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How will we avert asthma deaths without definitive diagnostics and universal access to effective treatment?

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Quality-assured asthma inhalers, that are essential to well-managed asthma, are either not available or are prohibitively expensive. The Global Asthma Insights and Reality surveys reported that less than 20% of patients with moderate-severe asthma use inhaled corticosteroid. Another barrier is that the health services lack the strategy, systems and trained staff for providing good asthma care.

According to another study, the availability and procurement of asthma inhalers was very poor in the public sector (which is the primary source of medicines for poor populations), while in the private sector the availability of salbutamol inhaler was better than that for corticosteroid inhalers. A limited number of studies relating to quality of treatment and prescription audits for asthma also showed irrational prescribing, poor asthma knowledge by doctors and poor quality of care for asthma patients.

Dr Kevin Mortimer, who is also the honorary faculty at the Malawi School of Medicine, said that "Inhaled steroids are on the WHO essential medicines list too. Yet inhaled steroids remain out of reach for many of the world's poor who have asthma. Basic effective treatments prevents asthma deaths."

When will universal access to asthma care become a reality?

Making universal access to standard asthma treatment and care a reality is a public health imperative. "How else will governments deliver on their promises to avert premature deaths due to NCDs including asthma? Research for definitive diagnostics of asthma needs to be scaled up alongside ensuring that effective asthma treatment is within reach of everyone in need. Governments have committed to achieve universal health coverage as well as provide social protection" said Rahul Dwivedi, Campaign Director of Vote For Health.

Chakatip Kiatduriyakul, a finance expert who lives in northern Thailand, had developed asthma when she was 6 years old. She has successfully managed her asthma for years. She shared "When the symptoms start, it is best to take medication right away otherwise it can get worse quickly. The medication is free since I have social security. I think it is important to have medication available all the time."

Undoubtedly strengthening health systems and ensuring universal health coverage becomes a reality are major priorities more so in contexts of low- and middle-income nations. Social protection is also among one of the SDGs. The time is over ripe to translate these political commitments into public health and social justice gains.

Professor (Dr) Surya Kant, who is also the Vice President of National College of Chest Physicians India, said "Inhalers are just like spectacles. If your bronchial tubes are weak, use an inhaler in the same way as you would use spectacles if your eyes are weak. As one brushes the teeth daily, so also an asthma patient needs to take the inhaler daily in the morning and evening. This will help control asthma very effectively."

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