Views from the London School of Hygiene & Tropical Medicine

Asthma: a neglected epidemic

Asthma inhalerProfessor Neil Pearce, Director of the Centre for Global NCDs at the London School of Hygiene & Tropical Medicine and member of the Global Asthma Network, makes the case for an increase in asthma surveillance and research.

Proposals to tackle non-communicable diseases (NCDs) will do little to prevent or control asthma despite the burden of the disease increasing rapidly as the world becomes more westernised.

Writing in The Lancet, Professor Neil Pearce and colleagues say that although asthma is a chronic respiratory disease and is therefore key in global NCD prevention, it rarely causes deaths in adults and proposed interventions will have little impact on it.

Priority has been given to reducing the number of adult deaths from four major NCDs: cardiovascular disease, diabetes, cancer and chronic respiratory disease. Interventions include tobacco control, salt reduction, improved diets and physical activity, reduction in hazardous alcohol intake, and essential drugs and technologies.

The authors say: “Tobacco control and essential medicines can be expected to help prevent exacerbations, and improved diets might lessen asthma severity, but these are only a small part of what is needed for improved global asthma control.

“Asthma afflicts individuals, families, and society by causing symptoms and morbidity, but it rarely causes death. Thus NCD targets focused largely on preventing deaths are inappropriate for asthma. People with symptomatic asthma lose time off school or work and are less productive, with direct and indirect costs to themselves and society. Asthma most commonly starts in childhood, which is not a target age group of the NCD agenda.”

The authors also express concerns that “the global burden of asthma, which is already substantial both in terms of morbidity and economic costs, seems to be increasing rapidly as the world becomes more westernised” and call for asthma to be made an explicit global-health priority, with new research and policy initiatives “before the rest of the world begins to have the levels of asthma prevalence and morbidity currently present in high income countries”.

Read the full Lancet article online

Image: asthma inhaler. Credit: Jenny Rollo

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