Asthma

Key Facts

• Asthma is a major noncommunicable disease (NCD) affecting both children and adults.
• Inflammation and narrowing of the small airways in the lungs cause asthma symptoms, which can include coughing, wheezing, shortness of breath, and any combination of chest tightness.
• In 2019, there were an estimated 262 million people with asthma and 461,000 deaths from the disease (1).
• Asthma is one of the most common chronic diseases in children.
• Inhaled medications can relieve asthma symptoms and allow people with asthma to lead normal, active lives.
• Eliminating triggers for asthma attacks can also help reduce asthma symptoms.
• Most asthma-related deaths occur in low- and middle-income countries, where asthma detection and treatment rates are poor.
• WHO is committed to improving the diagnosis, treatment and monitoring of asthma, reducing the global burden of NCDs and making progress towards universal health coverage.

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What is asthma?

Asthma is a chronic disease that affects both children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. This causes asthma symptoms - coughing, wheezing, shortness of breath and chest tightness. These symptoms are episodic and often worsen at night or during exercise. Asthma symptoms can also be made worse by other common triggers. Such provoking factors in different people can be viral infections (colds), dust, smoke, fumes, weather changes, grass and tree pollen, animal hair and bird feathers, strong-smelling soaps and perfumes.

Impact of asthma on daily life

Asthma detection and treatment rates are poor, especially in low- and middle-income countries.   

People with asthma who do not receive proper treatment may develop sleep disturbances, fatigue during the day, and poor concentration. People with asthma and their families may miss school and work, resulting in financial consequences for the family and community. If symptoms are severe, people with asthma may require emergency medical attention and may be admitted to hospital for treatment and monitoring. In its most severe cases, asthma can lead to death.

Causes of asthma

An increased risk of developing asthma is associated with a wide variety of factors, although identifying a single direct cause can be difficult.

• The likelihood of asthma increases if there are asthmatics in the family, especially among close relatives - parents or brothers/sisters.
• Asthma is more likely to develop in people who have other allergic diseases, particularly eczema and rhinitis (hay fever).
• The prevalence of asthma increases with urbanization, possibly due to exposure to multiple lifestyle factors. 
• Early life disorders affect lung development and may increase the risk of asthma. These include low birth weight, prematurity, exposure to tobacco smoke and other sources of air pollution, and viral respiratory infections.
• The risk of asthma is also thought to be increased by exposure to a range of allergens and irritants found in the environment, including indoor and outdoor air pollution, house dust mites, mold, and exposure to chemicals and exhaust fumes. or industrial dust. 
• Children and adults who are overweight or obese are at increased risk of developing asthma. 

Reducing the burden of asthma

Although asthma cannot be cured, proper management with inhaled medications allows people with asthma to keep the disease under control and lead normal, active lives.

There are two main types of inhalers:

• bronchodilators (such as salbutamol), which widen the airways and relieve symptoms; And
• steroids (such as beclomethasone), which reduce inflammation in the airways. It relieves asthma symptoms and reduces the risk of severe asthma attacks and death.

People with asthma may need to use an inhaler daily. Their treatment will depend on the frequency of symptoms and the types of inhalers available.

Coordinating breathing while using an inhaler can be challenging, especially for children and in emergency situations. The use of a special device makes it easier to use the aerosol inhaler and helps the medicine reach the lungs more effectively. A spacer is a plastic container with a mouthpiece or mask at one end and an opening for an inhaler at the other. A homemade spacer made from a 500ml plastic bottle can be as effective as a commercially produced inhaler.

Access to inhalers is a problem in many countries. In 2019, only half of people with asthma had access to bronchodilators and fewer than 20% had access to steroid inhalers in public primary care in low-income countries (2).

People with asthma and their families need education to better understand what asthma is, how to treat it, how to avoid it, and how to manage symptoms at home. It is also important to raise public awareness and, in some cases, combat the myths and stigma associated with asthma.

WHO Strategy for the Prevention and Control of Asthma

Asthma is included in the WHO Global Action Plan for the Prevention and Control of NCDs and the United Nations 2030 Agenda for Sustainable Development.

WHO is taking a range of actions to scale up the diagnosis and treatment of asthma.

The WHO Package of Essential Interventions for Noncommunicable Diseases (PEN) was developed to improve the management of NCDs in primary health care settings in low-resource settings. The PEN package includes protocols for the assessment, diagnosis and treatment of chronic respiratory diseases (asthma and chronic obstructive pulmonary disease), as well as modules for healthy lifestyle counseling, including tobacco cessation and self-care.

Reducing exposure to tobacco smoke is important for both primary prevention of asthma and treatment of the disease. The Framework Convention on Tobacco Control, as well as WHO initiatives such as MPOWER and mTobacco cessation, contribute to progress in this area.

Global Alliance to Fight Chronic Respiratory Diseases

The Global Alliance to Fight Chronic Respiratory Diseases (GACD) contributes to WHO's work to prevent and control chronic respiratory diseases. It is a voluntary alliance of national and international organizations and institutions from many countries committed to the idea of a world in which all people can breathe freely.