Silent killer: Why COPD deserves global attention

Leaders should prioritise making chronic obstructive pulmonary disease prevention (COPD) and care accessible to all. The time to act is now. Together, we can breathe easier!

Grace Russell

Silent killer: Why COPD deserves global attention

Tedros Adhanom Ghebreyesus and José Luis Castro

last update on 20 Nov 2024

Each year, over three million lives are silently cut short by chronic obstructive pulmonary disease (COPD), a noncommunicable disease too often overlooked despite affecting over 380 million people globally. COPD—the world’s fourth leading cause of death—has been largely absent from conversations on global health despite its devastating toll on patients and families. But we can no longer ignore it.

COPD is a progressive lung condition that makes it hard to breathe, causing symptoms like coughing, wheezing, and shortness of breath. The primary culprits behind COPD are tobacco smoking and air pollution. Smoking damages the airways and lung tissue, leading to inflammation and reduced airflow. Similarly, exposure to pollutants, such as vehicle emissions and industrial fumes, can worsen lung function over time.

For patients, living with COPD can be challenging, impacting their daily activities and overall quality of life. However, with proper management and lifestyle changes, many can find relief and improve their lung health.

Despite COPD’s prevalence, access to affordable care remains limited, especially in low- and middle-income countries where 85% of COPD deaths occur. This must change.

Despite COPD's prevalence, access to affordable care remains limited, especially in low- and middle-income countries where 85% of COPD deaths occur

Primary care integration

At the World Health Organisation, we promote integrating COPD diagnosis and treatment into primary healthcare systems, which is a crucial step toward reversing this trend. For many around the world, especially in poorer nations, primary care is their only point of contact with the health system. When governments build COPD control into primary healthcare systems and universal health coverage packages, we can make a meaningful difference in the lives of millions worldwide.

Countries worldwide are increasingly recognising the burden of COPD and incorporating it into their national health priorities. In the United States and Canada, comprehensive guidelines and public health initiatives aim to improve COPD management and patient outcomes. The United Kingdom and Spain focus on early detection and reduction of risk factors like smoking. Meanwhile, India and Brazil, facing a high disease burden, are integrating COPD into broader public health strategies, addressing environmental and lifestyle factors.

China's recent decision to include COPD in its National Basic Public Health Services programme marks a significant political commitment to care for COPD patients—nearly 100 million of them in China alone.

In parts of Africa, awareness is growing, with some regions starting to include COPD in their public health strategies. South Africa has been making strides in addressing respiratory health, including COPD, within its public health framework. Other countries are beginning to recognise the importance of air pollution and smoking which are risk factors.

Implementing WHO recommendations can significantly reduce the burden of COPD and create healthier environments for everyone

Growing awareness and committment

These efforts reflect a growing global commitment to tackling COPD, improving quality of life, and reducing the strain caused by this prevalent disease. As awareness continues to grow, we expect that other nations are likely to incorporate COPD into their national health strategies, aiming to reduce impact on communities.

Other effective policy tools and evidence-based technical packages are available to countries to prevent the scourge of COPD. Implementing the WHO-recommended MPOWER policy package, especially through effective tobacco taxes and smoke-free places, can prevent over 1 million people from dying from COPD each year. The treatment of COPD is also considered a "best buy" policy, a suite of interventions that can support countries in achieving the Sustainable Development Goal of reducing one-third of premature mortality from NCDs.

Prioritising WHO strategies for protecting people from air pollution will also contribute greatly. Air pollution contributes to 7 million deaths annually and exacerbates respiratory diseases. Implementing WHO recommendations on enforcing strict air quality standards, promoting clean energy sources, and investing in public transportation and active transport options like cycling and walking can significantly reduce the burden of COPD and create healthier environments for everyone.

Our message today is clear: COPD deserves urgent attention as other noncommunicable diseases, and national leaders should prioritise making COPD prevention and care accessible to all. The time to act on COPD is now. By prioritising action against this silent killer, we can extend lives, improve quality of life, and create healthier communities worldwide. Together, we can breathe easier!

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