No national asthma management programme, no specific immunotherapy reimbursement, no biological treatments
The GAN Phase I study found that Kosovo is one of the countries with the lowest prevalence of asthma as compared to other countries in the world. However, is this real, or an effect of the avoidance of stigmatisation, both by the family even and by the doctors themselves?
Public Health Plan
We suspect that the problem is probably bigger and is growing, in part due to the increase of air pollution in recent years, especially in the biggest cities. For example, Pristina experiences some of the worst air pollution found in Europe. According to Inside IQ Air, this is largely due to air pollution emissions coming from two coal-fired power plants located close to the capital, on which the country relies for a substantial amount of their power supply and in addition, high rates of indoor solid fuel burning, such as wood and coal. According to the World Bank: “The air pollution in the capital city of Pristina rivals that of big cities like Beijing, Mumbai, and New Delhi. Especially in winter, urban areas face severe smog episodes, caused by the increased demand for heat from the residential and commercial sector, which is mainly provided by burning solid fuels. Such levels of air pollution are unsafe for Kosovo’s population of 1.9 million and cause significant deleterious health impacts”.
Unfortunately, Kosovo does not have a national programme which may help to improve awareness and information about asthma among health care professionals to achieve better treatment adherence. The treatment of patients with asthma in Kosovo was previously carried out only by paediatricians and pulmonologists. But, with the development of the specialisation of allergo-immunology, a greater number of allergists are currently more involved in treatment of asthmatic patients. Their contribution is especially noticeable in preventing the development of allergic asthma, because of administering specific immunotherapy to children and patients diagnosed with allergic rhinoconjunctivitis.
Since 2005, as a member of Global Initiative for Asthma (GINA) assembly, Prof Luljeta Ahmetaj has worked hard to implement the GINA strategy for the management of asthma. In this regard, every year we have organised a national conference, with international participation, around the World Asthma Day in different cities of Kosovo.
Although allergists are doing a good job in treating allergic asthma with specific immunotherapy, very unfortunately this treatment is not reimbursed by our Ministry of Health. Even more dramatically, there is no availability of biological treatments in Kosovo.