Chronic respiratory diseases programme
The programme focuses on the 2 most common chronic respiratory diseases (CRDs): asthma and chronic obstructive pulmonary disease (COPD). Approximately half a billion people live with asthma and COPD and together these 2 conditions cause almost 4 million deaths every year. More than 1 million of these deaths occur “prematurely” – in people aged under 70 years. 90% of these premature deaths occur in low- and middle-income countries (LMICs).
Our work is mandated by the WHO Global action plan for the prevention and control of noncommunicable diseases 2013–2030 and the United Nations 2030 Agenda for Sustainable Development.
The main focus of our work in the Management of Noncommunicable Diseases unit is the early diagnosis and appropriate treatment of asthma and COPD, particularly in LMICs.
Diagnosis and management
The WHO package of essential noncommunicable (PEN) disease interventions for primary health care has guidance relating to the acute and long-term management of asthma and COPD in resource-limited settings. The interventions recommended in this guidance are also included in the updated Appendix 3 of the WHO Global NCD Action Plan and the UHC compendium.
Specific to children, the Pocket book of hospital care for children (2013) focuses on acute care at first-referral level in low-resource settings and includes guidance on the management of acute asthma exacerbations.
We are working with colleagues in the Child Health and Development Unit to update the guidelines on the management of asthma in children and adolescents, to include both acute and long term care.
We have also collaborated with colleagues working on rehabilitation to develop a module on COPD for the WHO Package of Interventions for Rehabilitation.
In settings with a high tuberculosis (TB) burden, there are particular challenges in the diagnosis of patients presenting with chronic respiratory symptoms and considerable disability caused by post-TB chronic respiratory disease. Building on the Practical approach to lung health, we are working together with the Global TB programme to raise awareness of these issues and develop pragmatic guidance.
The Department of Noncommunicable Diseases, Rehabilitation and Disability is updating WHO guidance for the diagnosis and management of asthma and COPD in primary care. The guidelines are strongly aligned with WHO’s fourteenth general programme of work (2025–2028), specifically strategic objective 3: advance the primary health care approach and essential health system capacities for universal health coverage.
The guidelines are being developed following the WHO handbook for guideline development. Brief biographies of the proposed Guideline Development Group for asthma can be found here, and for COPD can be found here.
Highlights
Related publications
The Package of interventions for rehabilitation outlines the most essential interventions for rehabilitation for 20 health conditions. For each of...
Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred...
WHO package of essential noncommunicable (PEN) disease interventions for primary health care
Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological,...
Global action plan for the prevention and control of noncommunicable diseases 2013-2020
The WHO Global NCD action plan 2013–2020 follows on from commitments made by Heads of State and Government in the United Nations Political Declaration...
Pocket book of hospital care for children: Second edition
This is the second edition of the Pocket book of hospital care for children. It is for use by doctors, nurses and other health workers who are responsible...
The Practical Approach to Lung Health (PAL) is one of the strategies intended to overcome the challenge posed by weak health systems. This initiative is...
Access to essential technology and medicines
The WHO NCD Global Action Plan includes the target of 80% availability of the affordable basic technologies and essential medicines, required to treat major NCDs in both public and private facilities.
However, data collected through the NCD country capacity survey reveals that for low- and low-middle-income countries:
- peak flow meters, the most basic technology included in PEN, are available in 25% of countries
- bronchodilator inhalers, potentially lifesaving emergency treatment, are available in 60% of countries
- steroid inhalers, an essential part of long term asthma treatment, are available in 40% of countries.
We are working to understand the barriers and potential solutions to address this.
Related links
Integration of prevention and control
An integrated approach, including both the prevention and management of asthma and COPD, is required to make progress towards SDG target 3.4 "By 2030, reduce by one third premature mortality from NCDs, through prevention and treatment".
Air pollution
Air pollution (indoor and outdoor) is associated with the development and worsening of CRDs, and improving air quality can result in respiratory health gains. We are collaborating with the Air Quality and Health Unit to develop tools and training for health care providers to help limit the impact of air pollution on people living with chronic respiratory diseases.
Air pollution and health training toolkit for health workersTobacco
Exposure to tobacco smoke is a risk factor for the development of asthma and COPD, and for worsening of existing disease. Smoking cessation has the greatest capacity to influence the lung function decline experienced in COPD. We are working together with the Tobacco Free Initiative to create Tobacco Knowledge Summaries for asthma and COPD, building on previous advocacy publications.
Don't let tobacco take your breath away: choose health, not tobacco, 31 May, World Tobacco Day
New tobacco and asthma knowledge summary
Related publication
Tobacco and chronic obstructive pulmonary disease (COPD)
Surveillance, monitoring and reporting
Data on CRDs is essential to assist policy-makers and managers in health systems planning, delivery, monitoring, and evaluation. Recently developed asthma and COPD indicators, published in the Noncommunicable disease facility-based monitoring guidance: framework, indicators and application, are now being integrated into the DHIS2 (District Health Information Software 2) NCD package.
Data on CRD risk factors is collected through several WHO surveys and presented in the NCD data portal.
- Global Adult Tobacco Survey
- Global Youth Tobacco Survey
- STEPwise approach to NCD risk factor surveillance (STEPS)
The Global Health Observatory also hosts the air pollution data portal.
Noncommunicable disease facility-based monitoring guidance
Global leadership
The Global Alliance against Chronic Respiratory Diseases (GARD) is a WHO-convened global network of stakeholders with a vision of “a world where all people breathe freely”.
Members of the GARD network are committed to reduce the global burden of chronic respiratory diseases (CRDs), focusing on LMICs. Through advocacy and collaborative networking, members are working to ensure all people with asthma and COPD receive a timely diagnosis and can access effective care, and to reduce exposure to risk factors such as tobacco smoke and air pollution.
