Building awareness of chronic respiratory disease and other NCDs
The Union has joined international efforts to raise awareness of the threat caused by the increase in non-communicable diseases as a partner in the Non-Communicable Disease (NCD) Alliance with the World Heart Federation, International Diabetes Federation and the Union for International Cancer Control. NCDs, including not only chronic respiratory diseases, but also cancer and diabetes, are under-recognised and under-funded by health systems. As the burden of disease in low- and middle-income countries begins to shift from infectious diseases to non-communicable diseases, this issue is a major public health challenge.
Many of these diseases, such as diabetes and tuberculosis, are linked, creating complex challenges for health care systems. It is The Union's goal to help meet these challenges and find health solutions for the poor. Learn more at www.ncdalliance.org
Diabetes: heading off a new co-epidemic
In the past 25 years, managing the co-epidemics of HIV and tuberculosis has presented an enormous challenge for health systems in low- and middle-income countries. In the 21st century, a new kind of co-epidemic is looming, created by the dramatically increasing number of people with diabetes.
Global data shows that diabetes increases the risk of tuberculosis by a factor of 2-3. With an estimated 387 million diabetic patients worldwide in 2014 and the number predicted to grow to 592 million by 2030, the diabetes epidemic threatens to cause an escalation in TB incidence as well as complicate the management of the disease. Read more.
Child Lung Health: Addressing respiratory diseases in children
Child lung health has been a focus of The Union for the past 15 years. In addition to developing a method to improve the care and outcome for children under five years of age with pneumonia, The Union has supported the development of guidelines for management of child TB, TB/HIV, HIV-related lung disease and asthma.
Applying The Union model to asthma
Asthma is a chronic, non-communicable lung condition affecting 235 million people worldwide. Asthma was once found predominantly in industrialised countries, and now, over the past 20 years, has become an increasingly widespread problem in low- and middle-income countries, particularly in urban areas. While asthma is not curable, it can be managed, and most of the 250,000 deaths that occur each year can be attributed to poorly managed care.
Over the past 15 years, helping low- and middle-income countries manage asthma has been one of The Union's priorities. The Asthma Division has developed an approach to asthma management that is based on The Union's successful approach to tuberculosis and produced a guide outlining its recommendations. Read more.
Reducing the lung health risks from indoor air pollution
Some 50% of the world's population uses solid fuels for cooking, light and heat. Most widely used in low- and middle-income countries, these fuels include not only coal, but also wood, dung, straw and agricultural waste. Combustion of these fuels releases a variety of pollutants, and exposure to these pollutants is a significant risk factor for a number of lung diseases. Each year an estimated 1.5 to 2 million deaths are attributable to indoor air pollution.
Since women and young children spend the greatest amount of time in the home, there is strong evidence of an association between exposure to solid fuel smoke and acute lower respiratory infections in young children and chronic obstructive pulmonary disease (COPD) and lung cancer in women. Men have been found to be at moderate risk for COPD and lung cancer, primarily from exposure to coal smoke.
As part of a World Bank-funded project, The Union conducted a case control study on the association between indoor air pollution and tuberculosis in Benin and China and developed a monograph on this issue. Read more.
Smoking cessation for TB patients
Pilot projects in Bangladesh, Benin, China and Sudan have shown the benefit of offering smoking cessation in conjunction with TB services. Smoking Cessation and Smokefree Environments for Tuberculosis Patients is a Union guide that presents an intervention, which can be implemented within the DOTS (Directly Observed Treatment, Short course) strategy to help patients quit smoking and make their homes smokefree.