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Asthma Management

An Adult and Child Lung Health scientific section working group

Working Group goal:

To develop and promote a strategic policy agenda on quality improvement package for the diagnosis, treatment and management of asthma

Background:

With a mandate to bridge the gap between the scientific disciplines related to tuberculosis (TB) and lung health; the Union adapted the TB model for the management of Asthma, and worked with partners to implement comprehensive lung health project funded by the World Bank.

The idea of The Union’s Comprehensive Approach to Lung Health, was the adaptation of the TB model and apply the DOTS principles for the management of patients with chronic airflow limitations”.  Pilot projects in Benin, China, El Salvador and Sudan generated valuable lessons on implementing standard case management for asthma and reducing the cost of medicines as a barrier to asthma treatment in resource limited settings. 

It is a comprehensive package where The Union designed ADF and provided countries with procurement and quality assurance services, as well as technical support related to selecting, quantifying, managing and using essential asthma medicines. These services were accompanied by The Union’s technical guidance about how to establish asthma programmes in the general health services and generate data for quality improvement and policy advocacy. The technical guidance included tools (The Union’s asthma guidelines to diagnose and treat asthma with a combination of inhaled bronchodilators and corticosteroids, training materials and information system) and assistance with programme evaluation’ quarterly reports.

Objectives:

The objectives of the working group are to:

  1. Sustain a platform of discourse and exchange of experiences and propositions among members regarding the management of Asthma.
  2. Conduct an online survey on “Asthma Management Situation” for countries interested in The Union Model and write a report/publish the survey results.
  3. Assemble and deliver special sessions on Asthma management at the Union World Conference on Lung Health in 2024/27.
  4. Review the Asthma training Materials and The Union Asthma Guideline.
  5. Develop a course for young Union consultants on Asthma management related to the Union Model.
  6. Conduct a multi-country pilot/ revive the existing in-country experiences
  7. Fund raising: explore the feasibility of using the member states call for integrating the prevention and control of non-communicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes.  

Activities:

In order to attain the objectives specified above, the Working Group will perform the following activities:

  1. Assemble and maintain an electronic mail group (e.g., Google Group, drag) of interested researchers and practitioners from the Union members and collaborators to discuss the above objectives.  An effective and instantaneous communication will be sustained with all the members by the WG leaders and co-leaders through regular virtual meetings (every other month), webinars and dissemination/sharing of documents, info-graphics/fact sheets, dedicated website and newsletters. 
     
  2. Design and prepare th
    Analyze and present survey results.  
     
  3. Conduct opportunistic face-2-face meetings of this WG at various TB, Lung health, NCD and communicable diseases conferences attended by members of the WG. Such interactions will strengthen the groups, create positive group dynamics and will effectually build bridges across disciplinary silos.  
     
  4. Develop and submit abstracts for joint presentations/satellite sessions with special emphasis Asthma management for the 54th Union World Conference on Lung Health in 2024 and other future international and national conferences on Pulmonology, NCD or communicable diseases.  
     
  5. Identify and involve key stakeholders (policy makers, programme managers of TB control, NCD care programme, infectious diseases/communicable diseases control programmes, tobacco control programmes, carers of patients with Asthma, health care providers etc) in interactive online consultations and webinars. The stakeholder consultations will enable the WG to acquire from their expertise, realization and knowledge on how to efficiently contribute to remove barriers, enhance support and improve Asthma care.
     
  6. Two virtual workshops of the working group will be conducted to review the Asthma Guidelines and training material through consultations.  
     
  7. Desk revision of the Training Modules Participants and Facilitators guidelines and preparation of course content. 
     
  8. Develop a multinational team from countries interested in pursuing the Union model to target the existing funding opportunities with prospects of submission of application for funding. 
  9. Prepare report with key strategic and operational recommendations for the Section. Committee, Applicants, the Secretariat and Technical Partners.  
  10. Identify and specify costs of poor asthma management in LMIC and show how good asthma management reduces costs  

End deliverables:

  1. Formulation of a sustainable global health group on Asthma management through electronic/virtual mode.
  2. Training and course material and guidelines updated
  3. A multi country pilot developed with a written expansion plan.

4.  Abstracts submitted to the 54th Union World Conference 2024.

5.  Detailed report to be presented at the 2024 Union Conference.

6. Identify and secure funding opportunities

References:

  1. Ait-Khaled N, et al.  Management of Asthma: A guide to the essentials of good clinical practice. Paris, France: International Union Against Tuberculosis and Lung Disease; 2008.
  2. Chiang C-Y, Aït-Khaled N, Bissell K, Enarson DA. Management of asthma in resource-limited settings: role of low-cost corticosteroid/b-agonist combination inhaler.  Int J Tuberc Lung Dis 2015; 19: 129-36.
  3. Chiang C-Y, et al.  Are national asthma programmes needed in resource-limited settings?  (Editorial).  Int J Tuberc Lung Dis 2012; 16:572.
  4. El Sony A I, et al.  Standard case management of asthma in Sudan: a pilot project.   Public Health Action 2013;3:247-252.
  5. Kan X H, et al.  Asthma as a hidden disease in rural China: opportunities and challenges of standard case management.  Public Health Action 2012;2:87-91.
  6. Ade G, et al.  Management of asthma in Benin: the challenge of loss to follow-up.  Public Health Action 2013; 3:76-80.
  7. Chiang C-Y, et al.  Management of asthma in resource-limited settings: role of low-cost corticosteroid/b-agonist combination inhaler.  Int J Tuberc Lung Dis 2015;19:129-136.
  8. Billo N E.  Do we need an Asthma Drug Facility?  Int J Tuberc Lung Dis 2004;8:391.