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New global estimates illustrate vast impact of two most common chronic respiratory diseases – expert comment

In 2015 chronic obstructive pulmonary disease (COPD) caused 3.2m deaths and asthma 0.4m deaths worldwide, according to a new global burden of disease study published in The Lancet Respiratory Medicine.

Led by researchers from the Institute of Health Metrics and Evaluation, University of Washington, the study found that asthma is the most common chronic respiratory disease worldwide, with twice the number of cases of COPD in 2015, but that deaths from COPD were eight times more common than deaths from asthma.

COPD is a group of lung conditions (including emphysema and chronic bronchitis) that cause breathing difficulties. Many cases of asthma and COPD can be treated or prevented with affordable interventions, but people are often left undiagnosed, misdiagnosed or undertreated. 

The study estimates that while overall prevalence and death rates have reduced since 1990, population growth and the ageing population mean that the numbers have increased. The number of deaths from COPD increased by 11.6% between 1990 and 2015 (from 2.8m to 3.2m deaths), and the number of cases increased by 44.2% (from 121m to 174.5m cases). Comparatively, deaths from asthma reduced by 26.2% (from 0.55m to 0.4m deaths) but prevalence increased by 12.6% (from 318.2m to 358.2m) over the same time period. 

So why are asthma rates increasing and what can be done to reverse this trend? Professor Neil Pearce from the London School of Hygiene & Tropical Medicine is leading Phase I of the Global Asthma Network which is launching its first global surveillance of asthma prevalence and management. He said:

“This study is a timely reminder that we must refocus our efforts to combat this dangerous disease. Although the number of deaths from chronic obstructive pulmonary disease has increased, we do know what causes it and how to stop it, so prevention efforts can be targeted. Sadly this is not the case for asthma.

“The number of people with the condition has increased in low- and middle-income countries over the last two decades. The tools to treat asthma are already available and the obstacles to well-managed asthma can be overcome. However, we still know very little about the causes of asthma, and why rates are increasing worldwide. This means many of the estimated 334 million people with the disease go undiagnosed or receive poor or inadequate treatment – a situation that can lead to diminished quality of life, disability and even death.

“We urgently need more information on the prevalence, burden and current management practices of asthma worldwide. This is essential to developing better asthma prevention and control.”