Dr Asher listed the common environment factors that have a positive association with asthma and can potentially increase asthma prevalence or make its symptoms worse: "Tobacco smoke exposure, open fire cooking, farm animals, high intensity truck traffic exposure, dampness in homes, fast food intake, obesity, paracetamol/ antibiotic use in first year of life, migration to higher prevalence country or greater family size (severe asthma)." She further said that asthma has an inverse association with "fresh fruits and vegetables intake, and breastfeeding of the child (in first six months of life) in non-affluent countries."
Assumption: All countries have national asthma strategies and management guidelines!
Not surprisingly, with long neglect asthma has faced from governments, national asthma strategies exist in only 23% of 103 countries surveyed in a study. Asthma management guidelines were available in 89% of 103 countries, said Dr Asher.
Dr Steve Graham, who has been advocating for accelerating response to childhood asthma over the years, said to Citizen News Service (CNS): "We know for fact that deaths due to asthma are much more common in resource limited settings, as people are unable to get on inhaled steroids or preventer therapies. Asthma remains a very important but neglected non-communicable disease (NCD) in children and adolescents in the world, there is no doubt about that."
United Nations Secretary General Ban Ki-moon had also said in a review meeting in July 2014 that "The global epidemic of NCDs is a major and growing challenge to development. Each year in developing countries alone, stroke, heart attacks, cancer, diabetes, or asthma kill more than 2 million people between the ages of 30 and 70""
Dr Karen Bissell, a senior consultant with The Union shared that asthma is also prioritised in the WHO Global NCD Action Plan of 2013-2020. The Action Plan has listed 25% reduction target for premature mortality from NCDs and 80% coverage of essential NCD medicines and technologies - we need to look for asthma as well in these targets, said Dr Bissell.
As Millennium Development Goals (MDGs) are about to expire at end of 2015, and new set of sustainable development goals (SDGs) might get adopted in UN General Assembly later this month (for 2015-2030), target 3.4 of draft SDGs aim to reduce premature mortality from NCDs through prevention and treatment and promoting mental health and well being, by one-third. Target 3.8 aims to achieve universal health care (UHC), including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The post 2015 development agenda does present a strong opportunity to push governments to act upon asthma related issues as well.
Barriers to access to asthma medicines
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