Management of chronic respiratory diseases
Overview
Chronic Respiratory Diseases (CRDs) represent a growing public health concern in the WHO South-East Asia Region, accounting for approximately 12% of all deaths. The two primary conditions—Chronic Obstructive Pulmonary Disease (COPD) and asthma—contribute significantly to disability, premature mortality, and economic burden across the region. In 2021, CRDs caused approximately 1.56 million deaths in the region, with COPD accounting for nearly 1.24 million and asthma for 254,834 deaths. Alarmingly, 37% of these deaths occurred before the age of 70.
Main risk factors of CRDs belong to environmental, behavioural, and metabolic categories. In the region, air pollution is the most important risk factor and remains a major concern with annual average PM2.5 concentrations exceeding WHO guidelines by nearly ninefold. Household use of polluting fuels such as biomass and coal is still a concern in many countries of the region contributing to indoor air pollution and disproportionately affecting women and children. Tobacco use remains highly prevalent along with exposure to second-hand smoke in the region. Occupational exposure to dust and fumes—especially in informal sectors like mining, construction, and agriculture also poses a significant risk.
Besides prevention of risk factors, effective health system responses to CRDs need to be prioritize for accessible, integrated, and equitable management across the continuum of care thus reducing associated morbidity and mortality
In terms of existing WHO technical guidance for prevention and management of CRD, the Implementation Roadmap for the Global Action Plan for the Prevention and Control of NCDs (2013–2030) provides an updated menu of policy options and cost-effective recommendations to reduce risk factors and improve the management of including:
Acute treatment of asthma exacerbations using inhaled bronchodilators and oral steroids.
Acute treatment of COPD exacerbations using inhaled bronchodilators and oral steroids.
Long-term management of COPD with inhaled bronchodilators.
WHO package of essential noncommunicable (WHO PEN) disease interventions for primary health care provides an integrated approach to strengthen NCD care services including CRDs in primary health care.
