Aït-Khaled Nadia, Enarson Donald A, Ottmani Salah, El Sony Asma, Eltigani Mai, Sepulveda Ricardo
International Union Against Tuberculosis and Lung Diseases, Paris, France.
Int J Chron Obstruct Pulmon Dis. 2007;2(2):141-50.
Respiratory disease has never received priority in relation to its impact on health. Estimated DALYs lost in 2002 were 12% globally (similar for industrialized and developing countries). Chronic airflow limitation (due mainly to asthma and COPD) alone affects more than 100 million persons in the world and the majority of them live in developing countries. International guidelines for management of asthma (GINA) and COPD (GOLD) have been adopted and their cost-effectiveness demonstrated in industrialized countries. As resources are scarce in developing countries, adaptation of these guidelines using only essential drugs is required. It remains for governments to set priorities. To make these choices, a set of criteria have been proposed. It is vital that the results of scientific investigations are presented in these terms to facilitate their use by decision-makers. To respond to this emerging public health problem in developing countries, WHO has developed 2 initiatives: "Practical Approach to Lung Health (PAL)" and the Global Alliance Against Chronic Respiratory Diseases (GARD)", and the International Union Against Tuberculosis and Lung Diseases (The Union) has launched a new initiative to increase affordability of essential asthma drugs for patients in developing countries termed the "Asthma Drug Facility" (ADF), which could facilitate the care of patients living in these parts of the world.
呼吸系统疾病对健康的影响从未得到过应有的重视。2002年全球估计损失的伤残调整生命年（DALYs）为12%（工业化国家和发展中国家情况相似）。仅慢性气流受限（主要由哮喘和慢性阻塞性肺疾病导致）就影响着全球超过1亿人，其中大多数生活在发展中国家。哮喘管理国际指南（GINA）和慢性阻塞性肺疾病管理国际指南（GOLD）已被采用，且在工业化国家证明了其成本效益。由于发展中国家资源稀缺，需要采用仅使用基本药物的方式来调整这些指南。政府仍需确定优先事项。为做出这些选择，已提出了一套标准。至关重要的是，科学调查结果应以这些标准呈现，以便决策者使用。为应对发展中国家这一新兴的公共卫生问题，世界卫生组织制定了两项举措：“肺部健康实用方法（PAL）”和全球抗击慢性呼吸道疾病联盟（GARD），国际防痨和肺部疾病联盟（防痨联盟）发起了一项新倡议，以提高发展中国家患者基本哮喘药物的可及性，该倡议称为“哮喘药物设施”（ADF），这可能有助于为世界这些地区的患者提供护理。
