As the world continues to battle the respiratory pandemic, it is important to remember that long before the COVID-19 pandemic began, millions of people around the world have been struggling with chronic respiratory diseases, such as asthma. Breathing is something that most of us take for granted, but for asthma, can always be a source of fear and anxiety. In India, nearly 90% of asthma patients do not receive adequate treatment, which is alarming given the country has over 34 million people with asthma, and 42% of deaths from asthma in the world occur in India. The high disease burden disproportionately affects the quality of life and causes school and work absenteeism for asthma patients and results in significant loss of productivity.
Understanding the Problem
Asthma is a complex condition of the airways of the lungs that affects people of all ages, races, and socioeconomic backgrounds. It is characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. These symptoms can range from mild to severe, and they can occur at any time, and often come with little or no warning. However, due to a lack of awareness, education, and support, many people continue to struggle with the condition. To effectively manage asthma, it is essential to understand the “what,” “when,” and “how” of the disease.
In India, a vast majority of asthma patients do not use their inhalers correctly, leading to poor asthma control and an increased risk of exacerbations. According to a Lung India report from 2022, the total use of inhalers by asthma patients in India is estimated between 6.8% and 10.3%, suggesting almost 90% underuse of Inhaled Corticosteroids (ICS). This highlights the pressing need for better diagnosis, awareness, and adherence to treatment. There are various patient support programs that have been launched to address the issue, including a digital asthma educator platform that assists healthcare professionals. It helps their patients to understand the inhaler technology, correct inhalation technique and better ways to manage their ailment. Such platforms and programs are an effective tool for improving patient inhalation techniques and effective asthma management among patients.
There’s Still Hope
The Indian Government has also taken several initiatives to combat the epidemic, such as the National Clean Air Programme (NCAP), launched in 2019, that aims to reduce particulate matter pollution by 20-30% by 2024. In addition, the Indian Council of Medical Research (ICMR) launched a project to set up specialized asthma clinics in district hospitals across the country. These clinics aim to improve access to diagnosis and treatment for patients with asthma and other respiratory conditions.
Healthcare professionals have also made strides towards adopting evidence-based recommendations for asthma diagnosis and management, such as the Global Initiative for Asthma (GINA) guidelines. Various organizations like the World Asthma Foundation and the Global Asthma Network have also been actively engaged in promoting asthma awareness and advocacy in India.
Bridging the Gap
Diagnosis, awareness, and adherence will continue to remain the cornerstones in managing asthma. We are in the right direction in our collective efforts to address the epidemic. Yet, there is quite a bit of ground to cover to achieve equitable treatment and prevention opportunities in an inclusive manner for India’s vast and growing population. Regular spirometry tests, or the non-invasive Fractioned Exhaled Nitric Oxide (FeNO) and Forced Oscillation Technique (FOT) that offer better diagnosis of asthma, should be made readily available for improved diagnosis.
Digital mediums such as social media platforms and video-sharing apps should also be leveraged to raise awareness, dispel myths and educate people about asthma. Industry and healthcare professionals should collaborate to build more patient support platforms, such as a unique digital asthma educator platform that assists healthcare professionals in helping their patients understand the correct inhalation technique and better ways to manage their ailment.
It is crucial for all stakeholders in the healthcare industry to come together to raise awareness of the latest innovations that can improve asthma care. Industry players have introduced inhalers with novel triple-drug fixed-dose combinations (FDC) and Bluetooth-enabled inhalation devices that can significantly enhance therapy adherence. Therefore, it is the collective responsibility of pharmaceutical industry stakeholders, regulators, policymakers and government to work together to create a comprehensive public health infrastructure that improves access to asthma care, from prevention to diagnosis to treatment.
World Asthma Day is a reminder of the millions of people worldwide living with this chronic condition. We need to disassociate from the stigma that surrounds it and focus on promoting awareness, understanding, and empathy. Together, let’s ensure equitable access to treatment, commit to “Asthma Care for All” and create a world where asthma does not limit anyone’s potential.
This article was first published in the Economic Times on May 2, 2023