Applying The Union model to asthma

The Union's approach to asthma management is adapted from international asthma guidelines and uses a framework based on The Union's model for tuberculosis services. This framework advocates for standard case management, use of simple tools for the diagnosis and classification of the severity of asthma, provision of essential medicines and careful monitoring and evaluation of asthma care.

The Management of Asthma: a guide to the essentials of good clinical practice (3rd edition, 2008) provides a detailed description of this approach. It is based on 12 years of experience and field-testing to ensure that the recommendations are feasible and sustainable in low- and middle-income countries. In conjunction with the guide, The Union offers a technical package for training in standard asthma management.

The Union's evaluation has shown that the main challenges to improving asthma care are:

  • lack of political commitment to fund non-communicable diseases
  • lack of structure or organisation for following up patients with chronic disease
  • high cost of equipment and essential medicines
  • lack of personnel trained to manage asthma
  • health services oriented for acute care are unable to organise the long-term management needed for asthma care.

In working with countries that request technical assistance, The Union seeks to help them address these challenges.

Since the high cost of essential asthma medicines is one of the most frequently cited barriers, The Union established the Asthma Drug Facility (ADF) to make quality-assured essential asthma medicines available and affordable in low- and middle-income countries.