Chronic obstructive pulmonary disease (COPD) now causes a large share of global deaths: more than 3.5 million people die each year, COPD accounts for about 5 per cent of deaths worldwide and it is the fourth leading cause of death. The main conditions are emphysema and chronic bronchitis.
About 90 per cent of COPD deaths occur in low- and middle-income countries, where diagnostic capacity is limited, specialist care is scarce and access to essential medicines is unequal. Primary healthcare systems are often overstretched and recommended combination inhalers can be unavailable or unaffordable.
Treatment has specific challenges. The recommended therapy for asthma and some chronic respiratory cases is a combination inhaler: a bronchodilator to open the airway plus a corticosteroid to reduce inflammation. Too often patients receive only a reliever inhaler, which gives short-term relief but does not control the disease. WHO will publish updated guidelines next year with input from experts in low- and middle-income countries.
Reductions in foreign aid have also weakened care because some clinics and trained staff who could detect and treat chronic conditions lost funding. Building capacity needs training, fair pay and roles that keep specialists working in public systems.
Difficult words
- chronic — Long lasting or continuing for a long time.
- obstructive — Blocking or limiting the normal flow of air.
- pulmonary — Related to the lungs and breathing.
- emphysema — A lung condition that damages air sacs.
- bronchitis — Inflammation of the tubes that carry air.
- diagnostic — Related to finding and identifying a disease.
- specialist — A health worker with advanced training in one area.specialists
- inhaler — A device that delivers medicine into the lungs.inhalers
- bronchodilator — A medicine that opens the airways in lungs.
- corticosteroid — A medicine that reduces inflammation in the body.
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How do limited diagnostic capacity and scarce specialist care affect patients in low- and middle-income countries?
- What changes could make combination inhalers more available and affordable in primary healthcare?
- Why are training, fair pay and defined roles important to keep specialists working in public health systems?
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