Comprehensive Approach to Lung Health (2005-2008)

The Comprehensive Approach to Lung Health project was funded by the World Bank to look at lung health from an interrelated and holistic, rather than disease-specific, perspective. It built on The Union's experience in delivering health services for tuberculosis and applying this model to other priority conditions.

The goal was to develop an approach that would help low-income countries to reduce their health services costs, improve the quality of these services and avoid unnecessary morbidity and mortality. It aimed at creating synergies between existing health services and eliminating inadequate practices that cause an enormous waste of funds and personnel resources. The prototype created is one that can be sustained, scaled up, folded into routine planning and financing and extended within each of the countries that participated and to others with similar conditions.

The project focused on asthma, child lung health, smoking cessation and indoor air pollution with activities taking place in Benin, China and Sudan.

Specific objectives were to:

• Demonstrate an effective and feasible means to prevent deaths from pneumonia in children under five years of age
• Address adult respiratory diseases by using holistic policies, services and interventions to reduce the impact of tobacco smoking and improve the management of asthma
• Conduct a case-control study of the link between indoor air pollution and tuberculosis in Benin and China
• Publish a monograph outlining steps to address the lung health consequences of indoor air pollution caused by the use of solid fuel in low-income countries
• Prepare a CD containing guidelines and training materials for distribution.

Global Asthma Survey on Practice

In 2003, a working group of The Union's Respiratory Disease Scientific Section initiated the Global Asthma Survey on Practice (GASP) to assess an audit procedure for use in emergency room situations in 13 centres in 11 countries. Patients with acute severe asthma were examined and questioned about the severity of their disease and their treatment in the previous four weeks.

The study revealed that although new treatments and guidelines have improved asthma care, they are being poorly implemented. Access to adequate treatment appears to be the critical factor for improving management of asthma, while more adequate training of physicians in public and private settings is also important. This study was coordinated by Prof Peter Burney, Imperial College, London, UK and Prof Nadia Aït-Khaled of The Union's Asthma Division.