Access to medicines is key to reducing suffering from asthma
- 7 May: World Asthma Day -

Bobby Ramakant *

Asthma causes disabling symptoms in millions of people who struggle to breathe, making ordinary activities extraordinarily difficulty – things like going to school, working at a job, looking after children or aging parents, running or even walking. About 235 million people in the world suffer from asthma and the number is increasing – asthma is a neglected epidemic.

There are high costs of poorly controlled asthma. "The costs of acute treatment at the doctor or hospital, the lost productivity of people with asthma or parents of children with asthma, the lost education of children who are too unwell to attend school, all amount to billions of dollars lost to society." says Professor Innes Asher, Chair of the Global Asthma Network (GAN) Steering Group.

Good asthma management can change all this. Appropriate management includes people with asthma knowing the steps to take to prevent their asthma symptoms and to treat worsening asthma (self management plans). They also need to be able to access effective health care management when it is needed.

Underpinning asthma treatment is ready access to quality–assured essential asthma medicines (a reliever such as salbutamol and a preventer inhaled corticosteroid such as beclometasone). But many countries in the world do not have these medicines readily available. Even where these medicines are available their cost may be beyond the reach of many of the asthma sufferers.

PROTECTING ACCESS TO ESSENTIAL MEDICINES FROM TRADE AGREEMENTS

It is vital that governments continue to develop coherent policies to enhance access to effective asthma medicines. Professor Asher expresses concern that "New international agreements being developed behind closed doors such as the Trans-Pacific Partnership Agreement potentially put at risk the ability of governments to negotiate lower prices for quality–assured medicines."

Christophe Perrin, Pharmacist and Coordinator, Asthma Drug Facility (ADF), International Union Against Tuberculosis and Lung Disease (The Union) said to Citizen News Service - CNS that: "After these products [asthma medicines and inhalers] lost their protection by the patents, generic companies started to work on inhalers and turbohalers. But not many generic manufacturers have been able to get a proper control on the technology as it is quite a complex one. It became very difficult to set up the manufacturing site working up to WHO quality standards. So, that means till today there are not many generic manufacturers worldwide which are able to compete at the same level of quality. We should invest in the asthma field because it needs financial resources, as well as human resources with high technical skills."

Christophe Perrin of ADF added: "Often for most of these medicines, we can find quite affordable generic versions which are also available in low and middle income countries. The concept of purchasing the priority medicine is not yet there in many countries, and most of them are not even facilitating it either."

"There are 235 million estimated asthma patients worldwide and most of them are far from reaching the standard treatment. Demand is not at the level of the need today" said Perrin. Asthma medicines must be included in national essential medicine list and supported by adequate resources and programmes so that all people with asthma can have access to these quality-assured affordable and essential medicines and care services. It is important to highlight the great work of Asthma Drug Facility (ADF) which Christophe coordinates as it has brought down the price of one year of treatment of severe asthma by 50 per cent. Such mechanisms must be supported so that affordable and quality assured asthma medicine become a reality for every person with asthma.

Health leaders must strive to put quality–assured essential asthma medicines on the WHO pre-qualification list by next year, have them on all national essential medicines lists by 2015, and within 5 years have these medicines available and affordable in all countries, said Global Asthma Network (GAN).

Let us hope this year's World Asthma Day on 7th May will serve as a pivot to galvanize more focussed action towards expanding access to asthma medicines.