WHO/UNAIDS African AIDS Vaccine Programme (AAVP).

Ruth Faden

Ruth R. Faden, PhD, MPH, is the founder of the Johns Hopkins Berman Institute of Bioethics and itsdirector from 1995 until 2016.

She was the inaugural Andreas C. Dracopoulos Director (2014-2016) and currently is, and has been since 1995, the inaugural Philip Franklin Wagley Professor of Biomedical Ethics. Dr. Faden’s current research focuses on structural justice theory and on national and global challenges in food and agriculture, learning health care systems, women’s health, the rights and interests of pregnant women, health systems design and priority setting, and access to the benefits of global investments in biomedical research. She is co-author, with Madison Powers, of the book Structural Injustice: Power, Advantage, and Human Rights (Oxford University Press).

Kalipso Chalkidou

Kalipso Chalkidou is the Head of Health Finance at The Global Fund to Fight AIDS, Tuberculosis and Malaria and a Visiting Professor at Imperial College London.

Prof Chalkidou was Director of Global Health Policy at the Center for Global Development and Professor of Practice in Global Health at Imperial College London. Her research considers how local expertise can inform the allocation of scientific and healthcare resources. Kalipso led the establishment of NICE International which she led for 8 years, and, more recently, of the international Decision Support Initiative (iDSI: www.idsihealth.org) which she directed and which is a multi-million multi-country network working towards better health around the world through evidence-informed spending in healthcare in low to middle income countries. She holds a doctorate on the molecular biology of prostate cancer from the University of Newcastle (UK), an MD (Hons) from the University of Athens and is a visiting Professor at King’s College London and an adjunct professor at Griffith University in Australia. She has held visiting positions at the Johns Hopkins School of Public Health and the London School of Hygiene and Tropical Medicine, sits on several journal editorial boards and has published over 100 peer reviewed papers and book chapters.

Susan Goldstein (Project director SA)

Prof Susan Goldstein is a public health medicine specialist and Deputy Director and COO at the SAMRC Centre for Health Economics and Decision Science-PRICELESS SA.

Prof Goldstein worked at the Soul City: Institute for Social Justice (SCI) for over 22 years, communicating about Health through drama with both adults and children. She has a special interest in Social and Behaviour Change Communication (SBCC), and Health Promotion, focusing on the social, economic and commercial determinants of health, immunization and children. She has been active in the NGO sector, on a number of boards such as the Southern African Alcohol Policy Alliance (SAAPA). Internationally she is on the Secretariat of the International SBCC Summit 2022, the Independent Monitoring Board for Polio Eradication, and the steering Committee for the Sustainable Health Equity Movement (SHEM).

Carleigh Krubiner (Project Director)

Dr Carleigh Krubiner is a bioethicist and non-resident fellow at the Center for Global Development.

Dr Krubiner’s work focuses on ethical issues surrounding equity in the development and delivery of health interventions in low and middle-income settings. Recent work includes approaches to priority-setting for Universal Health Coverage, ethics frameworks for COVID-19 vaccine allocation, the fair and responsible inclusion of pregnant and lactating people in epidemic vaccine development and deployment, and the indirect impacts of the COVID-19 pandemic across other areas of health. Her work has been published in leading academic journals including The Lancet, Vaccine, AIDS and the Journal of Medical Ethics and has been featured in media outlets including the New York Times, STAT, and NPR.

Prior to joining CGD as a Policy Fellow (2018-2021), she was a research scholar at the Johns Hopkins Berman Institute of Bioethics, where she remains an affiliated faculty member. Krubiner received her PhD in Health Policy and Bioethics from Johns Hopkins Bloomberg School of Public Health. Her dissertation focused on the ethical design of conditional cash transfer programs for health promotion.

Atiya Mosam

Dr Atiya Mosam is a Public Health Medicine Specialist

Dr Mosam is a proudly South African medical doctor. She completed her medical degree in 2007 at the University of the Witwatersrand and worked for the Johannesburg Metro District Health Services at Mofolo Community Health Centre in Soweto before joining the University of the Witwatersrand, School of Public Health as a Public Health Medicine Registrar in 2015. She is currently a Public Health Medicine Specialist who also holds a Masters of Public Health (Policy and Management) and a Masters of Medicine (Community Health). Atiya is interested in healthcare financing and economics as well as health promotion and prevention for non-communicable diseases. She aspires to contribute towards health for all South Africans and her passion for social upliftment extends beyond her career to involvement in numerous projects aimed at increasing awareness of and funding to various causes such a homelessness and HIV-affected youth. She has also served on various Executive Committees, including a role as the Secretary of the Public Health Association of South Africa.

Michael DiStefano

Michael DiStefano is a PhD graduate in Bioethics and Health Policy in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.

Dr DiStefano’s research interests include priority setting and resource allocation, ethical issues related to the measurement of health, and the ethics of surveillance and influence in health (from mobile health to health incentives programs). Michael received a Master of Bioethics from the University of Pennsylvania in 2014. His graduate thesis explored the ethics of using mobile health technologies to enhance TB treatment adherence. Prior to Hopkins, Michael interned at the World Medical Association and taught in the Biomedical Ethics department at Dong-A University in Busan, South Korea.

Ravikanthi Rapiti

Ravikanthi was a Technical Advisor of SAMRC Centre for Health Economics and Decision Science-PRICELESS SA based at the University of the Witwatersrand School of Public Health.

Ms Rapiti has worked on the Health Technology Assessment component of the USAID project of the Global Health Supply Chain (GHSC), which supports the South African National Department of Health. Ravikanthi has a Master’s degree in Public Health. Prior to joining PRICELESS, she worked as a researcher at the Medical Research Council, CAPRISA and the World Bank.

Aviva Tugendhaft

Aviva Tugendhaft is a senior researcher at SAMRC Centre for Health Economics and Decision Science-PRICELESS SAbased at the University of the Witwatersrand School of Public Health.

Ms Tugendhaft is a Senior Researcher at the SAMRC Centre for Health Economics and Decision Science -PRICELESS SA. She is currently busy with her PHD focusing on community-based decision making and priority setting, using a modified Choosing Health Plans Together (CHAT) tool. Aviva has an undergraduate Bachelor of Arts with Law and Political Science and a Masters in Health Sociology from Wits University. Prior to joining PRICELESS SA she worked in the NGO and public sectors where she was involved in programme and policy analysis and development, specifically with regard to HIV/AIDS and community initiatives. She also worked in the private sector where she developed workplace wellness programmers.

Ryan Li

Dr Ryan Li, Adviser for the Global Health and Development Group, Imperial College London.

Dr Li was the strategic and technical lead for several workstreams in the International Decision Support Initiative (iDSI). He led the development of an innovative method for assessing countries’ readiness for priority-setting and HTA, and completed this exercise for 17 countries across Asia, Africa and Latin America. Ryan also works on other practical support projects, including the development and implementation of evidence-informed clinical quality standards in Vietnam and India. Ryan worked for NICE International from 2013 to 2016. Prior to that he conducted systematic reviews at the National Collaborating Centre for Mental Health in developing clinical guidelines for NICE and joined University College London as a researcher on a clinical trial evaluating the clinical and cost-effectiveness of a psychological intervention for dementia carers. In 2013 Ryan successfully defended his PhD thesis exploring the carer coping mechanisms underlying the intervention’s effectiveness. This clinical trial (and part of Ryan’s PhD) was funded by the NIHR-HTA programme, in order to address a research gap highlighted in the NICE dementia guideline.

Maria Merritt

Prof. Maria Merritt is a core faculty member of the Johns Hopkins Berman Institute of Bioethicsand Associate Professor at the School of Public Health.

A major objective of Dr. Merritt’s current research, in collaboration with colleagues, is to develop a novel methodology for considering social justice impacts side-by-side with cost-effectiveness as part of economic evaluation in health policy. Dr. Merritt’s other areas of scholarly interest include the ethics of public health research in low- and middle-income countries – particularly questions about researchers’ responsibilities to benefit research participants and populations – and moral psychology, the study of feeling, thought, and action in morally significant contexts.

Sunita Potgieter

Dr Potgieter is a medical doctor, who started her career in Nutrition and Ethics gaining a PhD in Nutrition in 2013. She also has a postgraduate diploma in Health Research Ethics.

She has extensive experience in research and teaching at undergraduate and postgraduate level and has presented original research at national and international congresses and served as chair and vice-chair of various Faculty-wide committees. During my MB ChB studies she was also part of undergraduate research and held the position of senior researcher at the Division of Research Development and Support as part of the South African Values and Ethics (SAVE) team. She continues in this role as part of the Research Integrity team at Stellenbosch University. She has a great passion for clinical medicine, research, and teaching. On a personal note, She is a single mother of three children, an avid runner and triathlete and enjoys participating in endurance sport events. I have completed several Olympic and Ironman distance events, earning an Ironman World Championship slot in 2008.