Getting asthma onto the global agenda for health and poverty reduction Asthma is one of the most common chronic diseases in the world, currently affecting an estimated 300 million people worldwide.

It has been identified as a major global public health problem and international guidelines exist. However, in low- and middle-income countries, where the majority of the world's asthmatics live, most cases of asthma are undiagnosed, untreated or mismanaged. Although asthma cannot be cured, it can be treated and managed effectively. The severity of asthma can be reduced dramatically, and person's quality of life significantly improved.

When asthma is not treated or is mismanaged, it causes unnecessary suffering, disability and expense.

• People with asthma are less able to work or look after their families, significantly increasing the poverty of these families and their communities.

• Children with asthma are likely to miss much of their primary education, damaging their future prospects.

• The resulting emergency visits, hospitalisations and inappropriate treatments are a huge – and unnecessary – financial drain on struggling health systems. The high cost and low availability of essential asthma medicines are major obstacles to the management of asthma in low- and middle-income countries. A new mechanism has, however, proved that these obstacles can be overcome.

The Asthma Drug Facility (ADF), a project of the International Union Against Tuberculosis and Lung Disease, is helping low-income countries to obtain quality-assured essential medicines at an affordable cost. Through the ADF, the cost of one year of treatment for a patient with severe asthma has already come down to about US $50. In some countries, this is half of what they were paying before the ADF.

What needs to be done globally:

• increase the commitment of governments and donors to investing in asthma as a means of reducing poverty

• implement standardised management of asthma • make essential quality-assured asthma medicines available and affordable for people in low- and middle-income countries

• expand effective asthma management within the general health services

• monitor and evaluate quality of care

• gain more accurate global estimates about the epidemiological and financial burden of asthma

What this would achieve

• reduce unnecessary expense caused by emergency visits, hospitalisations, and ineffective, inappropriate medicines

• improve the quality of life of children and adults with asthma

• improve the ability of health systems to manage patients with chronic diseases

• reinforce international efforts for universal access to all essential medicines

• reduce poverty of individuals, communities and countries