2010 was year of the lung: Lung health needs attention

By Bobby Ramakant, CNS
January 5, 2011
The author is the Executive Director of CNS Stop-TB Initiative, and a World Health Organization (WHO) Director-General’s WNTD Awardee (2008). He writes extensively on health and development through Citizen News Service (CNS). Email: bobby@citizen-news.org, website: www.citizen-news.org

The year 2010 was declared as year of the lung recognizing that hundreds of millions of people around the world suffer each year from treatable and preventable chronic respiratory diseases. This initiative acknowledged that lung health has long been neglected in public discourses, and understood the need to unify different health advocates behind one purpose of lung health. The year 2010 came to an end, but the need to attend to lung health has certainly become more pressing as we enter in the year 2011.

The Year of the Lung was organised by the Forum of International Respiratory Societies (FIRS). FIRS includes the Asociacion Latinoamericana del Thorax (ALAT), the American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), the Asia Pacific Society of Respirology (APSR), the European Respiratory Society (ERS), the International Union Against Tuberculosis and Lung Disease (The Union), and the Pan African Thoracic Society (PATS).

There are a range of health and environmental factors that affect our lung health. This includes tuberculosis (TB), tobacco smoke, biomass fuel smoke, chronic obstructive pulmonary disease, asthma, pneumonia among other respiratory infections. The evidence of their potentially devastating effects on global public health is increasing and they require a coordinated approach for control. These diseases all occur in predominantly resource-poor countries. They are perpetuated by poverty and inadequate resources and their control and management require coordinated approach among health programmes at all levels.

Statistically, there is 1 TB-related death that takes place every 18 seconds, 1 HIV death every 16 seconds, 1 child dies of pneumonia every 15 seconds and 1 smoking-related death every 13 seconds. The enormous public challenge posed by the combined epidemics of tobacco smoking, HIV, TB and COPD, is undoubtedly alarming.

More than 2 billion people or a third of the world's total population, are infected with mycobacterium tuberculosis. Tuberculosis is now the world's seventh-leading cause of death. It killed 1.8 million people worldwide last year, up from 1.77 million in 2007. It is one of the three primary diseases that are closely linked to poverty, the other two being AIDS and malaria.

Tobacco smoking is unquestionably the primary risk factor for COPD. More than 5 million deaths are attributed to tobacco use every year. Smokers have two fold higher risk of developing active TB disease. Tobacco smokers have 2 times more risk of dieing of TB. Tobacco smoke increases the risk of pneumonia, influenza, menningococcal meningitis, among others. Evidence is accumulating that smoking is a risk factor for TB. However there is no published data on the cellular interactions of tobacco smoke and mycobacterium tuberculosis. The risk to develop active TB disease is higher when tobacco smoking is combined with alcohol.

Tobacco smoking cessation is an important part of the comprehensive tobacco control programme, and not the only part. So all components of the comprehensive tobacco control measures should be implemented for improving public health outcomes. Comprehensive tobacco control programmes can yield major public health outcomes, as 30% of male TB patients die of tobacco smoking.

Asthma is yet another major lung health challenge. It is a chronic disease that affects airways. When people have asthma, the inside walls of their airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that they are allergic to or find irritating. When airways react, they get narrower and lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night. When asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that vital organs do not get enough oxygen. People can die from severe asthma attacks.

More than 300 million people around the world have asthma, and the disease imposes a heavy burden on individuals, families, and societies. The Global Burden of Asthma Report, indicates that asthma control often falls short and there are many barriers to asthma control around the world. Proper long-term management of asthma will permit most patients to achieve good control of their disease. Yet in many regions around the world, this goal is often not met. Poor asthma control is also seen in the lifestyle limitations experienced by some people with asthma. For example, in some regions, up to one in four children with asthma is unable to attend school regularly because of poor asthma control. Asthma deaths are the ultimate, tragic evidence of uncontrolled asthma.

According to the Global Burden of Asthma Report, the majority of asthma deaths in some regions of the world are preventable. Effective asthma treatments exist and, with proper diagnosis, education, and treatment, the great majority of asthma patients can achieve and maintain good control of their disease. When asthma is under control, patients can live full and active lives.

Pneumonia claims two million children under five each year, yet no new drug, vaccine or special diagnostic test is needed to save their lives. The answers are at hand, and effective treatment is both inexpensive and widely available.

Host of other conditions that affect the lungs, are preventable, and often treatable.

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Posted on: January 05, 2011 12:45 PM IST