The Newshour with Jim Lehrer recently featured an interview with Dr. Refiloe Matji, HCI's Country Directory for South Africa. The episode aired on the US Public Broadcast System on March 24, 2009, World TB Day.

“The major problem in TB is compliance,” Dr. Matji points out. “If the patient does not adhere to the complete six months of treatment necessary to cure TB, deadly drug resistant strains of TB can develop.”

“Are we saying people who have TB are different than us? They are not.” she says. “Unfortunately, the circumstances in which they live may result in not complying with the full course of treatment.”

TB diagnostic procedures were developed over 100 years ago; new testing procedures are in use but not widely available. Often, a rural clinic must send the sputum to a facility in a faraway city for testing.

Dr. Matji describes the circumstances and challenges facing patients in rural areas who attempt to go to a clinic for testing and treatment: “A patient will walk the distance to the clinic." He is told to return home and come back in a few days. "You are ill. You are in pain…patients end up not coming back and dying.”

Living conditions in South Africa can be conducive to spread of the disease. It can get very cold in the winter, she explains. Therefore, homes with little heat, often do not have windows to provide the sunlight and circulation so important to controlling spread of the bacteria. In these homes, TB can be transmitted very easily.

However, Dr. Matji points out, when a patient begins treatment, infectiousness is reduced. Therefore, she emphasizes, it is critical that other members of the household undergo testing.

International commitment is essential to successfully treat and control TB, Dr. Matji says. She calls for development of new drugs that require a shorter term of treatment:

“It takes six months to cure a patient, which is a long time. Imagine if we were told there was a drug that would cure TB in 5 days.”

Dr. Refiloe Matji is a physician and public health specialist who is passionate about fighting the global threat posed by tuberculosis. She is an authority on TB surveillance, care, and control and has been a leader in raising awareness of TB/HIV co-infection, both in South Africa and internationally. She oversees the USAID Health Care Improvement Project activities in South Africa, Lesotho and Swaziland, where activities focus on strengthening TB prevention and treatment services; a USAID-supported TB project in South Africa; CDC-funded activities on HIV counseling and testing in South Africa, Lesotho and Swaziland; and a USAID-funded project addressing injection safety in Namibia.

Listen to the interview with Dr. Matji. For the March 24, 2009 feature on the spread of TB in South Africa, link to http://www.pbs.org/newshour/bb/africa/jan-june09/southafricatb_03-24.html.

Read a profile on Dr. Matji, published as part of USAID’s Women Making a Difference series.