Chronic respiratory diseases in developing countries: the burden and strategies for prevention and management.

TLDR

Chronic respiratory diseases pose a major public‑health challenge in developing countries, driven by high prevalence, severity, projected growth, and economic burden, while rising tobacco use strains limited resources. The paper calls for the implementation of smoking‑prevention and standardized asthma and COPD management programs, urging international action to reverse smoking trends and to promote essential drug availability, especially generic inhaled corticosteroids. To make these programs effective, the authors recommend identifying high‑quality generic producers, adding the drugs to national essential‑drug lists and procurement systems, adapting guidelines to local contexts, upgrading district‑level equipment, ensuring low‑price high‑quality drugs, training and supervising health personnel, monitoring performance, and mobilizing professional societies, NGOs, and media to strengthen tobacco control and case management.

Abstract

In developing countries, chronic respiratory diseases represent a challenge to public health because of their frequency, severity, projected trends, and economic impact. Health care planners, for example, are faced with a dramatic increase in tobacco use and must establish priorities for the allocation of limited resources. Nevertheless, smoking prevention and standardized management programmes for asthma and chronic obstructive pulmonary disease should be implemented in developing countries whenever possible. International measures will be required to reverse tobacco smoking trends, and international agencies could define essential drugs and equipment and encourage the use of generic drugs, particularly for corticosteroids inhaled at high dosages. For such programmes to be effective, producers of high-quality generics will need to be identified, and the medications added to national lists of essential drugs and included in procurement procedures. Other recommendations for alleviating the burden of chronic respiratory diseases in developing countries are: adapting guidelines to local contexts and ensuring their distribution; upgrading equipment at district level; purchasing high-quality drugs at low prices; routine training and supervision of health services personnel; and regular monitoring of performance. Social mobilization by professional societies, nongovernmental organizations, and the mass media will also increase government commitment to tobacco control and standardized case management.