Isaac Report

7/28/2019 Isaac Report

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Matthew Masoli

Denise Fabian

Shaun Holt

Richard Beasley

Medical Research Institute of New Zealand

Wellington, New Zealand

University of SouthamptonSouthampton, United Kingdom

Developed for the Global Initiative for Asthma

TM


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Actions Required toReduce the Burden of Asthma

1. Recognise asthma as an important cause of morbidity,

economic cost, and mortality worldwide.

2. Measure and monitor the prevalence of asthma, and themorbidity and mortality due to asthma throughout the world.

3. Identify and address the economic and political factorswhich limit the availability of health care.

4. Improve accessibility to essential drugs for the management

of asthma in low- and middle-income countries.

5. Identify and address the environmental factors includingindoor and outdoor pollution which affect respiratorymorbidity including that due to asthma.

6. Promote and implement anti-tobacco public healthpolicies to reduce tobacco consumption.

7. Adapt international asthma guidelines for developingcountries to ensure they are practical and realistic in termsof different health care systems. This includesdissemination strategies for their implementation.

8. Integrate the GINA guidelines with other global respiratoryguidelines for children and adults. In this respect, there isa requirement to merge the key elements of the differentrespiratory guidelines into an algorithm for use at the first

point of entry of a respiratory patient's contact with healthservices.

9. Promote cost-effective management approaches whichhave been proven to reduce morbidity and mortality,thereby ensuring optimal treatment is available to as manypersons as possible with asthma worldwide.

10. Research the causation of asthma, primary and secondaryintervention strategies, and management programmesincluding those for use in developing countries.

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Barriers to Reducing the Burden of Asthma (continued)

8. Patient barriers includinga. cultural factors

b. lack of informationc. underuse of self-managementd. over-reliance on acute caree. use of alternative unproven therapies.

9. Inadequate government resources provided for health careincluding asthma.

10. The requirement of respiratory specialists and relatedorganisations required to care for a wide variety ofdiseases, which has in some regions resulted in a failure toadequately promote awareness of asthma.

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Scotland Jersey

Guernsey Wales

Isle of Man England

New Zealand Australia

Republic of Ireland Canada

Peru Trinidad & Tobago

Costa Rica

Brazil United States of America Fiji

Paraguay Uruguay

Israel Barbados

Panama Kuwait

Ukraine Ecuador

South Africa Finland

Malta Czech Republic

Ivory Coast Colombia

Turkey Lebanon

Kenya Germany

France Japan

Norway Thailand Sweden

Hong Kong United Arab Emirates

Philippines Belgium Austria

Saudi Arabia Argentina

Iran Estonia Nigeria

Spain Chile

Singapore Malaysia Portugal

Uzbekistan FYR Macedonia

Italy Oman

Pakistan Tunisia Latvia

Cape Verde Poland

Algeria South Korea Bangladesh

Morocco Occupied Territory of Palestine

Mexico Ethiopia

Denmark India

Taiwan Cyprus

Switzerland Russia China

Greece Georgia

Romania Nepal

Albania Indonesia

Macau

Figure 1:Ranking of the Prevalence

of Current Asthma Symptomsin Childhood by Country (I)

(Written Questionnaire:Self-reported wheezing in the

previous 12 month period,in 13- to 14-year-old children.

See section on Methodological Issues.)

C

ountry

C

ountry

Prevalence of asthma symptoms (%)Prevalence of asthma symptoms (%)

0 5 10 15 20 25 30 35 40

Peru

New Zealand

Australia

Uruguay

Kuwait

United States of America

Canada

Kenya

Chile

Japan

Hong Kong

Paraguay

Singapore

Philippines

Malta

Argentina

France

Pakistan

Spain

Morocco

Thailand

South Africa

Portugal

Malaysia

Austria

Germany

Italy

Sweden

Finland

Lebanon

Taiwan

Bangladesh

Poland

South Korea

Iran

India

Ivory Coast

Estonia

China

Indonesia

Latvia

Russia

Uzbekistan

Albania

Figure 2:Ranking of the Prevalence

of Current Asthma Symptomsin Childhood by Country (II)

(Video Questionnaire:Positive response to clinical asthma scene,

in 13- to 14-year-old children.See section on Methodological Issues.)

0 5 10 15 20 25 30


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Scotland 18.4Jersey 17.6Guernsey 17.5Wales 16.8Isle of Man 16.7England 15.3New Zealand 15.1Australia 14.7

Republic of Ireland 14.6Canada 14.1Peru 13.0Trinidad & Tobago 12.6Costa Rica 11.9Brazil 11.4United States of America 10.9Fiji 10.5Paraguay 9.7Uruguay 9.5Israel 9.0Barbados 8.9Panama 8.8Kuwait 8.5Ukraine 8.3Ecuador 8.2South Africa 8.1Czech Republic 8.0Finland 8.0Malta 8.0

Ivory Coast 7.8Colombia 7.4Turkey 7.4Lebanon 7.2Kenya 7.0Germany 6.9France 6.8Norway 6.8

Japan 6.7Sweden 6.5Thailand 6.5Hong Kong 6.2Philippines 6.2United Arab Emirates 6.2Belgium 6.0Austria 5.8Spain 5.7Saudi Arabia 5.6Argentina 5.5Iran 5.5Estonia 5.4Nigeria 5.4Chile 5.1Singapore 4.9Malaysia 4.8Portugal 4.8Uzbekistan 4.6FYR Macedonia 4.5

Italy 4.5Oman 4.5Pakistan 4.3Tunisia 4.3Cape Verde 4.2Latvia 4.2Poland 4.1Algeria 3.9

South Korea 3.9Bangladesh 3.8Morocco 3.8Occupied Territory of Palestine 3.6Mexico 3.3Ethiopia 3.1Denmark 3.0India 3.0Taiwan 2.6Cyprus 2.4Switzerland 2.3Russia 2.2China 2.1Greece 1.9Georgia 1.8Nepal 1.5Romania 1.5Albania 1.3Indonesia 1.1Macau 0.7

C

ountry

Prevalence of asthma symptoms (%)

Figure 4:

World Map of the Prevalence of Clinical Asthma

10.1

7.6-10.0

5.1-7.5

2.5-5.0

0-2.5

No standardised data available

Proportion of population (%)*

0 5 10 15 20 25 30

Wales

Australia

Scotland

Republic of Ireland

Canada

Estonia New Zealand

United States of America

England

Malta

Norway

Denmark

Spain

Poland

Sweden

Finland

Netherlands

Portugal

Iceland

Germany

Switzerland

Turkey

Belgium

Greece

France

Austria

Argentina

Costa Rica

Thailand

Romania

Italy Hong Kong

Colombia

Albania

Bangladesh

Algeria

India

Ethiopia

Taiwan

Gambia

Tunisia

Figure 3:Ranking of the Prevalence ofCurrent Asthma Symptoms in

Adults by Country(Written Questionnaire:

Self-reported wheezing in the previous12 month period, in 20- to 44-year-old adults.

See section on Methodological Issues.)

See section on Methodological Issues.


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of years of life lost to that of years of healthy life lost, representing ahealth gap measure which incorporates both loss of life and the lossof quality of life. This allows a composite measure of the burden ofboth fatal and non-fatal disease. As a result, the years lost to

disability (YLD) is added to the years of life lost to prematuremortality (YLL) to yield an integrated unit of health - the "disability-adjusted life-year" (DALY), with one DALY representing the loss ofone year of healthy life. The DALYs lost due to asthma worldwide in2001 are presented, together with the 30 leading causes of DALYs.These data were obtained from the recently published WHO WorldHealth Report 2002.

E. Populations with Regular Access to Essential Drugs

The world map documenting the percentage of the population ineach country with regular access to essential drugs was reproducedfrom the WHO World Health Report 1998.

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