The challenges of asthma care in low- and middle-income countries: what’s next?

Complexo Hospitalar Santa Casa de Porto Alegre, Porto Alegre (RS) Brasil. 2. Scientific Committee, Global Initiative for Asthma – GINA – Bethesda (MD) USA. Asthma is a global health concern that affects millions of people worldwide, placing a significant burden on individuals, families, and communities. This chronic respiratory condition can have a profound impact on the quality of life and productivity of the patients. Understanding the global burden of asthma and recognizing the importance of asthma care for all is crucial to address this widespread issue globally. Firstly, it is essential to acknowledge the scale of the problem. Asthma is estimated to affect over 300 million people globally, and its prevalence continues to rise steadily. This chronic disease knows no boundaries and affects people of all ages, races, and socioeconomic backgrounds. From high-income nations to lowand middle-income countries (LMICs), asthma is a universal health challenge that demands attention. (1) The burden of asthma extends beyond individual suffering. Families with asthma members often face emotional, financial, and practical challenges. Frequent visits to healthcare facilities, medical expenses, and the need for ongoing treatment can strain household budgets. Moreover, asthma-related emergencies and hospitalizations can disrupt daily routines, impact education and work, and diminish the overall quality of life for both patients and families.(1) For the 2023 World Asthma Day (May 2), the GINA chose the theme “Asthma Care for All”, acknowledging the importance of initiatives for achieving the best diagnostic and management practices for all patients with asthma, regardless of the country economic development.(2) The majority of the burden of asthma morbidity and mortality occurs in LMICs.(3) Some LMICs report very high rates (up to 90%) of uncontrolled asthma.(4,5) The GINA strives to reduce this burden by encouraging healthcare leaders to ensure the availability of and access to effective, quality-assured medications.(2)