Asthma: WHO Role and Activities
The way forward and the role of the WHO
WHO recognizes asthma as a disease of major public health importance and plays a unique role in the co-ordination of international efforts against the disease. International action is needed to:
- increase public awareness of the disease to make sure patients and health professionals recognize the disease and are aware of the severity of associated problems;
- organize and co-ordinate global epidemiological surveillance to monitor global and regional trends in asthma;
- develop and implement an optimal strategy for its management and prevention (many studies have shown that this will result in the control of asthma in most patients); and
- stimulate research into the causes of asthma to develop new control strategies and treatment techniques.
International Study of Asthma and Allergies in Childhood (ISAAC): WHO collaborates in ISAAC and, more particularly, in the implementation of the study in developing countries with areas of severe air pollution. A preliminary objective is to obtain information on the association between childhood asthma and air pollution. The first results of this study have shown the prevalence of asthma symptoms to vary from 1.6% to 36.8%.
Global Initiative for Asthma (GINA): In 1992, WHO and the US-based National Heart, Lung and Blood Institute jointly formed GINA to cut deaths and disability by developing and implementing an optimal strategy for asthma management and prevention. Since its inception GINA has:
- produced a report covering a range of information detailing all the latest knowledge on causes, the mechanism of the disease, risk factors, management, education and socio-economic factors;
- developed guidelines on asthma management for doctors, nurses, public health officials, patients and their families;
- held workshops to introduce the GINA programme to public health officials and medical professionals in more than 80 countries, leading to implementation of the guidelines;
- been active in disseminating information in 20 languages and bringing together organizations devoted to improving asthma care;
- backed research efforts to improve asthma management.
WHO Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA): WHO is developing a strategy for the prevention of bronchial asthma through the management of allergic rhinitis. The strategy was conceived by specialists from all over the world at a December 1999 meeting on ARIA.
Allergic rhinitis is defined as an allergen-induced inflammation of the membranes lining the nose. Based on the time of exposure to the allergen, allergic rhinitis can be subdivided into perennial, seasonal or occupational disease.
Three statements must be taken into account for the successful prevention of bronchial asthma:
- Among the broad spectrum of allergic diseases, bronchial asthma is the most prevalent, dangerous and life-threatening.
- Underestimated up to now, allergic rhinitis is an important risk factor for asthma.
- One efficient way to prevent bronchial asthma is to control and treat allergic rhinitis from the very beginning of its inception.
Generally speaking, ARIA will broaden the perspectives for primary prevention of bronchial asthma and will promote better understanding of bronchial asthma among physicians and patients.
The specific goals of ARIA are defined as follows:
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- To increase awareness of allergy and allergic diseases as a preventable public health problem among the medical community, public health officials, and the general public;
- To prepare evidence-based guidelines for the prevention and management of allergic rhinitis as a key element of primary prevention of bronchial asthma;
- To educate physicians and other health care professionals about the relevance of allergic rhinitis to bronchial asthma; and
- To educate the public about the potentially fatal risks of allergy (anaphylaxis) and asthma, especially in children, and to encourage greater dialogue with their physicians. Better education and increased dialogue could avoid approximately 25,000 childhood deaths due to asthma each year