This is the sub-theme of this year's (2014) World Asthma Day (WAD), which was first celebrated in 1998 in conjunction with the first World Asthma Meeting in Barcelona. It is an annual event aimed at improving asthma awareness, diagnosis, treatment, and, ultimately, control, and is organized by the Global Initiative for Asthma (GINA) on the first Tuesday of May. The main theme of WAD 2014 continues to be 'You Can Control Your Asthma.'
Asthma is a common chronic non-communicable disease (NCD), affecting more than 300 million people worldwide. It is the most common NCD among children and a major public-health problem in developed as well as developing countries. In Western Europe as a whole, asthma incidence has doubled over the last ten years; USA has seen an increase of over 60% since the early 1980s; while 8% of the Swiss population suffers from asthma as against only 2% some 25-30 years ago.
Although asthma cannot be cured, it can be treated and managed effectively. The severity of asthma can be reduced dramatically, and the person's quality of life significantly improved. Untreated or mismanaged asthma causes unnecessary suffering and disability, putting a significant economic burden on poor families as well as huge financial drain on struggling health systems.
World-wide, the economic costs associated with asthma are estimated to exceed those of TB and HIV/AIDS combined. For example, annual asthma-care costs (direct and indirect) exceed US$6 billion in the USA and are nearly US$460 million in Australia; while Britain spends about US$1.8 billion on health care for asthma and because of days lost through illness.
Asthma control is the focus of the GINA Global Strategy for Asthma Management and Prevention, a comprehensive and practical resource about how to diagnose, assess, and manage asthma. A revised version of this report is being launched on World Asthma Day 2014. "Scientific understanding of what asthma control means and how to achieve it has evolved significantly in recent years," said Mark FitzGerald, MD, Chair of the GINA Board of Directors. "We need a practical strategy for implementing this knowledge to inform patient care worldwide, and that is what GINA aims to provide."
Dr Chiang Chen-Yuan, Director, Department of Lung Health and NCDs at the International Union Against Tuberculosis and Lung Disease (the Union), cited the low affordability of essential asthma medicines as one of the main barriers in providing proper asthma care in low- and middle-income countries. He told Citizen News Service (CNS) that, "Asthma Drug Facility has demonstrated that it is possible to provide essential asthma medicines at affordable price in low- and middle-income countries. Governments should raise sufficient funds, reduce the reliance on direct payments to finance services, and improve efficiency and equity in order to achieve universal health coverage. Meanwhile, the revolving drug fund of asthma may help maintain an uninterrupted supply of essential asthma medicines, which has been demonstrated in Benin."
However, Dr Chen felt that medicines alone will not help solve the problem. He said, "Patients who present themselves to health-care facilities may not be diagnosed, and those who are diagnosed may not be managed properly. Health-care providers need to be trained to provide standard case management of asthma. Asthma projects, piloted by the Union in Benin, China, El Salvador and Sudan, have demonstrated that training of health workers in the use of inhaled corticosteroids, for long-term management of asthma, result in proper asthma control and reduce emergency hospitalization. Countries where asthma patients still have poor access to proper asthma care should adopt this strategy piloted by The Union and partners to reduce suffering and to improve the quality of life of asthma patients."
Dr Karen Bissell, Consultant at The Union, shared with CNS that, "Following important meetings at the United Nations in 2011, countries have been preparing strategies to prevent and manage NCDs, including asthma. However, many health services are finding it a challenge to introduce asthma management into the general health services. Many are still struggling to access quality-assured essential asthma medicines that are affordable for their populations."
So, according to Dr Bissell, there is a need at the global level to increase the commitment of governments and donors to invest in asthma as a means of reducing poverty; implement standardised and effective management of asthma within primary health care and general health services; make essential quality-assured asthma medicines available and affordable for people in low- and middle-income countries; monitor and evaluate quality of care and gain more accurate global estimates about its epidemiological and financial burden.
Shobha Shukla, Citizen News Service (CNS)
(The author is the Managing Editor of Citizen News Service - CNS. She is a J2J Fellow of National Press Foundation (NPF) USA and received her editing training in Singapore. She has earlier worked with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also co-authored and edited publications on childhood TB, childhood pneumonia, Hepatitis C Virus and HIV, violence against women and girls, and MDR-TB. Email: email@example.com, website: www.citizen-news.org)
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