Revaz Vachnadze from Georgia chain smoked for many years. In the 1990s, he began experiencing severe chest pain, which doctors diagnosed as angina pectoris, a type of heart pain. What they did not check at the time were his lungs. Today, the 84-year-old university lecturer remembers this as the turning point that led to a significant deterioration in his health years later.
10 years without treatment
“For 10 years, I was treated for heart disease without anyone considering that something might be wrong with my lungs,” Revaz recalls. “It wasn’t until a regular therapist suggested a lung check that I was finally diagnosed with COPD – chronic obstructive pulmonary disease.”
By the time he underwent spirometry and saw a pulmonologist, Revaz’s lung capacity had dropped significantly. “They told me my lung capacity was down to 20–40%. My condition today is much worse than it was 30 years ago, not just because I’ve aged but because of all the years without treatment.”
Revaz’s experience is far from isolated. According to a new report by WHO/Europe and the European Respiratory Society (ERS), over 80 million people in the WHO European Region live with a chronic respiratory disease (CRD), many without knowing it. CRDs include conditions such as asthma and COPD, which are responsible for nearly 400 000 deaths each year and cost the Region more than US$ 21 billion annually.
CRD treatment and care: early diagnosis is key
Revaz’s COPD, a serious chronic lung condition commonly caused by tobacco use and air pollution, makes everyday tasks a struggle. Climbing stairs or feeling emotional can trigger shortness of breath and heart palpitations.
“Only my inhalers make me feel better,” he says. “But inhalers don’t cure the disease, they only help manage the symptoms. If I had started this treatment earlier, my symptoms could have been better controlled.”
His story underscores the importance of early diagnosis and a holistic approach in medicine. “Doctors need to look at the whole picture, not just the field they specialize in,” Revaz points out. “We need better awareness, and it must start in schools. Children should be taught early about the dangers of smoking so they can make informed choices. This is how we reduce CRD cases in the long run.”
A broader crisis: new report reveals the scale of CRDs
The new WHO/Europe–ERS report on CRDs paints a sobering picture: despite being preventable and treatable, diagnostic tools such as spirometry are not widely available, and many health professionals lack the training to detect early signs. Patients – especially in lower-income areas – often go untreated until their lung disease has progressed significantly.
“This report shows that chronic respiratory diseases, which affect 81.7 million people in the WHO European Region, have long been overlooked due to insufficient policy focus and underfunding. This neglect has led to underdiagnosis, misdiagnosis and incomplete data,” emphasizes Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
“To change this, we must strengthen health systems by making care for chronic respiratory diseases a core part of broader strategies for addressing noncommunicable diseases.”
Policies that protect lung health
Tobacco use and air pollution are the leading risk factors for CRDs. With more than 25% of adults in the Region still smoking, and youth increasingly exposed to e-cigarettes and other novel nicotine products, prevention policies remain a critical area for intervention.
WHO/Europe is calling on governments to:
- integrate CRD prevention and care into national health strategies
- tackle root causes
- improve training and tools for early diagnosis
- invest in data, rehabilitation and palliative care.
As countries prepare for the 2025 High-level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases and the Promotion of Mental Health, Revaz’s story speaks to the urgent need for better policies, early detection and comprehensive public health education to save lives across the Region and beyond.