Respiratory disease has never received priority in relation to its impact on
health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and
developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone
affects more than 100 million persons in the world and the majority of them live in
developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have
been adopted and their cost-effectiveness demonstrated in industrialized countries.
As resources are scarce in developing countries, adaptation of these guidelines using only
essential drugs is required. It remains for governments to set priorities. To make these choices, a
set of criteria have been proposed. It is vital that the results of scientific investigations are
presented in these terms to facilitate their use by decision-makers. To respond to this emerging public
health problem in developing countries, WHO has developed 2 initiatives: “Practical Approach to Lung Health
(PAL)” and the Global Alliance Against Chronic Respiratory Diseases (GARD)”, and the
International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative
to increase affordability of essential asthma drugs for patients in developing countries termed the
“Asthma Drug Facility” (ADF), which could facilitate the care of patients living in these
parts of the world.