[Perspectives] Refiloe Masekela: Building Access to Care for Childhood Lung Disease

Why It Matters

Improving paediatric lung‑care infrastructure reduces child mortality and strengthens health systems still recovering from the HIV epidemic, positioning South Africa as a model for low‑resource settings.

Key Takeaways

• Masekela leads efforts to expand pediatric lung disease services in South Africa.
• Early 2000s HIV crisis highlighted gaps in child respiratory care.
• Antiretroviral rollout later reduced HIV-related lung complications in children.
• University of KwaZulu-Natal integrates pulmonology training with community health outreach.
• AHRI backs research on environmental and infectious drivers of child lung disease.

Pulse Analysis

The early 2000s HIV pandemic devastated South Africa’s paediatric population, with many children succumbing to opportunistic lung infections before state‑run antiretroviral treatment (ART) became accessible. The lack of ART not only amplified HIV‑related mortality but also exposed systemic deficiencies in diagnosing and managing chronic respiratory conditions. This historical backdrop underscores why expanding paediatric pulmonology services is now a public‑health priority, as lingering lung disease continues to burden vulnerable children even after ART scale‑up.

Refiloe Masekela, dean of the University of KwaZulu‑Natal’s School of Medicine, is leveraging her clinical expertise and academic leadership to address these gaps. By integrating specialised pulmonology training into the university curriculum and partnering with the Africa Health Research Institute, she is creating a pipeline of clinicians equipped to deliver community‑based lung‑care. Outreach programs bring diagnostic tools, such as portable spirometry, to underserved clinics, while research collaborations generate data on environmental and infectious risk factors unique to the region. This dual focus on capacity‑building and evidence generation accelerates the translation of findings into practice.

The broader implications extend beyond South Africa’s borders. Strengthening paediatric lung‑care infrastructure contributes to the global agenda of reducing child mortality and aligns with Sustainable Development Goal 3.5, which targets the mitigation of non‑communicable diseases. As other low‑ and middle‑income countries confront similar post‑HIV health challenges, Masekela’s model offers a replicable blueprint for integrating specialty care into primary health systems, attracting donor investment, and fostering regional research networks. Continued support for such initiatives promises to close the care gap for millions of children at risk of chronic respiratory disease.