June 12, 2025
9 min watch
Key takeaways:
- Refiloe Masekela, MD, PhD, holds leadership positions in multiple organizations.
- Masekela’s clinical care and research both focus on pediatric asthma.
- Policy priorities include making care more accessible.
SAN FRANCISCO — “It’s been a fantastic ride. I’ve enjoyed every moment of it,” Refiloe Masekela, MD, PhD, chair of the Pan African Thoracic Society, told Healio at the American Thoracic Society International Conference.
Masekela was on hand to receive ATS’s World Lung Health Award in recognition of her lengthy career, which includes founding the African Chronic Respiratory Disease Observatory CHEST AFRICA.
Also, Masekela is co-chair of the Global Asthma Network and a National Institute for Health and Care Research Global Health Research Professor, with a focus on pediatric asthma clinical trials.
“In South Africa, where I come from, asthma is actually very common,” she said. “One in five adolescents in South Africa actually has it.”
Masekela began her career in a small, rural hospital where she was a medical doctor in the asthma clinic and frequently encountered patients with wheeze. Her mentors told her that if patients were wheezing, then they were not well and their asthma was uncontrolled.
“That’s where it all started. I was really worried,” she said. “Why is this disease, which is so common, not well managed?”
At first, Masekela attributed disease severity to a lack of medication adherence. But as she got older, she said, she understood the barriers in treatment such as the stigma associated with inhalers for many adolescents as well as access to care itself.
“There’s challenges in accessing medicines, coming to clinics, standing in long queues to get your chronic medication and also challenges in people actually getting the asthma label,” she said.
Most patients that Masekela sees have been referred to her, especially young children, by clinicians who do not feel confident in diagnosing them with asthma.
And like the United States, distance to clinics is an obstacle in South Africa too.
“Where I’m working at the moment, in KwaZulu-Natal, it’s a big province,” Masekela said. “We see patients come from up to 600 km away.”
Fortunately, she said, the government provides inhalers for those who cannot afford them, but they need an asthma diagnosis first.
Masekela said she and her colleagues strive to provide good notes so patients can connect with services closer to home, with regional hospitals engaged to ensure continuity of care.
“That’s very important. We work in a world where everything is still paper based,” she said. “We don’t have good electronic record keeping systems, so it’s really important that you do provide that patient with that letter so that they can continue to access care.”
Access to biologics and other therapies for severe asthma is limited to those with private health insurance in South Africa as well, Masekela added, as she estimated that fewer than 1% of patients can access them through state care.
Despite these obstacles, Masekela said she remains engaged in her work, which also includes roles as academic head of the department of Pediatrics and Child Health at the University of KwaZulu-Natal and global health professor studying interventions among children with asthma at the Africa Health Research Institute, where she is a faculty member.
“A journey, of course, has its ups and downs,” she said. “But for me, it’s been a great ride because I’ve managed to merge my two passions in both being both a clinician and a researcher.”
Masekela also calls her work leading the Pan African Thoracic Society, which comprises 52 countries, a privilege. As chair of the organization, she was a member of the panel at the ATS conference’s International Women in Pulmonary Leadership Brainstorming and Planning Session.
The session was hosted by ATS fellow Kaharu Sumino, MD, MPH, ATSF, and ATS international health committee chair Samya Nasr, MD, ATSF.
The panel also included Lynn M. Schnapp, MD, ATSF, former ATS president; Judith Garcia-Aymerich, MD, PhD, secretary-general of the European Respiratory Society; Juliana C. Ferreira, MD, PhD, ATSF, member of the Brazilian Thoracic Society; and Fanny Ko, MD, past president of the Hong Kong Thoracic Society.
The discussion provided an opportunity for these leaders to connect with each other and with members of the audience while coming up with ideas for the International Women in Pulmonary CCM workshop.
“It’s actually a privilege and to really try to find ways to support other women, especially in Africa, where there’s a real dire need,” Masekela said. “I’m really, really happy to be part of the process.”
Members of the panel also described the influential roles that mentors played in their careers. Masekela noted the influence that Sonia Buist, MD, ATSF, had on her development. Buist additionally had attended the session.
“Whenever I’ve had some challenges, or I felt locked in my career, she’s always there to bounce off ideas,” Masekela said.
Masekela also called Andrew Bush, MBBS (Hons), a great person whose experience and expertise she values, and she said the late Robin J. Green, PhD, FCCP, was influential too.
“He was a great mentor and a person who really got me involved in the asthma world,” she said.
Looking ahead, Masekela said she will continue to develop research with the Global Asthma Network. For example, she is involved in a clinical trial comparing the efficacy and health economics of tracks one and two of the Global Initiative for Asthma guidelines in younger children.
“If we see that the strategy works in young children, we can then recommend this to policymakers to be adopted as a treatment strategy,” she said.
Masekela also said she will be involved in advocacy, prioritizing access to inhaled medicine since people around the world are unable to afford basic treatment.
“Really working on policy impact is what I’m really passionate about,” she said, “so that we can really change lives of people, not only in my context, but globally.”
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