Auckland asthma expert leads global fight against the disease

In New Zealand more than 521,000 people are taking medicines for asthma − one in nine adults and one in seven children. It causes a death here every week.

Now a University of Auckland academic says the launch of the Global Asthma Report 2018 could improve asthma treatment and reduce deaths both here and overseas.

Today the report is being launched at the General Meeting of the Global Alliance against Chronic Respiratory Diseases of the World Health Organization (WHO) in Helsinki, Finland.

Professor Innes Asher, of the University’s Faculty of Medical and Health Sciences, is Chair of the Global Asthma Network (GAN).

Professor Asher, the Editor in Chief of the report, says the 88 page report is a cutting edge state-of-the-art document, with contributions from 53 experts around the globe, including herself, Philippa Ellwood and Dr Karen Bissell from the Faculty of Medical and Health Sciences at the University of Auckland, who are also members of the Steering Group of GAN. The report is an update on the state of asthma globally, including research on asthma hospital admissions, mortality, prevalence, severity and burden, risk factors and management.

“A large proportion of people in the world with asthma are not getting adequate treatment. Political commitment and action are required to make the burden of asthma a thing of the past,” says Professor Asher.

In New Zealand, more than 3,000 children each year are being admitted to hospital with asthma, and some of these will have had a potentially life-threatening attack. Across all age groups, hospitalisation rates are much higher for Pacific peoples (3.1 times higher) and Māori (2.4 times higher) than for other ethnic groups. Asthma costs New Zealand around $800 million each year.

This report includes 17 chapters, with up-to-date information, and asthma is put in the context of the United Nations Sustainable Development Goals (UNSDG) and the non-communicable disease (NCD) agenda. The report has 22 key recommendations to WHO, Governments, Health Authorities, Health Professionals, Professional Societies and Patient Organisations. These include recommendations to Governments to achieve the UN Strategic Development Goal 3: “ensure healthy lives and promote well-being for all at all ages” to lessen the burden of asthma.

Asthma is a particularly serious burden in low- and middle-income countries which are least able to afford the costs.

Professor Innes Asher

“This is clearly an issue for us in New Zealand where so many people live in poverty and in damp, cold crowded homes which can make asthma much worse.”

“Millions of people suffer from asthma because they do not get access to the medicines that lessen their breathing difficulties. Economies suffer because asthma keeps people away from work, or if they are at work, asthma stops them working effectively. Our recommendations include ways of improving access to essential asthma management in low- and middle-income countries. If the report’s recommendations were followed, the serious burden of asthma globally would be reduced.”

The economic costs of asthma in New Zealand were estimated to be $858 million for 2013; the costs in Europe were 19 billion Euros for 2011.

“Globally, avoidable asthma deaths – about 1000 per day - are still occurring due to inappropriate management of asthma, including over-reliance on reliever medication rather than preventer medication,” says Professor Asher.

Although asthma deaths have fallen a lot in New Zealand since the 1980s, about one person per week dies from asthma here, the report shows that in younger people (5-34 years old) our rate of death from asthma is one of the highest among high income countries.

“Asthma is a particularly serious burden in low- and middle-income countries which are least able to afford the costs.”

Good long-term management can reduce the burden of asthma, including taking steps to detect asthma and treat it earlier.

Professor Asher says other issues include a lack of access to essential and affordable asthma medicines is vital to improving asthma outcomes.

“While our knowledge has increased, the remaining gaps in the data about asthma are significant. New surveys are needed to update asthma trends, assess the burden of asthma, access to effective management and understand the causes,” she says.

“The Global Asthma Network is doing this new study of global surveillance: prevalence, severity, management and risk factors. There are 353 centres in 135 countries involved in some way in GAN, with 127 centres in 53 countries registered to undertake GAN Phase I. This new study is well underway in the Auckland region.”

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