The Global Asthma Report 2022

Global Asthma Network

References for text, tables and figures

1. Global Asthma Network

Ellwood P, Asher I, Billo N, et al. The Global Asthma Network rationale and methods for Phase I global surveillance: prevalence, severity, management and risk factors. Eur Resp J 2017;49:1601605.

Global Asthma Network Steering Group. Global Asthma Network Website: Global Asthma Network; 2012. Available from: http://www.globalasthmanetwork.org.

Global Asthma Reports. Available from http://globalasthmareport.org/.

Figure source: Global Asthma Network. March 2022.

2. Asthma and Factors Affecting it

Global Initiative for Asthma. Global strategy for asthma management and prevention, 2021. Available from www.ginasthma.org.

Holgate ST. A brief history of asthma and its mechanisms to modern concepts of disease and pathogenesis. Allergy Asthma Immunol Res 2010 July;2:165-171.

Pavord ID, Beasley R, Agusti A, et al. After asthma: redefining airways diseases. Lancet. 2018;391:350-400.

Silverwood R, Rutter C, Mitchell E, et al. Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three due to reverse causation? Clin Exp Allergy 2019;49:430-441.

Weinmayr G, Weiland SK, Björkstén B, et al. Atopic sensitization and the international variation of asthma symptom prevalence in children. Am J Respir Crit Care Med 2007;176:565-574.

Figure source: Weinmayr G, Weiland SK, Björkstén B, et al. Atopic sensitization and the international variation of asthma symptom prevalence in children. Am J Respir Crit Care Med 2007; 176: 565-74.

3. The Global Burden of Asthma

Asher I, Pearce N. Global burden of asthma among children. Int J Tuberc Lung Dis 2014;18:1269-78.

Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021;398:1569-80.

García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries. GAN Phase I study. Eur Respir J 2022 Feb 10;2102866. doi: 10.1183/13993003.02866-2021. Online ahead of print.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1204-1222 and S108-S109.

Mortimer K, Lesosky M, García-Marcos L, et al. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J 2022 Feb 24:2102865. doi: 10.1183/13993003.02865-2021. Epub ahead of print.

Salomon JA, Vos T, Hogan DR, et al. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet 2012;380:2129–2143.

Figures 1 and 2 sources: García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries. GAN Phase I study. Eur Respir J 2022; 2102866. doi: 10.1183/13993003.02866-2021. Online ahead of print;
Lai CKW, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2009; 64: 476–483;
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998; 12: 315-335.

Figure 3 source: Mortimer K, Lesosky M, García-Marcos L, et al. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J 2022; 2102865. doi: 10.1183/13993003.02865-2021.

Figure 4 sources: García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries. GAN Phase I study. Eur Respir J 2022; 2102866. doi: 10.1183/13993003.02866-2021. Online ahead of print;
Mortimer K, Lesosky M, García-Marcos L, et al. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J 2022; 2102865. doi: 10.1183/13993003.02865-2021. Epub ahead of print.

4. Asthma Deaths

Anderson HR, Gupta R, Kapetanakis, et al. International correlations between indicators of prevalence, hospital admissions and mortality for asthma in children. Int J Epidemiol 2008;37:573-582.

Asher I, Bissell K, Chiang CY, et al. Calling time on asthma deaths in tropical regions - how much longer must people wait for essential medicines? Lancet Respir Med 2019;7:13-15.

Chatenoud L, Malvezzi M, Pitrelli A, et al. Asthma mortality and long-acting beta2-agonists in five major European countries, 1994-2004. J Asthma 2009;46:546-551.

Ebmeier S, Thayabaran D, Braithwaite I, et al. Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993-2012). Lancet 2017;390:935-945.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1204-1222 and S108-S109.

Royal College of Physicians (UK). Why asthma still kills. The National Review of Asthma Deaths Confidential Enquiry Report, May 2014. London: RCP, 2014.

Figure 1 sources: WHO Mortality Database updated from http://www.who.int/healthinfo/statistics/mortality_rawdata/en/ [version dated 1 October 2017].
Population denominators from UN World Population Prospects, June 2017 revision http://data.un.org/Data.aspx?d=POP&f=tableCode%3A22 [Accessed 8 January 2018].
Income groups based on the World Bank 2014 definitions https://blogs.worldbank.org/opendata/new-country-classifications [Accessed 11 January 2018].

Figure 2 sources: WHO Mortality Database updated from http://www.who.int/healthinfo/statistics/mortality_rawdata/en/ [version dated 1 October 2017].
Eurostat: http://ec.europa.eu/eurostat/web/health/health-care/data/database [version dated 16 November 2017].

Figure 3 sources: Anderson HR, Gupta R, Kapetanakis V, et al. International correlations between indicators of prevalence, hospital admissions and mortality for asthma in children. Int J Epidemiol 2008;37:573-82.;
Pearce N, Aït-Khaled N, Beasley R, et al. Worldwide trends in the prevalence of asthama symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2007;62:758-66.

Figure 4 source: Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021;398:1569-80.

5. Global Asthma Management and Asthma Control

Akinbami LJ, Salo PM, Cloutier MM, et al. Primary care clinician adherence with asthma guidelines: the National Asthma Survey of Physicians. J Asthma 2020;57:543-55.

Asher I, Bissell K, Chiang CY, et al. Calling time on asthma deaths in tropical regions - how much longer must people wait for essential medicines? Lancet Respir Med 2019;7:13-5.

Bissell K, Ellwood P, Ellwood E, et al. Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014. Int J Environ Res Public Health 2019;16:605.

Bush A. Management of asthma in children. Minerva Pediatr 2018; 70: 444-57.

Knibb RC, Alviani C, Garriga-Baraut T, et al. The effectiveness of interventions to improve self-management for adolescents and young adults with allergic conditions: A systematic review. Allergy 2020;75:1881-98.

Figures 1 and 2 source: García-Marcos L, Chiang C-Y, Asher MI, et al. Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study. Lancet Global Health 2023; 11: e218–28.

6. COVID-19 and Asthma

Abrams EM, Sinha I, Fernandes RM, Hawcutt DB. Pediatric asthma and COVID-19: The known, the unknown, and the controversial. Pediatr Pulm 2020;55:3573-3578.

Chiang C-Y, Ellwood P, Ellwood E, et al. Infection with SARS-CoV-2 among children with asthma: evidence from Global Asthma Network. Pediatr Allergy Immunol. 2022;33:e13709. doi:10.1111/pai.13709.

Papadopoulos NG, Mathioudakis AG, Custovic A, et al. Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multinational cohort. Allergy 2021;76:1765–1775.

Viner RM, Mytton OT, Bonell C, et al. Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis. JAMA Pediatrics 2021;175:143-156.

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323:1239-1242.

Figures 1, 2 and table source: Chiang C-Y, Ellwood P, Ellwood E, et al. Infection with SARS-CoV-2 among children with asthma: evidence from Global Asthma Network. Pediatr Allergy Immunol. 2022; 33:e13709 doi: 10.1111/pai.13709.

7. Asthma in the African region

Baard CB, Franckling-Smith Z, Munro J, et al. Asthma in South African adolescents: a time trend and risk factor analysis over two decades. ERJ Open Res. 2021;7:00576-2020.

Ozoh OB, Aderibigbe SA, Ayuk AC, et al. The prevalence of asthma and allergic rhinitis in Nigeria: A nationwide survey among children, adolescents and adults. PLoS One. 2019;14:e0222281.

Ozoh OB, Eze JN, Garba BI, et al. Nationwide survey of the availability and affordability of asthma and COPD medicines in Nigeria. Trop Med Int Health. 2021;26:54-65.

State of Global Air Report 2020: https://fundacionio.com/wp-content/uploads/2020/10/soga-2020-report.pdf.

South Africa Table sources: Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021;398:1569-80;
Zar HJ, Ehrlich RI, Workman L, Weinberg EG. The changing prevalence of asthma from 1995 to 2002. Pediatr Allergy Immunol 2007;18:560-565.

8. Asthma in the Region of the Americas

Del-Río-Navarro BE, Berber A, Reyes-Noriega N, et al. Global Asthma Network Phase I study in Mexico: prevalence of asthma symptoms, risk factors and altitude associations-a cross-sectional study. BMJ Open Respir Res. 2020 Dec;7:e000658. doi: 10.1136/bmjresp-2020-000658.

Estela DB, Arturo B, Nayely RN, et al. Have asthma symptoms in Mexico changed in the past 15 years? Time trends from the International Study of Asthma and Allergies in Childhood to the Global Asthma Network. Allergol Immunopathol (Madr). 2021 Jan 2;49:1-10. doi: 10.15586/aei.v49i1.35.

http://isaac.auckland.ac.nz/phases/phasethree/results/results.php, 14th December 2021.

https://www.inegi.org.mx/, 14th December 2021.

Larenas-Linnemann D, Salas-Hernández J, Del-Río-Navarro BE et al. MIA 2021, Manejo Integral del Asma. Lineamientos para Mexico [MIA 2021, Comprehensive Asthma Management. Guidelines for Mexico]. Rev Alerg Mex. 2021;68 Suppl 1:s1-s122. Spanish. doi: 10.29262/ram.v68i5.880.

Soto Martinez M, Yock Corrales A, Aglietti F, et al. Change in the prevalence of asthma and rhinitis related symptoms in school-aged children and adolescents in Costa Rica. Eur Respir J 2020 56:3119; DOI 10.1183/13993003.congress-2020.3119.

Tratamiento del asma en edad pediátrica. Guía de Práctica Clínica: Evidencias y Recomendaciones. Mexico, CENETEC; 2020 [fecha de consulta]. Disponible en: http://www.cenetecdifusion.com/CMGPC/GPC-SS-009-20/ER.pdf.

Urrutia-Pereira M, Chong-Neto H, Mocellin LP, et al. Prevalence of asthma symptoms and associated factors in adolescents and adults in southern Brazil: A Global Asthma Network Phase I study. World Allergy Organ J. 2021 Mar 17;14:100529. doi: 10.1016/j.waojou.2021.100529.

9. Asthma in the Eastern Mediterranean Region

Asthma-webpage at KSA MOH-website: https://www.moh.gov.sa/en/awarenessplateform/VariousTopics/Pages/Asthma.aspx.

Chiang C-Y, Aït-Khaled N, Bissell K, Enarson DA. Management of asthma in resource-limited settings: role of low cost corticosteroid/β-agonist combination inhaler. Int J Tuberc Lung Dis 2015;19:129–136.

El Sony A, Chiang C-Y, Malik E, et al. Standard case management of asthma in Sudan: a pilot project. Public Health Action. 2013 Sep 21;3:247–252.

Fazlollahi MR, Najmi M, Fallah Nezhad M, et al. Paediatric asthma prevalence: The first national population-based survey in Iran. Clinical Respiratory J 2019;13:14-22.

Global Initiative for Asthma. Global Strategy for Asthma management and prevention, 2021. Available from: www.ginasthma.org.

http://www.pakistanchestsociety.pk/asthma-guidelines/.

Mallol J, Crane J, Von Mutius E et al. The International Study for Asthma and Allergies in Childhood. (ISAAC phase III) a global synthesis. Allergol Immunopathol (Madr). 2013;41:73-85.

Mohammad Y, Brough G. The impact of conflict on asthma. J Thorac Dis 2019;11:3202-3206. doi: 10. 21037/jtd 2019.07.1.

Mohammad Y, Shaaban R, Salman HA, Shabraq BN, Dubaybo B. improving the quality of hospital care provided for asthma out-patients in a country in turmoil: a report from Syria. J Thorac Dis. 2019;11:1047-1055. doi: 10. jtd.2019.02.76.21037/ .

Mohammad Y, Waked M, Hamzaoui A. (2019) Chronic Respiratory Diseases in the Arab World. In: Laher I (eds) Handbook of Healthcare in the Arab World. Springer, Cham.

To T, Viegi G, Cruz A, et al. A global respiratory perspective on the COVID-19 pandemic: commentary and action proposals. Eur Respir J. 2020;56:2001704.

Sudan Figure 1 source: El Sony A, Chiang C-Y, Malik E, et al. Standard case management of asthma in Sudan: a pilot project. Public Health Action. 2013 Sep 21;3:247–252.

Figures 2 and 3 source: El Sony A et al. The International Multidisciplinary Programme to Address Lung Health and TB in Africa “IMPALA” unpublished.

Table sources: Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021;398:1569-80;
Lai CKW, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2009; 64: 476–483;
The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998; 12: 315-335.

10. Asthma in the European Region

Banteva MN, Manoshkina EM, Sokolovskaya TA, Matveev EN. Trends in incidence and dynamics of chronic pathology in children aged 0-14 in the Russian Federation. Social’nye aspekty zdorov’a naselenia / Social aspects of population health [serial online] 2019; 65(5):10. Available from: http://vestnik.mednet.ru/content/view/1105/30/lang,ru/. (In Rus).

Haahtela T, Herse F, Karjalainen J, et al. The Finnish experience to save asthma costs by improving care in 1987-2013. J Allergy Clin Immunol. 2017;139:408-414.

Ntzounas A, Giannakopoulos I, Lampropoulos P, et al. Changing trends in the prevalence of childhood asthma over 40 years in Greece. Pediatr Pulmonol 2021;56:3242-3249.

World Bank. 2019. Air Pollution Management in Kosovo. World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/33041 (accessed 10/15/2021).

11. Asthma in the South-East Asian Region

Danansuriya MN, Rajapaksa LC, Weerasinghe A. Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study. World Allergy Organization Journal 2015; 8:19.

GBD compare, Viz hub. (2021, June 30). Retrieved from https://vizhub.healthdata.org/gbd-compare/.

Gunasekera KD, Amarasiri DL, Fernando A, Wickramasinghe R, The prevalence of asthma and related atopic diseases in Sri Lankan children from 2001 to 2013 utilizing the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Eur Resp J 2018 52:PA4609; doi: 10.1183/13993003.congress-2018.PA4609.

Nandasena S, Wickremasinghe AR, Sathiakumar N. Respiratory health status of children from two different air pollution exposure settings of Sri Lanka: a cross-sectional study. Am J Ind Med. 2012;55:1137–45.

Senaratne R & Mendis S (Editors). (2018). Prevention and Control of Noncommunicable Diseases: Think Globally - Act Locally; Lessons from Sri Lanka. Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka. ISBN 978- 955 -3666-20 - 8.

Singh V, Gupta R. Influence of a Clinic-Based Group Intervention on Asthma Perception and Management in India. J Asthma & Allergy Educators 2011;2:71-74.

Singh V, Sinha HV, Gupta R. Barriers in the management of asthma and attitudes towards complementary medicine. Respiratory Medicine 2002; 96:835-840.

12. Asthma in the Western Pacific Region

Asher MI, Rutter CE, Bissell K, et al. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet 2021;398:1569-1580.

Asher MI, Stewart AW, Clayton T, et al. Has the prevalence and severity of symptoms of asthma changed among children in New Zealand? ISAAC Phase Three. NZ Medical J 2008; 121, 52-63.

Ding B, Small M. Disease burden of mild asthma in China. Respirology 2018;23:369-77.

Feng ML, Yang ZW, Pan LY, et al. Associations of Early Life Exposures and Environmental Factors With Asthma Among Children in Rural and Urban Areas of Guangdong, China. Chest 2016;149:1030-41.

Foliaki S. Epidemiology of Asthma in Selected Pacific countries. May 2007. https://mro.massey.ac.nz/bitstream/handle/10179/1565/02_whole.pdf?sequence=1&isAllowed=y.

Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet 2019;394:407-18.

Hsieh KH, Shen JJ. Prevalence of childhood asthma in Taipei, Taiwan, and other Asian Pacific countries. J Asthma 1988;25:73-82.

Li J, Wang H, Chen Y, et al. House dust mite sensitization is the main risk factor for the increase in prevalence of wheeze in 13-to-14-year-old schoolchildren in Guangzhou city, China. Clin Exp Allergy 2013;43:1171-79.

Yan DC, Ou LS, Tsai TL, et al. Prevalence and severity of symptoms of asthma, rhinitis, and eczema in 13- to 14-year-old children in Taipei, Taiwan. Ann Allergy Asthma Immunol 2005;95:579-85.

Yeh KW, Chiang LC, Huang JL. Epidemiology and current status of asthma and associated allergic diseases in Taiwan- ARIA Asia-Pacific Workshop report. Asian Pac J Allergy Immunol 2008;26:257-64.

Taiwan Figure 1 source: Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021;398:1569-80.

New Zealand Table source: Asher MI, Rutter CE, Bissell K, et al. Is the worldwide burden of asthma symptoms in school children changing? Global Asthma Network Phase I: repeated cross-sectional studies. Lancet 2021; 398:1569-80.

13. New Approaches with Asthma Medicines

Chiang C-Y, Aït-Khaled N, Bissell K, Enarson DA. Management of asthma in resource-limited settings: role of low cost corticosteroid/β-agonist combination inhaler. Int J Tuberc Lung Dis 2015;19:129–136.

Crossingham I, Turner S, Ramakrishnan S, et al. Combination fixed‐dose beta agonist and steroid inhaler as required for adults or children with mild asthma. Cochrane Database of Systematic Reviews 2021; 5(5):CD013518. doi: 10.1002/14651858.CD013518.pub2.

Global Initiative for Asthma. Global Strategy for Asthma management and prevention, 2021. Available from: www.ginasthma.org.

O’Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled Combined Budesonide–Formoterol as Needed in Mild Asthma. New Engl J Med 2018; 378: 1865-76.

Reddel HK, FitzGerald JM, Bateman ED, et al. GINA 2019: a fundamental change in asthma management. Eur Respir J 2019; 53: 1901046.

14. Asthma in the Context of other Chronic Respiratory Diseases in LMICs.

Allwood BW, van der Zalm MM, Amaral AFS, et al. Post-tuberculosis lung health: perspectives from the First International Symposium. Int J Tuberc Lung Dis 2020 Aug 1;24:820-828.

Knowledge Translation Unit, University of Cape Town. Practical Approach to Care Kit (PACK): PACK overview. https://knowledgetranslation.co.za/pack/.

Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021; 397: 928-40.

van Gassel RJJ, Bels J, Remij L, et al. Functional Outcomes and Their Association With Physical Performance in Mechanically Ventilated Coronavirus Disease 2019 Survivors at 3 Months Following Hospital Discharge: A Cohort Study. Crit Care Med 2021;49:1726-1738.

World Health Organization. Package of essential noncommunicable (PEN) disease interventions for primary health care in low-resource settings. World Health Organization 2010 https://www.who.int/ncds/management/pen_tools/en/.

Figures 1 and 2 source: Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021; 397: 928-40.

15. Improving Access to Essential Asthma Medicines

Ozoh OB, Eze JN, Garba BI, et al. Nationwide survey of the availability and affordability of asthma and COPD medicines in Nigeria. Trop Med Int Health 2021;26:54-65.

Plum C, Stolbrink M, Zurba L, et al. Availability of diagnostic services and essential medicines for non-communicable respiratory diseases in African countries. Int J Tuberc Lung Dis 2021;25:120-125.

Sanyang B, Jagne E, Sefa N, Touray S. Availability, cost, and affordability of asthma and chronic obstructive pulmonary disease medications in The Gambia. J Pan Afr Thorac Soc 2021;2:33-41.

World Health Organization. WHO guideline on country pharmaceutical pricing policies. 2nd ed. World Health Organization, 2020.

World Health Organization. Selection of essential medicines at country level: using the WHO model list of essential medicines to update a national essential medicines list. World Health Organization, 2020.

Figure 1 source: Ozoh OB, Eze JN, Garba BI, Ojo OO, Okorie EM, Yiltok E et al. Nationwide survey of the availability and affordability of asthma and COPD medicines in Nigeria. Trop Med Int Health 2021;26:54-65. Doi:10.1111/tmi.13497.

Figures 2 and 3 source: Plum C, Stolbrink M, Zurba L, Bissell K, Ozoh BO, Mortimer K. Availability of diagnostic services and essential medicines for non-communicable respiratory diseases in African countries. Int J Tuberc Lung Dis 2021;25:120-125.

16. Asthma Management in Low- and Middle-Income Countries

Aït-Khaled N, Enarson DA, Management of Asthma: the essentials of good clinical practice. Int J Tuberc Lung Dis. 2006;10:133-7.

Chiang C-Y, Aït-Khaled N, Bissell K, Enarson DA. Management of asthma in resource-limited settings: role of low cost corticosteroid/β-agonist combination inhaler. Int J Tuberc Lung Dis 2015;19:129–136.

Global Initiative for Asthma. Global Strategy for Asthma management and prevention, 2021. Available from: www.ginasthma.org.

Reddel HK, FitzGerald JM, Bateman ED, et al. GINA 2019: a fundamental change in asthma management. Eur Respir J. 2019; 53:1901046.

WHO Guidelines Approved by the Guidelines Review Committee. Practical Approach to Lung Health: Manual on Initiating PAL Implementation. Geneva: World Health Organization 2008.

17. The Role of Patient Advocacy

Global Partnership to Roll Back Malaria. (2000). RBM advocacy guide. World Health Organization. https://apps.who.int/iris/handle/10665/66634.

Haughney J, Winders TA, Holmes S, et al. Global Quality Standard for Identification and Management of Severe Asthma. Advances in Therapy 2020;37: 3645‐3659.

Mathioudakis AG, Custovic A, Deschildre A, et al. Research Priorities in Pediatric Asthma: Results of a Global Survey of Multiple Stakeholder Groups by the Pediatric Asthma in Real Life (PeARL) Think Tank. J Allergy Clin Immunol Pract 2020; 8:1953-1960.

Os‐Medendorf H, Deprez E, Maes N, et al. The Role of the Nurse in the Care and Management of Patients with Atopic Dermatitis. BMC Nursing 2020;19:102.

Winders T, Maspero J, Callan L, Al-Ahmad M. Perspectives on Decisions for Treatment and Care in Severe Asthma. World Allergy Organization Journal 2021;14:100500.

Winders TA, Wilson AM, Fletcher MJ, et al. A patient-centered description of severe asthma: Patient understanding leading to assessment for a severe asthma referral (PULSAR). Patient 2019;12:539‐549.

18. Asthma, Climate Change and Planetary Health

Clean air statement-International Day of Clean Air for Blue Skies https://www.cleanairblueskies.org/statement/message-international-day-clean-air-blue-skies-un-secretary-general-antonio-guterres.

https://www.ersnet.org/news-and-features/news/ers-publishes-position-statement-asthma-environment/.

Sanson A, Van Hoorn J, Burke S. Responding to the Impacts of the Climate Crisis on Children and Youth. Child Development Perspectives 2019;13:201-207.

United Nations Children’s Fund (UNICEF). Clear the air for children. The impact of air pollution on children. UNICEF October 2016 ISBN: 978-92-806-4854.

World Bank; Institute for Health Metrics and Evaluation. The Cost of Air Pollution: Strengthening the Economic Case for Action. World Bank, Washington, 2016. DC.

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The global epidemic of NCDs is a major and growing challenge to development.

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